Understanding the Use of Digital Health in Australian Pharmacies

Background Digital health technologies, including electronic prescribing (e-prescribing), electronic health records (EHRs), and telehealth, are increasingly integrated into community pharmacy practice in Australia. These tools have the potential to improve medication safety, streamline workflow, and enhance patient-centred care. However, their uptake and effective use are influenced by interoperability issues, regulatory constraints, funding models, and varying levels of digital literacy among pharmacists and consumers. While existing literature has examined aspects of digital health in healthcare more broadly, there remains limited research that brings together the perspectives of pharmacists, consumers, and policy experts to understand the adoption of these technologies in Australian community pharmacies. Aims The thesis aimed to examine the utilisation, benefits, and barriers associated with e-prescribing, EHRs, and telehealth in Australian community pharmacies, and to identify strategies and priorities for their effective implementation. Methods A multi-phase design was used. A systematic review was undertaken to identify barriers and facilitators to e-prescribing adoption in community pharmacy, followed by narrative reviews on tele-pharmacy and EHR integration. Quantitative data were collected through national cross-sectional surveys of community pharmacists and consumers to assess current use, perceived benefits, and challenges. Qualitative insights were obtained from a Delphi study with experts in pharmacy, digital health, and policy to determine priority digital health interventions and optimal implementation strategies. Results Across e-prescribing, tele-pharmacy, and EHRs, benefits included improved medication safety, dispensing efficiency, access in rural and underserved areas, and continuity of care, constraints included alert fatigue, technical and communication errors, extra retrieval steps and uneven training in e-prescribing, unclear rules, uneven infrastructure and connectivity and workload pressure in tele-pharmacy, and poor interoperability with inconsistent pharmacist access and workflow disruption in EHRs. Findings converge on four system-level gaps: interoperable data flow across vendors and settings, workforce readiness and digital literacy, perceived usability and workflow fit, and alignment of policy and funding for sustainable community pharmacy practice. Surveys of pharmacists revealed variable uptake of digital health tools, with challenges in system integration and limited policy support. Consumer surveys indicated high acceptance of e-prescriptions for convenience and environmental benefits, but raised concerns about privacy, perceived usability, and limited awareness of features such as the Active Script List. The Delphi study prioritised EHRs, e-prescribing, and tele-pharmacy for national implementation, emphasising the need for workforce training, infrastructure investment, interoperability standards, and supportive policy frameworks. Conclusion The research demonstrates that while digital health technologies are well positioned to enhance the role of community pharmacy in the Australian healthcare system, their potential is constrained by persistent technical, organisational, and policy barriers. Effective integration requires coordinated strategies that address interoperability, improve digital literacy, and align funding and regulatory settings. The findings provide an evidence base for policymakers, professional bodies, and healthcare providers to strengthen digital health adoption in community pharmacy, ensuring equitable access, improved service delivery, and better patient outcomes.