Our next speaker is Melissa Skilbeck. She's the Deputy Secretary of the Victorian Department of Health and Human Services. Given she heads up the department's regulation, health protection and emergency management division, it's safe to say she's had a very busy year. There's a strong public health theme in her work, which includes identifying risks and social regulation to influence behaviours. Recent achievements in her division include the highest five-year-old immunisation schedule coverage in Australia and real time health emergency monitoring of numbers of patients arriving at the ED's across the state.
We're very pleased to have Melissa speaking today about the development of SafeScript, a real time prescription monitoring system that has been a long time in the making but launched broadly in 2019. SafeScript provides prescribers and pharmacists with the clinical tool to make safer decisions about prescribing or dispensing high risk medicines, and facilitates early identification, treatment and support for patients who are developing signs of dependence. And the reason we are really interested in having her talk about this is it's a system that's connected across the whole nation of Australia. It was a lot of effort to get that into place and it's been fully embraced, and so we'd like to learn from her about how she did it and how that whole group did it.
Thank you, Wendy. Thank you very much. And can I extend my congratulations to everyone involved in the establishment of the Centre. I couldn't agree more with the need for digital to join with health for better outcomes, and that was a key driver here. Hopefully, if Liz can put up the slides, we'll be showing you what drove us to SafeScript. Doctor McCauley noted a decade ago a number of people driving for a SafeScript system, and indeed the Council of Australian Governments had made a decision to do it a little bit less than 10 years ago. Yet it took quite a bit longer than that.
If I go to the slide, deaths in Victoria sadly drove us. So the classic comparison, to give a sense of proportion, is deaths from prescription medicine vis-à-vis road fatalities in the state of Victoria. Now that was the very significant increase in the mauve bar there of deaths due to prescription medicine. So the Victorian coroner was making a lot of commentary around that, directly to our department and ministers, as well as some more personal advocacy. The next slide shows you a picture of the Millington family.
John and Margaret Millington is there with their son, Simon. He became addicted to prescription medication following a car accident, and very sadly he died in 2010. His parents have been extraordinary in their campaigning for a real time prescription monitoring system. They have assisted us enormously throughout the journey, and I was just talking to the team today about giving them an update on some happy news that had occurred from New South Wales yesterday, which I'll get to.
They had a working example and the passion behind the impact of people seeking additional prescription medicine from multiple prescribers; in the particular case of their son, across state lines. The system was hopeful to give prescribers and pharmacists real time data about a patient's history of high risk medicines like benzodiazepines and oxycodone and others, so that they could better coordinate care and prevent multiple prescribers prescribing the same medicine unknowingly, and reducing that to reduce the risk of harm. As I said, many others in addition to the Millington’s have also been impacted to be clear about that.
For us, we did a lot of pre work before we got an approval from the Victorian government in 2016, where we got a budget commitment of 29.5 million over four years and the four years to do the project. But if you look to the next slide, we could not do this alone and I just note there the extraordinary array of individual organisations who assisted us along the way in various ways, but in particular through expert advice all the way through.
It was a co-designed system. We did not always agree entirely and there were different factors in some degree of detail of implementation. But very, very clear message from practitioners and from medical digital software providers, PHN's, et cetera, that the information needed to be genuinely real time; that importantly it shouldn't interrupt clinician workflows, and there was an array of different workplaces that clinicians were in and that meant different things, but it meant that we were in the space of engaging with the pre-existing practice software in a number of workplaces and professions; and that health practitioners needed support to interpret and act appropriately on the information they received; that foremost this needed to be a tool that supported better clinical advice and treatment.
As Doctor McCauley noted, we partnered with Fred IT largely to design the technology on which this program is based. We also had support from Microsoft and from AHPRA, the Australian Health Practitioner Regulatory Agency, who gave us access to confirm registered practitioners for access to the system, and also supported our education and delivery around the system.
I'm going to show you a slide that I suspect many of you have vastly more technical background to understand, but in effect this illustrates the platform is based on real time data, and that is it's based through the prescription exchange services, which Fred IT had a significant experience and expertise. This meant that our background information is continually updating. It also meant the prescribers didn't need to click in and out of systems. We integrated SafeScript with the multiple key platforms for prescribing and dispensing.
We held a lot of test sessions with users, different sorts of practitioners in different environments, to get feedback on both design and usability. Because that interface was fundamental to the effectiveness of SafeScript as a tool supporting clinical treatment, and a great number of people assisted to do that.
The other element of support was online training, which is the next slide. Both online and face to face, once we could do that. A significant amount of work that is ongoing to support clinicians on how to best respond to this new information that SafeScript provides. And it provides information on the screen, you'll see in the corner there, that gives a degree of warning or a green light to the intended additional prescription that a doctor might put forward or the dispensing event. But on the basis of a number of algorithms that go to combinations of drugs or sheer volume of morphine equivalent doses that might present risk as advised to us by a clinical group that we're regularly testing that listing of risky combinations of drugs with.
We rolled out SafeScript initially in Victoria in October of 2018. Initially for a trial period and then on a voluntary basis for practitioners. On the 1st of April this year it became mandatory for prescribers and pharmacists to use the system under state law. The popups that you see have been responded to now for all of this year. We're starting to see some outcomes. It was, though, a point of some debate between the expert group I noted before and ourselves. Clinical experts were wanting more alerts rather than less. A lot of the advice we received from behavioural insights folk, those who do the nudging in policy world, were very clear about alert fatigue. So that's a balancing act we're still testing as we go and keep active maintenance of the system.
The sorts of drug or dose combinations that trigger a red alert there have triggered, in the last six months, about 2.3 million alerts. So there is a significant amount of alerting going into practitioners. There is additional information and the question then becomes, has it been worthwhile? What's the worth of what we have done?
We go onto the next slide. We've attempted to test this in a number of ways. We believe the SafeScript system has already proven its worth and did so in its first weeks of operation. It was not only rare that a system was delivered on time and to budget in the manner in which we did with such a genesis as it had, but importantly, on a policy basis, it certainly proved its worth. If you see the little map there, Victoria developed SafeScript separately from the national system that was previously being pursued, and we were previously pursuing, because the significant advances in technology meant that there was a much better option available through the exchanges.
But of course from a policy position, one state having a system and not neighbouring states across the borders, to hark back to the Millington’s' experience, it was not going to be successful unless it was national. So it's with a great amount of pleasure and pride that we look at that map and see that almost all of our fellow sub national jurisdictions are now onboard. The additional bit of information we have from yesterday is the New South Wales state budget has provided our colleagues with some funding to implement the SafeScript national platform as well. So that's a very significant gain.
Albeit the system is mandatory, nevertheless there's always a question as to how many practitioners are both registered and using the system. And we know that we have over 87% of GPs, 82% of pharmacists, and around 60% of nurse practitioners, of those who are registered and some of those are non-practicing, the total registrations, are on the system and using it.
Then we go to trying to establish whether we've had an impact on harm to those taking prescription medicine. We've seen a downward trend on people seeing four or more prescribers, which is something of a leading indicator. We have also seen a reduction in the number of deaths from prescription medicine overdoses. This information in the bottom corner there has only just come out from the Victorian coroner's office. And while a small decrease from 2018 to 2019 of 424 deaths to 405 might seem relatively small, it's the first time we've seen any reduction in a decade.
The coroner's court noted SafeScript along with some excellent clinical resources that the Australian College of General Practitioners had introduced as well, and I'm sure there are other influences. Attribution is awfully difficult. But we take those signs and our own interventions looking at the data ourselves to get in contact with practitioners when we see things, to be confident that this has had a very significant impact on public health already. We look forward to a much more significant impact across the nation as this becomes a genuinely national platform, and hopefully it's another example of why digital health is so important. Thank you.