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e-prescribing is coming

November 25, 2020
PrescribeIT Alberta pilot program to be slowly expanded.

Ask Lethbridge Medicine Shoppe licensee Chad Baker about a common piece of technology in pharmacies and medical clinics and his answer is simple:

“It’s the 21st century; there’s obviously better technology available than fax machines.”

In fact, fax machines may soon go the way of the rotary telephone. Two years ago, Great Britain’s Department of Health announced it was phasing out fax machines. Earlier this year, New Zealand’s Ministry of Health ordered pharmacies to get rid of their fax machines and replace them a secure, digital alternative by the end of 2020. It stands to reason other countries will follow suit.

Chad would like to see the same sort of action in Alberta. He’s been an enthusiastic participant in a pilot program for PrescribeIT, an e-prescribing platform facilitated by Canada Health Infoway and being deployed in jurisdictions across the country.

PrescribeIT integrates with electronic medical records (EMR) and pharmacy management systems (PMS) to allow prescribers to create and securely send prescriptions electronically to the pharmacy of the patient’s choice.

According to Darcy Stann, Senior Advisor Regulatory Affairs for PrescribeIT, there are many advantages to e-prescribing over traditional prescribing methods, including greater accuracy and fewer transmission errors.

“Once the EMR and PMS are conformed to PrescribeIT, the prescription will be downloaded directly into the PMS,” said Darcy. “It will usually go into a work queue and then can be pulled up when the pharmacist is ready to tackle it. As we know, a significant source of prescription error occurs from transcription, so we’re removing that completely. PrescribeIT also greatly reduces potential for fraud (e.g., forgeries) and medication misuse, especially with narcotics and controlled substances. There will also be a decreased risk of privacy breaches due to a fax going inadvertently to the wrong number. I know on my personal fax machine I often get faxes intended for a hardware store. Things happen.”

The ability to communicate directly with prescribers—without the use of telephones or fax—via a fully encrypted clinical communications feature is another plus of PrescribeIT.

“It’s like instant messaging on steroids,” said Darcy.

Chad anticipates the clinical communications feature will be a huge time saver.

“Right now, if you have a question that you need urgently answered, you fax the clinic, they put it in a pile, and they get back to you in a few days or a week,” said Chad. “Meanwhile, you’re trying to juggle what you think is best for the patient without getting the necessary information from the prescriber. It can be tricky. I’m looking forward to seeing how the communication feature works.”

ACP deputy registrar Jeff Whissell is interested to see how PrescribeIT will benefit prescribers, pharmacies, and, most importantly, patients. He says while PrescribeIT has many advantages over traditional prescribing methods, pharmacy teams will still need to work with patients and prescribers to ensure appropriate drug therapy is prescribed.

“Pharmacists have to be mindful to carefully assess what’s coming across their screens,” said Jeff. “They will need to think about how they manage to assess the appropriateness of prescriptions, how they’ll create change if needed, and how they’ll work with the patient once they come to pick up the prescription. It’s important that the pharmacist continues to work closely with the patient even though workflows will change as a result of PrescribeIT. There is still an important role for pharmacists to be involved with the patient and hopefully this actually frees them up to spend a little more time with the patient.”

Jeff says pharmacy teams will also need to ensure that their PMS can integrate with PrescribeIT and, once PrescribeIT is available, they’ll need to submit a Privacy Impact Assessment to the Office of the Information and Privacy Commissioner. PrescribeIT offers support to pharmacies for both.

Alberta Health is allowing PrescribeIT to gradually expand its pilot program to more prescribers, including community-based addiction centres to handle methadone prescriptions and walk-in community clinics for acute care purposes. It’s hoped PrescribeIT will be available on a larger scale in Alberta by the end of 2021. Ultimately, the success of the platform will depend on widescale adoption by prescribers and pharmacies—something Chad encourages enthusiastically.

“The biggest thing is encouraging other prescribers in your community to get on board,” said Chad. “Some physicians may not be keen on trying out a new technology but if you have a good relationship with a prescriber it could be one of those things you encourage. It’s going to be the future. There are some great advantages. We’ve quite enjoyed it.”