Dr. Lynn McCallum, the primary physician at Enhance Health Medical in Edmonton, shares her perspective on how e-prescribing can help streamline communication between physicians and pharmacists and deliver greater access to care for her patients.
What are some of the biggest challenges currently faced by Alberta’s health care system?
A lot of the challenges we’re seeing right now revolve around access to care. There’s a big gap in regards to what the health care system is being required to do and what we can do comfortably. The pandemic put a strain on everybody from doctors and nurses to hospitals as whole. Delays in regular screenings, testing and surgical care have all had significant ramifications. Many patients have also been left without access to a family doctor either because of retirement or their physician relocating. Here in Alberta, we’re lucky that pharmacists can take a more active role in patient care to assist with access, but we don’t want this to result in scattered care, so it’s important to have tools in place that enable effective communication so that we can work collaboratively.
From your perspective, how can some of these challenges be improved by implementing digital health tools like e-prescribing?
Each member of a patient’s care team – be it their primary care physician, a specialist or their pharmacist – is an expert in their own field and ideally we are all supporting each other. Strong collaboration, for example with our pharmacy partners, is ultimately for the benefit of our patients – pharmacists are the experts in pharmaceuticals, and as a doctor, I rely on them. Unfortunately, a lot of the processes still in use for communicating within the circle of care are antiquated and clunky, and they don’t facilitate easy and effective collaboration. Tools like fax and phone take a lot of time for all those involved and can be very disruptive, especially when a fax goes astray or we end up playing phone tag, ultimately delaying patient care.
At my practice, we’ve implemented PrescribeIT, a national e-prescribing service from Canada Health Infoway that connects family physicians like myself to community-based pharmacies. PrescribeIT enables us to digitally transmit prescriptions and exchange secure messages with the pharmacy team, all within our existing EMR system. This allows members of the care team to collaborate, provide clarifications and receive feedback in real time.
How do you find e-prescribing is helpful to family physicians like yourself when your patient receives a prescription from a pharmacist?
It really comes down to collaboration and being actively involved in our patient’s care. When everyone on a patient’s care team can work more seamlessly together, navigating pharmacist-initiated prescriptions and follow-ups is more straightforward. For example, a pharmacy colleague may send me a fax outlining that they’ve refilled a prescription for a patient of mine as it will run out before they can get an appointment with me, and they’ve suggested the patient follow up with me for further refills. The information being shared in this example is very important for me to know, but with it being transmitted via fax, it’s not particularly efficient, and it’s often filtered through assistants on either end.
Based on Infoway-CMA survey data from 2021, 93% of Canadian family physicians are using EMRs, and about a third have transitioned to electronic fax for prescriptions, but it’s still vulnerable to error. When you can replace fax with tools that have integrated secure messaging capabilities like PrescribeIT, it really improves patient care. Because PrescribeIT functions on the backend of my EMR and the pharmacy’s management software, we can easily fire off a couple of lines to one another, and they can see it and respond right away to align on next steps. It cuts down on the time between that patient encounter at the pharmacy and the communication to me, so this process becomes so much smoother and almost instantaneous.
How has e-prescribing helped to alleviate some of the pressures on your practice?
Having had experience with e-prescribing when practicing in the US, I was excited when PrescribeIT became available in Alberta. It streamlines my workflow and saves time for myself and my patients. Instead of worrying about details like whether the printer’s loaded, I usually have prescriptions ready and sent to the patient’s pharmacy of choice before we’ve even finished the appointment. When you can tell a patient that the prescription is already at the pharmacy and they don’t need to plan to make an extra trip or wait around, they just love that. It helps to reduce some of the barriers to patients filling their prescriptions, which is a huge value add to effective patient care. PrescribeIT is also a safer method of medication management when dealing with narcotics because the system is very secure and Alberta accepts use of PrescribeIT for the Tracked Prescription Program. Signatures are not required, so we can directly transmit prescriptions to the pharmacy instead of writing out triplicate prescriptions.
PrescribeIT is still fairly new here in Alberta, so not every pharmacy is online yet, making the contrast really noticeable. As the physician, feeling confident that the prescription has arrived at the pharmacy and then being able to easily see when it’s been picked up gives us some reassurance that the patient has the prescription in hand. We can also see when a prescription is not picked up, and this type of visibility can allow us to have important conversations with our patients – like whether the medication is too expensive for them – so we’re addressing these barriers, helping to improve medication compliance for better health outcomes. As more pharmacies and clinics come online, I think we’re going to start to see the benefits more clearly, and we’re going to look back and wonder how things worked without it.
Banner image credit: Heung Soon, pixabay.com