Dr. Soreya Dhanji, a family medicine physician in Toronto, Ont., shares her experience with how implementing PrescribeIT has reduced the administrative burden in her practice and improved continuity of care.
Walk me through what a typical day at work looks like for you. How much time do you spend on administrative tasks?
During a typical day, I’ll see patients booked back-to-back for a variety of concerns and procedures. I think I speak for many of my colleagues when I say that the actual practice of medicine and the interactions with my patients are my favourite parts of the job. However, increasingly, administrative tasks can lead to hours of extra work beyond direct patient care – from charting and completing lengthy patient referral forms to answering communications from other members of the patient’s care team such as pharmacists – all eating into time seeing patients. When these administrative tasks pile up, I can spend anywhere from two to four hours after a full day of clinic getting caught up, which is a significant source of burnout among family physicians.
How can digital tools like PrescribeIT reduce the administrative burden for a physician’s practice?
In medicine, much of our communication is still reliant on fax, which is inefficient and can be unreliable. Far too often, we’ll encounter pharmacies or specialists having difficulty receiving a fax or communications coming through that require further clarification, all adding up to time away from patients. A couple years ago, my practice implemented PrescribeIT, a national e-prescribing service that provides safer and more efficient medication management by connecting community-based prescribers to pharmacies in the community, enabling the digital transmission of prescriptions.
PrescribeIT’s clinical communications tool also facilitates direct, secure messaging between prescribers and the pharmacists. Whether it's having confirmation from the pharmacy, discussing a patient's medical history, or addressing questions, the entire process is more streamlined. It also gets documented directly within my EMR, which eliminates extra clerical work while still ensuring an accurate and up-to-date patient record. Even without 100% of pharmacies enrolled yet, implementing PrescribeIT has noticeably reduced our administrative burden, saving me, on average, an hour a day.
How do you think broader adoption of e-prescribing will impact and improve health care delivery?
With e-prescribing, I find there's increased communication within the patient’s circle of care and because it integrates directly with our EMR, it also improves continuity of care. Being able to see that the patient has filled the prescription allows me to understand what the patient has tried when we're thinking of other approaches.
Recently, I had an elderly female patient on blood pressure medications for hypertension that I wanted to keep a close eye on, and in this case PrescribeIT allowed us to optimize the patient's safety and cardiac health. With the prescription, I requested that the pharmacist keep me apprised of blood pressure readings when the patient came into the pharmacy between our regular follow-up appointments. Despite adherence to the medication, the patient wasn’t responding as we’d hoped, and the pharmacist was seeing increases in the patient’s blood pressure. Using PrescribeIT’s clinical communication tool, the pharmacist alerted me to this, and we were able to adjust the patient’s medication regimen. I also had the necessary visibility into the situation so that I could prioritize bringing the patient in for an exam.
What are some challenges physicians experience when implementing new tools like PrescribeIT and how can those be mitigated?
With the introduction of new digital tools, it’s important that we are prioritizing usability and interoperability – building and implementing tools that can work with the systems that are already in use by physicians and pharmacists. It’s challenging when different systems don’t communicate seamlessly with each other. It’s so convenient that PrescribeIT is integrated into the backend of our existing EMR system and doesn’t require a separate login.
When our practice implemented PrescribeIT, there was an initial learning curve of adjusting to a new workflow. This meant training for not just physicians like myself, but also our administrative staff and is an area where I think we can continue to improve. We’re also not at the point yet where you can implement PrescribeIT and be done with those older methods of communication. There is still going to be a transition phase to navigate when not all pharmacies are up and running in the online system, but the long-term benefits of a more streamlined workflow and more time for patient care are surely worth the wait.
Do you think e-prescribing is here to stay?
An estimated one in four Albertans are without a dedicated primary care provider. We need to take every available step to decrease administrative burden in order to help family physicians free up time that can be spent with patients. In my experience, implementing tools like PrescribeIT is one of these steps. Even though not all pharmacies are enrolled with PrescribeIT yet, I’ve already seen a noticeable reduction in my time spent on pharmacy-related administrative tasks, and this can only improve as PrescribeIT is more widely adopted.
With more Canadians receiving care from multiple health care professionals, I’ve also found that e-prescribing has reduced fragmentation of care between different health professionals. It’s important we continue to raise awareness and emphasize the value of PrescribeIT, not only among health care practitioners but also patients. Pharmacists are often more accessible to patients, so it’s a significant benefit to them, knowing that they can talk to their pharmacist about any concerns or their response to a medication and that this can easily be communicated directly back to their family physician. The more we can all work together, the better the outcome for all involved in the patient’s circle of care.