e-Prescribing Supports Transitions of Care

By Ian Lording

The story is all too common—it is a weekend, and a patient is discharged from the hospital with 20-plus medications. A local pharmacist tries to track down the hospital physician to clarify the medications listed, some of which are illegible due to poor handwriting. It is a pharmacist’s nightmare, one that can require hours on the phone, while still managing other patients.

e-Prescribing Supports Transitions of Care

The patient, wanting to have their medications in hand before they go home, must wait in the pharmacy after a long stay in the hospital. That wait is longer than it should be due to the time it takes to clarify the medications.

We see this situation in pharmacies every day. Pharmacists will even personally deliver medications late at night, after their shift is done, so patients do not go without. While we may applaud their commitment to go above and beyond, these situations should not arise in the first place. The administrative burden of hospital transitions, when pharmacists must manage discharge paperwork and reconcile medications, too often contributes to stress and anxiety within the pharmacy team, and negatively impacts patient care.

Fortunately, innovative approaches and tools help alleviate some of these pain points. Among them is PrescribeIT®, Canada Health Infoway’s (Infoway’s) national e-prescribing service that enables the digital transmission of prescriptions between prescribers and community pharmacies, thereby enabling safer and more efficient medication management.

In a hospital setting, PrescribeIT® is embedded within a prescribing system, such as a hospital’s health information system (HIS) or physician’s electronic medical record (EMR), as well as within the pharmacy’s pharmacy management system (PMS). Electronic prescribing enabled by PrescribeIT® significantly reduces the likelihood of errors (especially as they pertain to legibility/handwriting) and provides the ability for pharmacists and prescribers to communicate to one another securely via a messaging tool (clinical communications). If the community pharmacy team spots a possible error, they can leverage clinical communications to resolve the issue more rapidly with the patient’s prescriber.

The security of PrescribeIT® increases pharmacists’ confidence that the prescription is legitimate. They no longer need to play phone tag to confirm its legitimacy, which is particularly helpful in situations involving complicated opioid prescriptions. PrescribeIT’s features address common issues faced by pharmacists and can not only save time when caring for patients discharged from the hospital, many of whom are on complex medications, but can also enable improved care and reduce stress and anxiety on both sides of the counter.

PrescribeIT® has begun to ramp up its efforts in the hospital sector. The Ottawa Hospital (TOH) was the first hospital to launch PrescribeIT® with core e-prescribing functionality. Significant momentum and great success are already being realized: PrescribeIT® e-prescriptions replaced 70 per cent of print and fax prescriptions during the trial phase. Workflow efficiency has improved and there has been a reduction in errors. The project has successfully moved from a pilot to full-scale implementation with more than 2,500 prescribers.

Dr. Glen Geiger, Chief Medical Information Officer at TOH, attributes the success primarily to the foundational work that had occurred in previous years at the hospital, making it easy to integrate PrescribeIT® into the hospital’s workflow. Those foundational elements include: the establishment of a comprehensive HIS; an active database of patients’ pharmacies; and enabling patients to update their pharmacy information directly through a patient portal tied to the HIS. Looking ahead, TOH wants to build on its success by expanding the use of PrescribeIT® from ambulatory care to include inpatient care, as well as incorporating additional PrescribeIT® functionalities such as clinical communications.

“Electronic prescribing is a safer, more reliable way to provide prescriptions to patients and pharmacies, and is a better service for everyone,” says Dr. Geiger, adding that PrescribeIT’s underlying value proposition comes from its ability to reduce medication errors and prescription misuse, improve medication adherence and increase overall efficiency. “All prescribers and pharmacists across the country should get onboard with the service.”

The word seems to be spreading, with growing interest from hospitals across the country. In addition, PrescribeIT has strengthened its commitment to the hospital space with the recent announcement of its partnership with Meditech (one of Canada’s major HIS providers) to carry out a pilot in Ontario in the coming months.

Hospitals’ adoption of PrescribeIT® is a strategic priority for Infoway, with hospital-specific medication management functionality under consideration. The more players that adopt PrescribeIT®, the more community pharmacies will continue to see efficiencies in their workflows. Community pharmacies are already experiencing the benefits of increased adoption rates in family physicians’ offices, and we look forward to even more value to community pharmacy as additional clinical settings start onboarding with the service.

This blog post originally appeared as an article in the Winter 2023 issue of Neighbourhood Pharmacy Gazette.

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About the author
Ian Lording

Ian Lording

Ian Lording is a pharmacist and Vice President, PrescribeIT® at Canada Health Infoway. Ian’s passion is to better leverage digital solutions to improve health outcomes for all Canadians.