Trials of electronic prescriptions set for next year

Move welcomed by Pharmacy Guild

Electronic prescriptions will be trialled next year ahead of what could be a national rollout of the service.

Electronic prescription systems allow doctors to send prescriptions to pharmacists digitally. They are designed to reduce prescribing errors, saving pharmacists time and money, and give doctors better insight into how patients take medication.

The National Health IT Board has commissioned trials of e-prescribing services in three regions.

Prescriptions will be sent to a "transaction broker", and downloaded by a pharmacist once a patient has presented them with a barcoded paper prescription.

Pharmacy Guild chief executive, Annabel Young, says pharmacists will not have to re-enter prescription data into their systems – reducing transcription errors.

"We're expecting that in conjunction with the introduction of e-prescribing there'll be some improvement to the GP prescribing software so there'd be fewer errors in the prescriptions. At the moment a GP can have a favourites list which has drugs on it that are no longer available in New Zealand or no longer subsidised. If someone prescribes an unsubsidised drug you really need to go back and check what they meant.

"A lot of this is about the time it takes ... and your ability to do more services."

A 2008 study by the United States Health and Human Services Department found "complete use" of e-prescribing systems and lists of lower cost and generic drugs could save US$3.9 million (NZ$5.4m) per 100,000 patients per year on prescription drug spending.

Ms Young says in New Zealand most prescription anomalies are picked up and checked out by pharmacists, and prescription drug spending here is unlikely to drop with the introduction of e-prescribing.

The service will be able to send status updates to the prescriber if requested, for example notifying a doctor when a prescription has been picked up.

This is a "big step forward", Ms Young says.

In the US 30 days' worth of medicine lasts on average for 45 days – indicating people under-dose – and she suspects the same is true here.

"If you are the prescriber and you can see that pattern ... you can get a sense of not just if they are taking the medicine but their collection record can give you an idea of the rate at which they're taking it."

Health IT board director Graeme Osborne says pharmacists will be able to communicate with GPs via the system.

Ad Feedback "When a pharmacist is dealing or working with a patient sometimes they'll realise the patient isn't fully informed about what the GP is expecting of the drug and what the side-effects may be. It would allow a pharmacist to put a note back to the GP to say, `Hey, be aware patient A wasn't exactly up to speed'."

The prescription information will be sent to data repositories such as the TestSafe databases in Auckland and Christchurch, and other regional repositories to be set up under the national health IT plan.

"When [patients] are anywhere else in the health system the clinician they are dealing with will know what drugs they have had dispensed for them. That's a big issue we've got with people with chronic illnesses and sometimes the elderly – they forget exactly what they're on."

The repositories will support electronic health records due to be in place by 2014 under the national plan.

The records will let New Zealanders and their clinicians access an online record of their health – including GP visits, specialist and hospital treatment, test results and prescriptions.

Auckland software firm Simpl developed an e-prescription service for the Pharmacy Guild of Australia in 2008 for A$2m to A$3m (NZ$2.5m to NZ$3.8m).

Simpl chief executive Bennett Medary says the service is used by 6500 doctors and 2950 pharmacies.

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