It Is Important To Know There Are Traps And Problems Associated With E-Prescribing That Need Avoiding!
These two useful articles appeared last week.
First we had:
What GPs should watch out for when ePrescribing
GPs have called for careful uptake of electronic prescriptions due to privacy concerns and the complexities for patients with multiple medications.
02 Dec 2020
Electronic prescriptions (ePrescriptions) are
surging in popularity, with GPs and pharmacists lining up to switch to a faster
system.
More than 800,000 ePrescriptions have been generated since May, but Adelaide GP
Dr Danny Byrne has warned GPs to be absolutely certain they are sending scripts
to the correct mobile phone number.
‘Think before you click e-script to ensure the mobile number is the correct one,’
he told newsGP. ‘If not, it’s an indefensible breach of privacy, or even a
legal case and payout by your medical defence organisation.’
South Australia is the latest state to have the functionality rolled out as
part of a staggered introduction, with GPs and
pharmacies now able to use the system.
Dr Byrne, who is also the RACGP SA/NT Provost, has been an early adopter of electronic
prescribing (ePrescribing) under the Australian Digital Health Agency’s (ADHA)
trial rollout. He has sent more than 300 ePrescriptions since July and recently
ran a webinar on their growing use.
‘The biggest issue is teenagers,’ he said. ‘Imagine you have a 14-year-old
teenage girl who has been coming to your practice since she was three.
‘She wants to go on the pill, and gets an ePrescription – but it gets sent to her
mum’s mobile, as that’s the one in the system.’
Dr Byrne also warned that the system as it stands can be too confusing for
older patients on many different medications.
‘If you have a patient on 10 medications with multiple repeats, don’t do [ePrescriptions]
for them,’ he said.
‘It’s too confusing, since each prescription is a separate text message. They
can’t handle 10 messages.’
The ADHA is working on the Active Script List as a longer-term solution for patients
with many medications.
‘This will be the solution for complex patients on multiple medications. Until
then, use paper,’ Dr Byrne said.
Other possible issues Dr Byrne flagged include:
· situations where a couple share one mobile phone, meaning one partner could see a sensitive script
· if GPs delete prescriptions from the patient’s record, it can prevent the ePrescription from working when the patient visits their pharmacy if it hasn’t yet been dispensed
· the need to confirm patients have received the script by text message
· repeats will usually come back to the original patient’s phone, even if they have forwarded the SMS to a third party to pick up the item for them.
‘We are very
good with the uptake of technology but we do have to stop and think and double
check – especially with teenagers,’ he said.
Dr Byrne said that ePrescriptions have proven their worth for simple, one-off
scripts in conjunction with telehealth, as well as dramatically simplified his
workload of bulk repeat scripts for aged care home residents.
More here:
https://www1.racgp.org.au/newsgp/professional/what-gps-should-watch-out-for-in-the-rush-to-epres
Then we had:
GP tips on how to avoid e-script privacy breaches
Dr Daniel Byrne from SA, who has been e-prescribing since July, has some words of wisdom for other GPs
4th December 2020
Always check who owns the mobile number before issuing an e-script — that’s the top tip to avoid privacy breaches from Dr Daniel Byrne, a GP from SA who has been using e-prescribing since July.
Dr Byrne shared his words of wisdom during a webinar hosted by the Australian Digital Health Agency last week.
He pointed out how easily a privacy breach could occur, such as if the mobile number listed in a patient’s record belonged to a parent and dated back to when the patient was a toddler.
He shared the hypothetical of a case of a teenage girl presenting confidentially for the contraceptive pill, only for the e-script to be sent to the mother’s mobile because the GP hadn’t checked the number.
“For goodness sake, make sure you’re aware of inadvertent privacy slip-ups like that,” Dr Byrne said.
“That will cost your medical defence organisation 10s of 1000s of dollars in a payout, in a slip up like that.
“That’s something I have been really, really aware of — whose mobile phone number is actually in the patient’s file.”
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Dr Byrne’s other tips:
- Always check the patient has received the e-script token, which takes just a few seconds to arrive. “If it hasn’t arrived in three seconds it’s not going to arrive.”
- Be aware the token opens in a web browser, meaning patients with an older-style phone with a browser may not be able to use an e-script.
- Some patients may want to go back to paper scripts, after trying an e-script.
- The pharmacy can’t dispense an e-script if you delete it from the patient’s record before they have been to the pharmacy. Dr Byrne found this by mistake when he “tidied up” his script list to get rid of a one-off script with no repeats for a patient who called up for more medication but who was due for a follow-up consultation. “If you are doing these one-off scripts, to help them out, you’ve got to leave them there, on your main screen.”
- The e-script system can’t handle one private and one PBS script for the same medication and the same patient.
More information: AHDA webinar 2020; 30 Nov
More here:
https://www.ausdoc.com.au/news/gp-tips-how-avoid-escript-privacy-breaches
So despite general enthusiasm there are still potential traps and issues that have yet to be properly sorted.
This is surely a situation where not being at the bleeding edge makes sense as does learning from those who have gone ahead!
David.
The well of knowledge and experience is suffering from drought. You get a sense things have hit a wall. The current mob with a few exceptions seem to have just wandered into digital health and walk around with a script they have little depth of knowledge to understand let alone dream of new and innovative ways to shape the future of healthcare.
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