A prescription to change

A funny thing happened the other day that made me think I was back in the last century.

My son was holidaying with friends about four hours from home, and had a recurrence of his atopic eczema. Unfortunately he had forgotten his topical steroid, so I organised the dispensing of the medicine through a pharmacy, local to where he was staying.

Firstly the pharmacist requested me to fax the script but, as I had disposed of my last fax machine in 1993, this was not possible. I asked if I could email the script and fortunately the pharmacist agreed, though I do not believe it was particularly secure. All was well until at the end of our conversation when I was reminded to send the original script to the pharmacy. At this point I realised we are so far away from true digital healthcare.

So I did a lot of research into this matter and realised that there is both State and Commonwealth legislation governing the dispensing of medicines. Looking at these documents, a valid prescription must be on paper, in the medical practitioner's own handwriting using indelible ink, signed and dated. There are mandatory details including the medical practitioner's name, address and phone number (NO need for prescriber number), the patient's name and address (NO need for the date of birth), and details about the medicine. Oh, and by the way this can be written on a serviette from the local coffee shop as there are no specifications on the paper to be used. Personally I am wondering if a chiselled stone tablet would be acceptable!

You might ask why I did not use the computer to write the script. Well I am an Emergency Physician, and at my home I cannot afford to purchase practice software that has electronic prescribing capability. There is no alternative! Even if I did manage to order the medicine electronically, I would still have to print the script, sign it, scan it, email it, and then send it through the mail.

In my mind I envisaged using my computer to access a secure server with secondary code certification (via my phone), enter the appropriate prescription details and send the script through to a 'pharmacy cloud' with a message my son a QR code. He could then go into any pharmacy, have the QR code scanned, and the pharmacist could confidently dispense the medicine following confirmation of his identity.

There is a long way to go before we have a safer, and more simple system for prescribing medicines for patients and unfortunately the road is tortuous, as it includes changing legislation involving the Commonwealth and all State governments. But it is journey that we must take to improve the quality and safety of care to our patients.