Rational use of Medicines E learning Course

Rational use of medicines
An e-learning course
E-Prescription
Dr Lokendra Sharma,
Principal Government Medical College Alwar
Sr Professor and Head of Pharmacology RUHS-CMS,Jaipur
https://www.facebook.com/media/set/?set=a.5180860621944003&type=3

DISCLAIMER
• The views and opinions expressed in this presentation (PowerPoint slides) are
those of the individual presenter and should not be attributed to THSTI, WHO,
PCI its officers, employees, volunteers, members, chapters, councils, special
interest area communities or affiliates, or any organization with which the
presenter is employed or affiliated.

Background
THSTI-WHO-PCI is developing an e-learning course on the
‘Rational use of medicines’. This proposed course is intended to
be of high-quality, India-centric, content-driven course steered by
eminent faculty and subject matter experts. The target
participants attending this course will be pharmacists.

Telemedicine/ E-PRESCRIPTION

Rational se of medicines
INTRODUCTION
• Electronic prescription (e-prescribing or e-Rx) -
computer-based electronic generation,
transmission, and filling of a medical prescription
• Error-free, accurate, and understandable
• Electronically transmit a new prescription or
renewal authorization
• Reduce the risks associated with traditional
prescription script writing
• Facilitate knowledgeable decision making

FUNCTIONS:
• Patient's identification
• Generating a complete active medication
list, incorporating electronic data received
from an insurance provider
• Access to patient historical data
• Prescribe or add new medication
• Viewing, removing, change dose, or renew
medications

FUNCTIONS (Contd.):
Safety checks : automated prompts that offer:
• information on the drug
• potential inappropriate dose
• route of administration
• drug-drug interactions
• allergy concerns,
• Warnings/ caution

Experiences with adverse drug reaction
reporting by patients: an 11-country survey
Adverse Drug Reaction (ADR) notification
drop box with ADR notification forms
(right) and ADR alert cards (left)

FUNCTIONS (Contd.):
• Flagging lower cost alternatives (if
available)
• Providing information on formulary, patient
eligibility, and authorization requirements
• System integration capabilities (e.g.,
connection with various databases)
• Educational capabilities (e.g., patient
education, provider feedback)

MODEL:
The basic components of
an electronic prescribing
system are the:
• Prescriber - typically a
physician
• Transaction hub
• Pharmacy with
implemented electronic
prescribing software
• Pharmacy Benefit
Manager (PBM)

MODEL:

Prescriber

Improving patient safety & quality of care
• Illegibility from handwritten prescriptions is eliminated, decreasing
medication errors- decreasing risks related to liability.
• Oral miscommunications regarding prescriptions can be reduced
• Warning and alert systems are provided at the point of care
• flag lethal dosages and lethal combinations of drugs.

Saving Clinicians Time:
• reduce the volume of pharmacy call-backs
• reduction in labour costs, handling costs, and paper expenses
• renewal authorization can be an automated process - efficiencies for
both the prescriber and pharmacist.
• enhancing continuous patient documentation.
• Allowing greater prescriber mobility - write/renew prescriptions from
anywhere

Increasing patient convenience and
medication compliance
• Approx. 20% of paper-based prescription orders go unfilled.
• By elimination or reducing waiting period - reduce the number of
unfilled prescriptions —> increasing medication adherence.
• Allowing the automated renewal of medications improves the efficiency
of this process
• Patient's prescriptions are filled can also help clinicians assess patient
adherence.

LIMITATIONS:
• Financial Cost and Return on Investment (ROI) – (greatest implementation
barriers)
• purchasing,
• implementing,
• supporting and
• maintaining
• costs pertaining to management of the interface, customization due to
flexibility, training, maintenance, and upgrades
• Change management -transitioning from paper-based prescriptions to e-
prescribing.

LIMITATIONS(Contd.):
• Integrity of data input –
• Accidental data entry errors – Ex. selecting the wrong
patient or clicking on the wrong choice in a menu of dosages.
• System downtime –
• Network issues, hardware failure, or loss of electricity.
Protocols to address this if the situation arises, needs to be in
place.

Medication errors can occur anywhere
Prescribing
Repackaging Dispensing
Administration Monitoring

Errors are not the result of an individual
failure, but of a systems failure

LIMITATIONS(Contd.):
Patient Access Lost –
• a software malfunction in the health care
provider's office
• This leaves the patient at the mercy of
technicians or other undiscoverable workers.

Indian Scenario:
• Government of several state in 2014 - started issuing e-
prescriptions in government hospitals.
• The biggest advantage– all the medical data stored in
the server of state health department which can be
referred to in future.
• private sector- initiated to build software to support
Electronic Prescription in India.
• ERXPAD.COM is one among the pioneer player in cloud
based electronic prescription software in India.
• Other private players are : WONDRx, DOXPER

Here we look at the top 10 most popular Online Medicine delivery App in India 2021 that are helping deliver emergency needs at home.
1. 1mg2. Pharmeasy3. Practo4. Netmeds5. Medlife6. Apollo Pharmacy 247
7. MediBuddy8. MedPlus Mart9. SastaSundar10. Healthmug

5 take home message
• 1. Reduce prescribing and dispensing errors
• 2. Decrease the work needed to execute a prescription
• 3. Speed receipt of prescribed drugs
• 4. Avoid more adverse drug interactions and reactions
• 5. More reliably offer to substitute less expensive drug alternatives

Thank you

Rational use of Medicines E learning Course

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