With e-scripts on their way, we look at the pros and cons of this change in the way GPs and pharmacies work. So, let’s take a look at both sides of the debate and see which side the script falls.
Last week, we looked into what seems the inevitable entry to the Australian pharmacy market of Amazon Pharmacy, and with it what will be a proliferation of digital or e-scripts.
But e-scripts were on the medical news horizon well before Amazon began making noises, with the Australian government on a mission to see them as a normal part of the business of medicine, with trials already well underway around the country.
This clearly has a range of ramifications for GPS, pharmacies and consumers/patients. So, let’s take a look at both sides of the e-script debate and see which side the script falls.
E-prescriptions: The Pros
For those with chronic or ongoing medical conditions requiring continual renewal of scripts and issuing of meds, e-scripts could be a medical blessing. The most obvious benefit that comes with the roll-out of e-scripts is convenience and access, which can in turn lead to better health outcomes.
And consider people living in rural and remote locations where seeing a GP can sometimes be difficult. The permanent inclusion of telehealth in the MBS, in line with the gradual introduction of e-scripts, means those living remotely will never fear getting access to basic medical attention and prescribed medication again. Hard to argue with that.
The associated health benefits of the uninterrupted supply of medication cannot be ignored either, which studies have found results in better overall patient outcomes. So, if the rollout of e-scripts means the 19% of Australians who report waiting too long to get an appointment with their GP end up having much readier access to their prescribed medication, there will be associated enhanced health outcomes.
There could also be better patient safety due to the improvement of avoidable errors associated with written prescriptions such as dosage, duplication of therapy, failure to identify drug allergies and selection of incorrect medication--all issues that a digital system of issuing scripts might help prevent.
From a pure cost perspective, notwithstanding what a new market player like Amazon could do competition-wise by offering slight discounts and free or low-cost delivery, a well-designed e-script system also offers a range of benefits including:
- Containing info about cost-effective therapies
- Suggesting discontinuation of high-cost medications
- Recommendations about optimisation of current therapies
However, there are some important negative downsides to e-scripts that must be taken into account.
E-prescriptions: The Cons
The Royal Australian College of General Practitioners (RACGP) is cautious in its approach to the e-script rollout. While it accepts some of the arguments, particularly the overarching ‘continuity of care’ that e-scripts might bring, the RACGP has concerns about quality and safety.
Adelaide GP Danny Byrne opened up about his experiences with e-scripts in an interview with the RACGP, noting a range of issues he could foresee, including:
- Possible confusion for elderly or other patients who are not tech-friendly
- Breaches of patient privacy guidance for medications (eg people who share a phone number)
- Incorrect input of data, particularly phone numbers, meaning e-scripts go to the wrong person.
There is also the potential for some human error creeping in when GPs fill out e-scripts, leading to incorrect medication or dosages being prescribed, or situations where patients are given the choice of a range of similar medications/generics and may inadvertently select the incorrect dose. Such errors could be avoided with human interaction between the GP, patient and pharmacist.
There is also the digital elephant in the room - tech itself.
While we are moving to tech-based solutions for so many aspects of our daily lives, tech does fail - consider over the past few years the range of issues that have hit banks and other corporations that have reduced face-to-face service in lieu of digital tech and apps. Or, at a higher level, internet service providers and the outages they sometimes experience, meaning access to a digital version of a script is not possible.
You Can’t Stop E-script Progress
While the roll-out of e-scripts has its pros and cons, and the rollout of any new technological development brings with it teething issues, it looks almost certain that e-scripts, like telehealth, are here to stay.
While they may never fully replace hardcopy scripts in the way telehealth will never replace face-to-face visits with GPs, as e-scripts become more and more a part of our broader health services, some of the issues will be ironed out and hopefully more of the benefits will flow through.
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