Posted on March 19, 2019 by Seema Nayani
One of the places I frequent is my local Tim Horton’s (very Canadian of me, eh?). When I’m picking up my medium steeped tea double-double, I marvel at the ability of the staff to complete orders in a timely, and accurate manner. Tim’s, and other establishments that pride themselves on consistency of their final product, have analyzed their workflows to a science. They provide a streamlined experience — their menus are pared down, they use technology to communicate efficiently within their locations, and the staff follow standardized processes.
This led me to think, why can’t pharmacy workflows be this smooth? One word comes to mind — variability. In the practice of pharmacy, there is so much variability, that it can feel like you’re jumping hurdles when trying to complete a prescription.
There is variation in how prescriptions look, how they are received by the pharmacy, and which form of a medication can be used to fulfill a prescription (often dependent upon the insurance coverage of the patient, and even the province where the patient lives). There even is variation in what container a medication can be given in based on the patient’s preference (vial with a safety-cap, easy open vial, pill-pack).
Pharmacies are interacting externally with many different prescribers (for example, family physicians, nurse practitioners, specialists and dentists) daily, via phone and fax; and each prescriber has his or her own workflow that the pharmacy needs to navigate to be able to address the patients’ concerns. These are only a few examples of variability in pharmacy workflow.
What if we could standardize some of this process, to make pharmacy workflows a bit smoother? A logical place to start would be the beginning of the workflow — how the prescription enters the pharmacy. Currently, prescriptions are either handwritten or printed from the prescribers’ computer system (electronic medical record, or EMR) and brought to the pharmacy, or faxed into the pharmacy. We know the challenges of reading handwritten prescriptions, but even computer-generated prescriptions that are printed can have challenges as there are so many different EMRs in use today by prescribers. We also know fax machines are an unreliable technology, with prescriptions often delayed or never received. PrescribeIT™, Canada’s national e-prescribing service, has the promise to standardize this initial step of pharmacy workflow.
PrescribeIT™ will integrate with all EMRs and pharmacy management systems (PMS) to enable prescriptions to be sent electronically from a prescriber’s EMR right into a pharmacy’s PMS. This will standardize the format of the prescription (no need to try to interpret handwritten prescriptions) and pre-populate the dispensing screen, reducing the amount of re-entry of information needed and room for error. This alone is valuable for the pharmacy staff, as that variability at the start of the pharmacy workflow is eliminated, which in turn is safer for our patients.
PrescribeIT™ also has additional functionality that is valuable for pharmacists, including authentication of prescriptions sent via the service, ability to communicate directly with a prescriber and the ability to send e- renewals. However, from a workflow stand point, there is great promise to simplify what needs to happen to fill a prescription.
Let’s take this first step, and learn from other industries, that workflow elements need to be standardized. This makes for a safer dispensing process for our patients, and a better experience for the pharmacy staff.
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Seema is a practicing pharmacist, and continuously looks for opportunities to implement digital health solutions to improve patient care and the clinician experience. She is the Pharmacist Leader at Canada Health Infoway where she provides clinical expertise and support to a number of Infoway initiatives, including PrescribeIT™. Seema graduated from the University of Toronto, and holds certifications in Healthcare Information and Management Systems, Geriatrics and Diabetes.