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Closing the Circle of Patient Care

Posted on April 25, 2019 by Dr. Mohamed Alarakhia

Physicians, nurse practitioners, pharmacists and other clinicians all play an important role in patient care. In the current landscape of the health care system, providers far too often operate in silos. Despite this recognition, we still haven’t fully figured out how to break down barriers and address patient care seamlessly.

A starting point for better integration may be implementing digital technologies in the way we work. In my practice, we’ve begun offering digital tools, services and communication such as electronic referral and virtual visits. This has improved the way we interact with our patient community, which we’re seeing translate into better health outcomes. The question is, what other tools can help reduce gaps across the entire health sector and support the circle of patient care?

I’m also an early adopter of PrescribeIT™ — an e-prescription service that was built to eliminate the need for paper prescriptions and enable secure communication between prescriber and pharmacist. Since implementing it into my practice, I have seen significant improvements in the level of care I’m able to provide my patients, directly and indirectly.

First, I’m able to more easily and efficiently monitor prescriptions electronically. We know that approximately one in three prescriptions for health conditions are never filled, and about half are not taken as prescribed. PrescribeIT™ allows me to monitor prescriptions and identify potential issues. For example, an elderly patient with emerging memory issues visited my office to address an infection. The following day, I opened my electronic medical record and saw that there was no dispense notification, which told me the prescription had not been picked up. Because of this, I was able to follow-up with the pharmacist. The pharmacist connected with the patient and it was clear the patient had forgotten to pick up her prescription. The pharmacist arranged to have the prescription delivered directly to the patient. This prevented a potential acute worsening of the patient’s memory issues and resulting hospitalization. The ability to understand if a patient has picked up a medication also opens the door for further dialogue with the patient, which can yield great insights into how patients want to treat their medical condition.

A second important benefit of PrescribeIT™ is the improved and seamless communication between prescriber and pharmacist. Instead of using fax and phone to communicate about important patient information, I electronically connect with pharmacists and respond to patient inquiries quickly. Recently, I issued a request for a patient’s refill to his pharmacist through PrescribeIT™ for a medication previously prescribed by another provider. I was immediately alerted that the patient was also being prescribed methadone by a clinic. PrescribeIT™ allowed us to identify this deadly combination and avoid a catastrophic patient event.

While clinicians will adopt technology at different paces, it’s important to be open to the ways that digital health solutions can improve our practices, and more importantly, the care of our patients. By embracing digital health tools, we can close the circle of care and improve communication between health care providers, patients and the community.

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Mohamed AlarakhiaDr. Mohamed Alarakhia is a Family Physician at the Centre for Family Medicine Family Health Team (CFFM FHT), the Managing Director of the eHealth Centre of Excellence (eCE) in Waterloo, Ontario and the Chief Clinical Information Officer at the Waterloo Wellington LHIN. Mohamed’s vision for health informatics led to the establishment of the eCE in 2014, which is an organization dedicated to improving patient care through the better use of digital health. He also serves as an Assistant Clinical Professor at McMaster University and an Adjunct Professor at the University of Waterloo.

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