How to kick-start ePrescribing in Canada

Canadians spend $34 billion on medications every year, whether out of pocket or via drug plans, yet we still mainly fill prescriptions by carrying a slip of paper from our doctor to the pharmacy.

Besides being increasingly inconvenient, paper prescriptions have a high margin of error which costs us time, money and in some cases, lives. Case in point: one-in-nine emergency visits results from drug-related adverse events. As we move into the future of healthcare, implementing digital solutions like ePrescribing can easily ensure that our prescriptions are assessed and checked at the point of prescribing and/or at the pharmacy level to avoid these high stakes errors.

ePrescribing is the digital generation, authorization and transportation of prescriptions from doctors to pharmacies, insurers and patients. According to the Canadian Medical Association (CMA) and Canadian Pharmacists Association (CPhA), ePrescribing, combined with a Drug Information System (DIS) providing access to complete medical histories, can reduce medication error making the system:

  • Safer and healthier for patients;
  • More efficient and less risky for doctors and pharmacists;
  • More cost effective by saving Canadian taxpayers time and alleviating the enormous strain that currently exists on the entire Canadian healthcare system today which will ultimately save millions of dollars.

While we have been talking about this move to digital health for years, and have been making some progress as made evident by current pilot projects, we still have a ways to go.

What’s taking so long?

Many peer countries are ahead of Canada when it comes to adoption of ePrescribing. In 2013, 73 per cent of U.S. physicians reported that they ePrescribed prescriptions to their patients, up from a mere four per cent from 2002. Today, 95 per cent of U.S. pharmacies accept electronic prescriptions.

In Canada, our strategy has been to build province-wide Drug Information Systems (DIS) before starting to ePrescribe. These digital repositories store a complete medication history for all citizens in a province, so needless to say, it takes some time.

So far six provinces have DIS, but it will still be some time before ePrescribing is widespread. Simply put, we’re behind because our approach is broad and the dependencies on each province are significant.

A DIS in Canada is the prerequisite to ePrescribing, but doctors will only ePrescribe if they can do so for the majority of their prescriptions and pharmacies will only adopt it if most local physicians ePrescribe — a chicken and egg scenario if you will. What’s important, however, is that ePrescribing has the potential to be the “killer app” that unlocks significant clinical and financial value from DIS investments.

Rethinking our approach

For Canada to catch up, we need to think big but start small; we need to dual track ePrescribing and DIS; and we need to roll out more ePrescribing pilots in targeted regional clusters.

When the 79 per cent of Canadian physicians using EMRs leverage or add an ePrescribing capability, the demand plus competitive pressure promises to create a tipping point, spurring more pharmacies to adopt ePrescribing.

In areas where the adoption is high among local, trusted partners, a network effect will be created that will drives this virtuous cycle.

The time is now

Conditions are ripe for ePrescribing in Canada. We have the technology. Practitioners and patients want it. We have the regulations in place to ensure authenticity, confidentiality, accuracy. With the courage to think differently and by taking a regional approach, we can kick-start ePrescribing to improve health outcomes for all Canadians.

Has your doctor prescribed medication for you electronically? What is your local pharmacy doing to improve the care they offer? And what do you think is the biggest benefit as a patient? Please comment, we’d like to hear your thoughts.

Vincent Ng is a licenced pharmacist and currently acts as a Senior Manager and Health Business Consultant at TELUS Health