In the academic curriculum of future pharmacists, greater emphasis should be placed on acquiring competencies necessary for public health protection.
Prescriptions, in accordance with article 95b of the Polish Pharmaceutical Law Act (PLA), may be issued in electronic or paper form. Although the legislation has indicated e-prescription as the preferential way of prescribing drugs, the traditional paper form of prescription is still more common. In accordance with the law, the paper-based prescription is only allowed in the case of the unavailability of an appropriate IT system as well as in the case of pro auctore, pro familiae (prescribed for doctorís or his familyís use) and cross-border prescriptions, which are prescribed in other countries. Doctors, nurses and midwives who temporarily work in Poland can also prescribe medication on paper (1). Prescriptions prescribed by pharmacists or other medical professionals in other countries are not accepted in Poland. Article 96a (PLA) defines in detail the information that must be in a prescription. These are data of the patient (first and second name, full address, patient identification number and date of birth) the medical service provider (name, full address, phone number and identification number) and the prescriber (first and second name, professional title, phone number, and professional license number), and data on the medicinal product (name, strength, quantity, and dosage). The legal requirements state that a paperbased prescription must contain the handwritten signature of the prescriber and the date of the prescription, and the data of the printing entity. Moreover, in the case of prescribing drugs covered by a refund or controlled drugs (e.g. morphine), a prescription must contain additional identification number. These numbers are given by the National Health Fund. The provisions of the Act (PLA) concern prescriptions issued both for reimbursed and non-reimbursable drugs. The rules for prescribing and dispensing medicines are the same, regardless of the level of reimbursement. Based on article 96a, paragraph 12 (PLA), an ordinance (an executive act) has been issued which regulates exactly the scope of
Tom 75 • nr 8 • 2019 [4]. Ujawnienie tajemnicy zawodowej jest karane na podstawie art. 266 § 1 Kodeksu karnego, który stanowi, że "kto wbrew przepisom ustawy lub przyjętemu na siebie zobowiązaniu, ujawnia lub wykorzystuje informację, z którą zapoznał się w związku z pełnioną funkcją, wykonywaną pracą, działalnością publiczną, społeczną, gospodarczą lub naukową, podlega grzywnie, karze ograniczenia wolności albo pozbawienia wolności do lat 2" [5].
Introduction: Patientsí rights must be respected at every stage of therapy, including during biological drug therapy. For clinicians, it is key to be involved in the decision-making process with regard to the choices of medication and possible drug substitution. In Poland, the law encourages automatic drug substitution and does not recognize disparities in biological drugs. Aim: The main aim of the paper is to describe the present legal situation depicting the scope of autonomy of a hospitalized patient. Methods: An analysis was conducted of the Polish regulations, the doctrine and administrative decisions and European Medicines Agency guidance documents. Results: In Poland, patients who require therapy with advanced technologies such as biopharmaceuticals, may obtain access to medicine within a special drug reimbursement program in a hospital. Hospitals are supplied with the drugs necessary for drug therapy programs via public procurement. This means that hospital procurement procedures decide which drug a patient will receive. It is not the decision of the health care provider. In view of this, the Polish Patient Ombudsman, in a decision confirmed by the Provincial Administrative Courts, pointed out that the selection of a drug for therapy should depend on current medical knowledge rather than on the result of a tender carried out by a hospital. Conclusions: Polish solutions based on the lack of an obligatory requirement to consult a substitution with a treating physician deviate from the standard practices followed in numerous EU countries and the US.
The implementation of new technology is a response to the challenges of the current health system, such as ageing population and rising treatment costs. Focusing on improving the quality of the services provided and increasing access to treatment guarantees a feeling of safety in the therapeutic process. Amendments introduced to the law and implementing the idea of digitisation of the health care system may turn out to be significantly beneficial for both the medical personnel and the relatives taking care of the patients. New solutions can be applied by Home Hospices, whose functioning is a significant challenge for organizational and financial reasons. The aim of this paper was to analyse current legal regulations governing electronic prescribing. In addition, the impact of e-prescription and related eHealth elements on the availability and quality of palliative care services was assessed. Modern information and communications technology can solve many problems related to access, quality and cost-effectiveness of medical services, in particular those concerning palliative care. E-prescription is a tool that can significantly improve patient care through simplified prescribing rules. New rules for issuing and confirming orders for medical devices also make it much easier for carers.
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