Electronic transmission of prescriptions in primary care: transformation, timing and teamwork

Abstract

INTRODUCTIONDuring the coronavirus disease 2019 (COVID-19) pandemic lockdown in New Zealand in March 2020, there was a rapid shift to virtual consultations in primary care. This change was supported by system adjustments to enable electronic transmission of prescriptions without a handwritten signature if they met certain security criteria. International research suggests potential for unintended consequences with such changes, so it is important to understand the effect on professional practice in New Zealand general practice and community pharmacy.AIMThe purpose of this study was to undertake a preliminary exploration of the experiences of New Zealand general practitioners and community pharmacists when prescriptions are transmitted electronically directly from prescriber to pharmacy.METHODSSemi-structured interviews with a purposive sample of four pharmacists and four general practitioners gathered qualitative data about their experiences of the shift to electronic transmission of prescriptions. Participants’ perceptions of effect on professional workflow, interprofessional interactions between general practitioners and pharmacists, and interactions with patients were explored. Interviews were audio-recorded, and the data analysed thematically using an inductive approach.RESULTSFour themes were identified: workflow transformation; mixed impact on interactions with patients; juggling timing and expectations; and new avenues for interprofessional communication (with some cul-de-sacs).DISCUSSIONBoth general practitioners and pharmacists experienced transformational changes to workflow. This was positive for general practitioners due to saved time and increased work flexibility. Pharmacists noted potential benefits but also some challenges. To fully reap teamwork benefits, more work is needed on managing the timing issues and patient expectations, and to refine the new modes of communication between health-care practitioners.

Exploring patient perspectives on Iran’s Electronic Prescription System: a Qualitative Inquiry

“…Moreover, it eliminates paper documentation, reduces production costs, assists treatment decisions through decision support systems, and enhances service quality for patients ( 10 , 12 ). Research indicates a preference for electronic prescribing among primary care practitioners, citing benefits such as enhanced legibility, reduced medication errors, and streamlined workflows ( 4 , 8 , 9 , 13 ). Conversely, the inherent challenges of manual prescription systems, such as illegible handwriting leading to medication errors, underscore the pressing need for electronic prescribing solutions to enhance patient safety and elevate the standard of care ( 4 , 9 , 13 ).…”

Primary care: The central function and main focus of the health system

“…5 Here, we follow with pharmacists' perceptions of the same changes, providing further detail about refinements needed to truly embed the advances prompted by the pandemic. 6 Other articles related to COVID-19 in this issue show how the Japanese public altered their healthcare-seeking behaviours during pandemic waves 7 and how an interprofessional education programme adapted to remain viable. 8 Unrelated to COVID-19, other research articles are about midwives' experiences in providing care for circumcised women 9 and a paper about healthcare service providers' concern at the challenges faced by aged Pacific peoples with cognitive impairment and dementia.…”