Individuals Appreciate Having Their Medication Record on the Web: A Survey of Attitudes to a National Pharmacy Register

“Background: Many patients receive health care in different settings. Thus, a limitation of clinical care may be inaccurate medication lists, since data exchange between settings is often lacking and patients do not regularly self-report on changes in their medication. Health care professionals and patients are both interested in utilizing electronic health information. However, opinion is divided as to who should take responsibility for maintaining personal health records. In Sweden, the government has passed a law to enforce and fund a national register of dispensed medications. The register comprises all individuals with dispensed medications (6.4 million individuals, September 2006) and can be accessed by the individual online via “My dispensed medications”. The individual has the right to restrict the accessibility of the information in health care settings.
Objective: The aim of the present study was to evaluate the users’ attitudes towards their access to “My dispensed medications” as part of a new interactive Internet service on prescribed medications.
Method: A password-protected Web survey was conducted among a first group of users of “My dispensed medications”. Data was anonymously collected and analyzed with regard to the usefulness and design of the Web site, the respondents’ willingness to discuss their “My dispensed medications” with others, their reasons for access, and their source of information about the service.
Results: During the study period (January-March, 2007), all 7860 unique site visitors were invited to answer the survey. Invitations were accepted by 2663 individuals, and 1716 responded to the online survey yielding a view rate of 21.8% (1716/7860) and a completion rate of 64.4% (1716/2663). The completeness rate for each question was in the range of 94.9% (1629/1716) to 99.5% (1707/1716). In general, the respondents’ expectations of the usefulness of “My dispensed medications” were high (total median grade 5; Inter Quartile Range [IQR] 3, on a scale 1-6). They were also positive about the design of the Web site (total median grade 5; IQR 1, on a scale 1-6). The high grades were not dependent on age or number of drugs. A majority of the respondents, 60.4% (1037/1716), had learned about “My dispensed medications” from pharmacies. 70.4% (1208/1716) of all respondents said they visited “My dispensed medications” to get control or an overview of their drugs. Getting control was a more common (P < .001) answer for the elderly (age 75 or above), whereas curiosity was more common (P < .001) for the younger age group (18-44 years).
Conclusion: We found that users of the provider-based personal medication record “My dispensed medications” appreciated the access to their record. Since we found that the respondents liked the design of the Web site and perceived that the information was easy to understand, the study provided no reason for system changes. However, a need for more information about the register, and to extend its use, was recognized.”
Article
Montelius E, Åstrand B, Hovstadius Bo, Petersson G, J Med Internet Res 2008;10(4):e35, doi: 10.2196/jmir.1022

Doctors and pharmacists join smartcard critics

“With its rollout coming closer, critics of the German smartcard project are once again becoming louder. Three regional political representative bodies of doctors, dentists and pharmacists are now supporting an anti-smartcard alliance.”
Article
e-Health Europe, 17 September 2008

Private e-scrips to launch

“Pharmacist Paul Naismith is taking a punt on launching a privately-owned electronic prescribing project, ahead of the release of a KPMG review on options being considered by the federal Government.
Mr Naismith, chief executive of pharmacy IT supplier Fred Health, said improving “basic safety” by reducing medication errors was too important to delay.”
Article
Karen Dearne, Australian IT, 16 September 2008

Google Health to make prescription data available to users

“Through a partnership with Google Health, pharmacy technology providers, PDX, Inc. , and Rx. com, will make prescription data available to Google Health users.
Under the agreement any pharmacy using the PDX Electronic Health Record or the Rx. com Electronic Prescription Record will be able to import their customer’s prescription history into Google Health.”
Article
Molly Merrill, Healthcare IT News, 25 August 2008

DH group to look at wider NHS CRS access

“The Department of Health has convened a group to look at widening access to the NHS Care Records Service including representatives from patients, nurses and pharmacists, according to Prof Michael Thick, Connecting for Health�s chief clinical officer.”
Article
e-Health Insider Primary Care, 15 July 2008

The Counterfeiting Superhighway

“The internet has the power to be the greatest single force for good in history, the capacity to enable each of us to learn about people, places and events that were previously unimaginable. Daily, billions of people use this remarkable resource to communicate, conduct business, buy and sell goods and services. It�s hard to remember what daily life was like before the internet and equally to imagine life without it. However, surely, with this capacity comes responsibility.
How many of us would routinely invite fraudsters, thieves, pornographers, paedophiles, criminal gangs, terrorists and the like, into our homes? All of these inhabit the dark recesses of the internet and, every time we log on, we risk coming across them. While conducting The Counterfeiting Superhighway research, the EAASM encountered some extremely unscrupulous internet traders. To my mind, they are among the worst type of online predator, and are totally uncaring for their target. They don�t spare a second�s thought for the health and welfare of their �customer.� They don�t care if the customer (potentially every one of us) lives or dies, gets well or manages an illness. These criminals (and that�s exactly what they are) are the manufacturers and purveyors of counterfeit medicines, and their activities pose a significant global threat to public health today.”
Report
European Alliance for Access to Safe Medicines, July 2008

Online pharmacies a ‘counterfeiting superhighway’

“Over 60% of medicines purchased online are fake and could potentially be lethal for vulnerable patients, says a new report by the European Alliance for Access to Safe Medicines (EAASM).
In a study of over 100 online pharmacies selling 30 commonly purchased prescription-only medicines, the alliance found that 62% of the medicines were counterfeit and 95.6% of the online pharmacies were operating illegally. Most sold medicines without a prescription that would normally be needed for the drugs.”
Article
e-Health Europe, 8 July 2008

Pharmacies Take E-Prescription Campaign Straight to Consumers

“While waiting for a couple of major policy pieces to fall into place, pharmacies are taking their campaign for electronic prescriptions to the people.
And they hope people, in turn, will take it to their doctors.
The country’s independent and chain pharmacies last week launched a national effort to educate customers and enlist their help in speeding up the evolution of digital prescriptions.”
Article
George Lauer, iHealthBeat, 8 May 2008

Pharmacies to Push E-Prescribing

“Ten major pharmacy chains are launching a national marketing campaign to raise consumer awareness about electronic prescriptions.
The chains, which along with participating independent pharmacies represent 26,000 stores, are sponsoring a new Web site for consumers, at LearnAboutEprescriptions.com. The site explains the technology and enables a consumer to enter a ZIP code to find physicians and pharmacies that support e-prescribing. Electronic prescription network vendor SureScripts, Alexandria, Va., also supports the site.”
Article
Health Data Management, 29 April 2008

One in ten EPS pharmacies scanning all barcodes

“Only 11% of pharmacies enabled for the Electronic Prescription Service are scanning every barcode prescription with problems including slow download speeds, the barcodes themselves being too faint to scan and slow log-in times, according to a survey.”
Article
eHealth Insider Primary Care, 29 April 2008

Dutch Health Ministry warns pharmacies

The Dutch ministerial health inspection office warns pharmacies about problems with medication registration software. The software does not produce warnings on drug interaction. The inspection office also notices lack of actualized patient databases.

Letter (Dutch)
IGZ, 28 April 2008

Is There a Successful Business Case for Telepharmacy?

“North Dakota has developed a successful statewide telepharmacy program, known as the North Dakota Telepharmacy Project, to restore, retain, and establish retail pharmacy services in medically underserved rural communities through the use of telepharmacy technology. A financial analysis of income statements and balance sheets for three consecutive years (2002, 2003, and 2004) was conducted to evaluate the utility of telepharmacy in rural areas. Financial analysis included review of common size income statement, ratio analysis, horizontal analysis, and examination of the overall effectiveness of the SBU model using these analytical procedures.
The purpose of this study was to assess the financial operation of a Single Business Unit (SBU), consisting of one central retail pharmacy and two remote retail telepharmacies. Analyses of income statements and balance sheets for three consecutive years (2002�2004) were conducted. Several items from these statements were compared to the industry average. Gross profit increased from $260,093 in 2002 to $502,262 in 2004. The net operating income percent was 2.9 percentage points below the industry average in 2002, 3.9 percentage points below in 2003, and 1.3 percentage points above in 2004. The inventory turnover ratio remained consistently below the industry average, but it also increased over the period. This is an area of concern, given the high cost of pharmaceuticals and a higher likelihood of obsolescence that exists with a time-sensitive inventory. Despite these concerns, the overall trend for the SBU is positive. The rate of growth between 2002 and 2004 shows that it is getting close to median sales as reported in the NCPA Digest. The results of this study indicate that multiple locations become profitable when a sufficient volume of patients (sales) is reached, combined with efficient use of the pharmacist�s time.”
Abstract
Shamima Khan, Herbert W. Snyder, Ann M. Rathke, David M. Scott, Charles D. Peterson. Telemedicine and e-Health. April 1, 2008, 14(3): 235-244. doi:10.1089/tmj.2007.0045

Government admits security issues remain on electronic health record

“The government has admitted much more work has to be done on patient security and confidentiality concerns, associated with allowing pharmacists access to patient Summary Care Records (SCRs).”
Article
Leo King, Computerworld UK, 11 April 2008

Pharmacists may get access to patient care records

“The government has announced it will investigate how community pharmacy access to the NHS Care Records Service (CRS) could be achieved.
The news comes despite BMA concerns about the impact on patient confidentiality of extending access to an additional professional group working in the commercial sector.”
Article
e-Health Insider Primary Care, 7 April 2008

French patients able to update insurance smartcards

“Smartcard security specialists Xiring and mobile phone operator SFR are working together to deploy the largest �Machine to Machine� network in the French healthcare sector, allowing citizens to have their smartcards updated by pharmacists every time they are treated.”
Article
e-Health Insider Europe, 27 November 2007

Patients hold the key to who may have access to their medical records

“Ask a group of community pharmacists what would make their professional lives easier and many would say access to patients� medical records. But this is something that has, so far, eluded the profession.
Now a pilot service, which allows patients to access their own medical records via the internet, could solve the problem. One of the doctors at the centre of the pilot � which will be rolled out to 100 sites in the next few weeks � says patients can use the technology to give pharmacists access to their records.”

Clare Bellingham, The Pharmaceutical Journal, Vol 278 No 7438 p160, 10 February 2007

Article

The surveillance of the people with chronicle diseases making the personal electronic folder in pharmacies for these patients)

Delia Carmen Mihalache*, Andrei Achimas-Cadariu*, Richard Mihalache**
*Medical Informatics and Biostatistics Dept., University of Medicine and Pharmacy “Iuliu Hatiegan”, Cluj-Napoca, Romania
**Faculty of Pharmacy, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania

Abstract:

AIM: The aim of the project is to create the databases in pharmacies, which will include all the medications and treatment schedules for the patients with chronicle disease.
MATHERIAL AND METHOD: In every pharmacy, each patient will have his own electronic file, where the pharmacists have to mention all the medication delivered. For a good supervision of the patients, these people will be distributed to the specific pharmacy, where they will purchase all the drugs, including the over-the-counter. We will supervise only the chronicle disease (e.g. cardiovascular diseases, asthma, hepatitis, epilepsy, Parkinson disease, ulcer, diabetes etc), because in this cases are huge risks for medical interactions between treatment for acute disease and chronicle disease, who can be omitted by the specialists, pharmacists and patients. Using this system the pharmacists can informed all the time the patients how to incorporate the medication into your daily lifestyle, how to manage side effects, when to seek medical help and how to keep track of important information for the doctor and pharmacist.
Doctors can send prescriptions via Internet or wirelessly to the pharmacy (pharmacy receives it as a fax). Alternately, it can be printed via an infrared printer and given directly to the patient. This system removes the possibility of illegible prescriptions and patient tampering, increases efficiency and optimizes the time of physicians and pharmacists. In the same way, the pharmacists will send the information to the doctors.
RESULTS: The databases can provide detailed data about the prevalence and incidence of diseases, distribution of risk and preventive factors, interaction of the drugs, adverse events and patterns of drug utilization.
DISCUSSION: Information obtained in pharmacies will be send to the general practitioners and specialists for:

• Identify the possible drug interaction of the chronicle diseases therapy with treatment for acute disease;
• Identify the other possible reaction which could appear during the therapy;
• Avoid the self medication, which could harm results of the therapy instituted by the specialists;
• Avoid the overdose and under dose because the patient unawareness;

CONCLUSION: The last decade has seen a surge in the use of computerized health care data to provide better health service for the patients and information for pharmacoepidemiology and pharmacovigilace. Results of this study may be compared with clinical trial data and the limited published data from observational studies. In general practice it is know that unlabelled drug related adverse events are more frequently reported compared to labeled events.