Pharmacists need to embrace ehealth

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Consumers transferring between community/residential care facilities/hospitals are among the most vulnerable patients in the community – vulnerable because this is a time when communication errors are likely, writes Grant Kardachi.

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There is an abundance of evidence to show that these transitions are key areas of occurrence for errors due to incorrect transcriptions in case notes, drug charts etc which may lead to eventual readmissions or adverse events.
In addition, the Australian Commission on Safety and Quality in Health Care, in its Literature Review: Medication Safety in Australia found medication-related hospital admissions have been estimated to comprise 2 per cent to 3 per cent of all Australian hospital admissions. The growing ageing population is compounding the situation with data showing 12 per cent of all medical admissions and 20 per cent to 30 per cent of all admissions in the population aged 65 years and over are estimated to be medication-related.
“There were 9.3 million separations from Australian hospitals in 2011-2012, which would suggest a medication hospital admission rate of 230,000 annually. With an average cost per separation in 2011-12 of $5,204, this suggests the annual cost of medication-related admissions is $1.2 billion,” the report says.
For some years now we have been awaiting a solution to these problems in the form of personally controlled electronic health records or eHealth as it is popularly known.
An eHealth record is an electronic summary of a person’s health records which the individual and their health providers can access whenever they need, from wherever they are.
The eHealth record system was rolled out nationally in July 2012 and the aim was to give healthcare providers involved in a person’s care access to a summary of their key health information, including information such as medications, hospital Discharge Summaries, allergies and immunisations.
The health sector saw this as a major step forward in providing better and more consistent care but unfortunately the system has been plagued with problems and as a result there has been a very low take up rate among the public.
We need to address the problems and have eHealth widely accepted and implemented so that we can provide better healthcare while also reducing problems such as those associated with hospital admission and discharge. Electronic records greatly reduce the incidence of clerical and input error and the subsequent hospital readmissions which may follow.
The use of eHealth can help pharmacists play a major role in helping to ensure our health system remains more sustainable, not only by reducing readmissions but by assisting compliance in medication regimens across the whole community. We need to take responsibility as a community to see that eHealth gets established and is widely implemented so that its benefits can flow through to everyone.
Another area of technological innovation is Telemedicine which is of particular use from a pharmacist’s perspective in providing mediation management for remote patients, and hence in reducing medication misadventures. This is particularly relevant when remote residents may have no other access to health professionals.
The smart phone has greatly added to the availability of help and advice for patients and one app which is linked to pharmacies is a good example. The app tracks how many repeats are left and warns patients when they are running low.
The app works by linking into the software that runs in many pharmacies so it automatically knows all the prescription medications a patient is taking and from that an interactive function can be utilised to help manage medications for the patient that includes everything from reminders to fill scripts, reminders to follow up to see the doctor for new scripts. The pharmacist can send them a message to tell them when it’s ready to collect.
This is technology working with pharmacists to provide the best outcomes for consumers. Clearly it has an advantage over some other available options in that it links the pharmacist to the patient, rather than simply having the app serve as a reminder or alert system.
Pharmacists also have many other facilities at their disposal to assist in medication compliance including Dose Administrations Aids which are most common for people who take lots of different medicines regularly. About 9 million are used by Australians living in their own homes every year. Dose Administrations Aids are available in a variety of different forms to meet the needs of patients.
Consumer Medicine Information leaflets are provided by your pharmacist and these provide all the information about what a drug does and what to do if you have any side effects. These are especially useful for patients starting a new medication.
Pharmacists are constantly developing new ways to inform and advise their patients and customers on ways to get the best use from their medicines and reducing medication misadventures, and as technology develops, pharmacists will evolve the way they do business to further incorporate this technology in their professional practice. in their professional practice.

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“We need to take responsibility as a community to see that eHealth gets established and is widely implemented so that its benefits can flow through to everyone.”

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Grant Kardachi
Grant Kardachi was recently re-elected president of the Pharmaceutical Society of Australia for a fourth term. He is a community pharmacist who recently sold his business interests but is still accredited to undertake medication reviews and sits on the Australian Association of Consultant Pharmacy.