The digital medication scheme - how essential, economical, trustful and likely as a key performance indicator

I remember the time before the digital revolution, when the medication scheme an information tool in paper format on the treatment and posology, was primarily used by the caregivers. In that time the fundamental principle serving as basis of the legal elements of health records and the ethical data handling was confidentiality.??

In the era of digitalisation, the applicability of the medication scheme has expanded to a digital tool as part of a digital network enabling electronic transfer of records. At present, the regulatory framework on artificial intelligence (AI) and personal data protection (GDPR) represent new legislative tools governing the performance of the medical scheme in its digital variant.?

The medication scheme should essentially represent a snapshot of a medical treatment. Therefore, it can be viewed only as a complementary source of information next to the bigger and more fundamental digital tool known as "e-health record".??

In practice the completion of the medication scheme is being sourced partially from data of the e-health record as well as the big data collected from payment transactions.

How essential is a medication scheme?

The primary need of a medication scheme has remained constant - this is the essential tool for communication between caregivers where the patient is centrally involved.

A relevant research on survivors of stroke or transient ischemic attack and their families (or caregivers) has shown that timely initiation of secondary prevention measures after stroke are critical for risk mitigation which would require an intensive education during the revalidation stage.?In these circumstances, it is reported that lack of time, possible patient anxiety, low literacy, and increased administration have a negative impact on the adherence of a treatment (1).?

This is one of many situations where a well completed medication scheme represents the essential tool not only for exchange on information but also for empowering the patient to overcome his vulnerability and to spare some of the administration burden to both - the patient but also the caregivers.

How economical is a medication scheme?

Generally speaking, patients with an sub-optimal level of education tend to see more doctors on the same matter which would result in a longer list of prescribed medicines.?

Next to it, in the era of digitalisation, the use of social media became critical in the patients interaction and exchange on shared health problem and treatments (2).

Where the patient claims his right to choose?between the consumption of different prescriptions, the updated medication scheme can provide an objective snapshot about the repeated use of a frequently taken antibiotics, for instance, or about the switch to other medication leading to an improvement of the patients health condition.

How trustful is a medication scheme?

A medication scheme can be trustful only if it is updated on a regular basis. This takes time and expertise. The deeper insights that a digital medication scheme can deliver, such as interactions, side effects and incompatibilities of different nature, require efforts beyond a routine consultation. In the same time, data connectivity may not always guarantee the digital availability of records.

Where big data can help to perform updates in a fast and efficient manner, it remains in the hands of software developers and their instructors to enable the optimal environment on the data sourcing and visualisation. Some questions of importance include data retention and time window reflected in the snapshot of a digital medications scheme. For instance, where vaccination scheme is part of a e-health record, the vaccination snapshots are not part of a medication scheme.

Is a medication scheme a key performance indicator?

The digital health environment is still under development. The patients become more assertive and demanding but in their status of a patient, they remain vulnerable.

The caregivers are bound to deontological principles while coping with an increasing speed of under-regulated technological implementations.

New medicines with a short history of use become available. In the case of the COVID - vaccines - the need for repeated use is even indispensable.?The use of vaccines is a limitation that could be partially compensated by sourcing the big data.?

In conclusion, it is premature to consider any potential of the digital medication scheme as a key performance indicator.?It is the patient who remains centrally involved and - most importantly - the final informant and consumer.

References:

1) Dalli, L. et al. 2022. Understanding of medications and associations with adherence, unmet needs, and perceived control of risk factors at two years post-stroke. Research in Social and Administrative Pharmacy. 18/9, p. 3542-3549.

2) Benetoliab, A. et al. 2018. How patients’ use of social media impacts their interactions with healthcare professionals. Patient Education and Counceling. 101/ 3, p. 439-444.