Patient Care Goes Far Beyond the Visit; Implementing Tools Like e-Prescribing Gives Family Physicians Much Needed Support

As a rule of thumb, if I spend one hour in direct patient care, I'm spending 30 minutes to one hour on non-clinical tasks. This can include charting and documentation, gathering and interpreting clinical information — either in preparation for or after a patient visit, to complete a referral, for example — and preventative care measures. This is by no means unique to my practice — respondents to the Canadian Medical Association’s latest National Physician Health Survey spent an average of 10 hours per week on administrative tasks. Canadians are living longer, and many are living longer with multiple chronic medical conditions. The more complex a patient’s concerns are, the more time-intensive associated administrative tasks will be.

Even something as seemingly simple as the prescription process comes with complexities to ensure patients receive their medication in a safe and timely manner. With health care systems nationwide struggling with physician shortages, it's increasingly important to prioritize implementing digital health tools that streamline processes and allow health care providers to focus more of their time on direct patient care. Tools like PrescribeIT , a national e-prescribing service, can help streamline the prescription process by connecting prescribers to community-based retail pharmacies, enabling the digital transmission of prescriptions.

Let's say a patient with multiple chronic medical problems presents for an office visit and they haven't been in for a while. They might have three or four issues to discuss, one of which requires a specialist opinion, another which will require blood work and another that involves changes to their medication. Even if I’m being highly optimistic and the visit takes 20 minutes, the work involved afterwards may include charting, creating and sending a referral supported by the appropriate investigations and setting alerts within my electronic medical record (EMR), among other time-intensive tasks.

Any time an element of a patient’s care is transferred to another member of their care team, be it a pharmacist or a specialist referral, maintaining effective communication within the patient’s circle of care is essential, and this takes much more time than most Canadians might realize. There are a number of cognitive checkpoints I’ll go through as the prescriber to ensure that the prescription is created safely in the context of a patient’s other medications, allergies, medical conditions, and beyond. Likewise, the pharmacist will undergo their own reviews and safety checks to ensure they are dispensing medication safely. When we consider that 55 per cent of adults aged 18 to 79 use at least one prescription medication each month (StatsCan ), we begin to understand how quickly this time can add up. Tools like e-prescribing enable pharmacies to receive prescriptions directly into the pharmacy management system, populating all the required information and allowing more time for patient care.

Although I follow a careful process when creating a prescription, checks and balances exist within the system to ensure the safety of the patient. In the dispensing process, questions and concerns from the patient’s pharmacy team can often arise when new medications are prescribed, particularly in the case of more complex patients. Traditionally, health care has relied heavily on fax with some phone calls mixed in — and in many cases it still does. This chaotic mix of communications, often filtered through assistants on either end, can make even the simplest question a challenge, delaying patient care. Having tools in place that prioritize communication between health care providers, such as PrescribeIT’s integrated clinical communications tool, enables the prescriber and pharmacy to communicate directly, quickly address clarifications and align on next steps.

As we look to address challenges in health care delivery, implementing tools that streamline daily processes and best practices are fundamental steps we can take right now. e-Prescribing is a tool that is readily available and there’s no reason for it not to be the best practice for prescription management so health care providers have more bandwidth for what matters most: patient care.

Click here for more information on PrescribeIT and how it can streamline your workflow.

Dr. Rashaad Bhyat serves as Senior Clinician Leader at Canada Health Infoway. He is a family physician with a passion for digital health and practices in an EMR-enabled clinic in the Greater Toronto Area.