The countdown has begun for this measure, which is part of the digital component of 2025 health plan. First step was experimentation, from 2017, of the dematerialized prescription of before its generalization in 2019. The e-prescription should then be extended to the acts of biology and paramedics between 2020 and 2022. Carried out by Canadian law, these experiments should, by the terms of their deployment, make the dematerialized prescription and the only vector of doctors’ prescription.
Within one year, any measure falling within the scope of the law relating to prescription and the provision of care, products or services are covered by health insurance. It does not therefore concern at this stage the products or services not reimbursed by the latter. The same order may also apply to the rules relating to the conditions for certification of prescription assistance software for physicians and dispensing, while ensuring the safety and integrity of data in order to generalize electronic prescription in stages.
What Was and to Be Done?
- Launch of work to extend the digital prescription to all health products building on the work of coding medical devices with drug database publishers.
- Launch of an experiment on drugs in health facilities.
- Start of the generalization of the digital medical prescription of health products in the city and health facility.
- Start of experiments for e-prescriptions of biology and nursing.
- Launch of experimentation for physiotherapy acts.
- Starting the generalization of e-prescription for biology and nursing.
- Generalization of the e-prescription of acts performed by all medical auxiliaries.
3 Technical Interests of Online Prescription Service
There was developed a model of digital relationships between physicians and pharmacists to manage the same prescription. The solution chosen for experiments is the use of a QR Code 2D printed by the doctor on the prescription given to the patient. This code is flashed by the dispensing pharmacist and transmits the data to Medicare. Then there is validation of integration of the process in the management software of the health professionals concerned and testing of interoperability of existing drug databases.
E-prescription Experiments in Progress: which Balance?
According to the situation with experiments, 119 doctors and 57 pharmacists were equipped with a software solution integrating the 2D PEM. They processed 54900 electronic medical prescriptions sent to Medicare.
This first report highlighted:
- the interest in participating in the experiment on the part of the targeted professionals, as well as their involvement in the process;
- identification of variable physician/pharmacist couples with limitations found in large pharmacies;
- limitations in the use of the QR Code, relating to the number of data contained in the latter or to their reading with the handhelds of pharmacies.
The positive points of this experimentation of dematerialized orders:
- Interoperability between the software products has been verified. There was no rejection when reading prescriptions by pharmacists;
- patients did not express a refusal for this type of prescription transmission.
4 Obstacles to Allowing the Development of E-prescription
For now, and pending the results of a new phase of experimentation to be conducted on the ground, the generalization of the electronic medical prescription will still have to overcome some obstacles.
For the moment, only two LAPs have been approved. What will happen tomorrow for other software used by doctors. The same will apply to LADs of pharmacists. The question of the server through which the dematerialized orders will pass is also at the center of the debates on the experiment in progress. The unions of doctors are not in favor of this server being in the hands of Medicare only.
Finally, the question of the articulation of digitized prescription with the shared medical file is far from being solved. If a patient does not wish to see such an order, data management, and by extension, statistical studies, will not be possible. Beyond these few questions, one last important, remains open: who will pay what and to whom once the process is generalized.
Benefits for Canadian Online Pharmacies of E-prescription
10,000 doctors trained per year
Up to 20% more doctors can be trained according to the training capacities of the faculties and the needs of the territories.
Pharmacists will deliver drugs
Until 2022, Canada will experience more retirements of doctors than arrivals. The authorities will therefore defend several unpublished amendments in the short term to free up medical time and meet needs. One of the amendments will allow pharmacists to deliver drugs for minor everyday ailments, such as angina, cystitis without having to ask for a prescription from the doctor.
Hospitals and maternity clinics nearby
In the city, health professionals will soon be able to organize care within the territorial communities. 1200 of these communities are expected by 2021.
Telecare and e-prescriptions
You will be able to leave your doctor’s office without a paper prescription. And if you are on vacation, a pharmacist can help you by finding the digital prescription in your personal medical file. This is a real progress which is technically possible from 2020. Always to facilitate access to care, we will extend the teleconsultation to pharmacists, physiotherapists, midwives, or speech therapists who can for example provide online sessions.
A right against a doctor
Faced with the shortage of professionals, there will be given a favorable opinion, against the opinion of the authorities, to a text which creates an enforceable right. A patient who cannot find a doctor can go to health insurance where he will be appointed a physician.
Newsletter – the essence of news
Your email address is collected to allow you to receive medical news and commercial offers. If patients have the right to freely choose their doctor, the opposite is true too. The amendment against will be moved on this proposal. Likewise, any coercive measure will be rejected imposing a place of installation on t doctors. There are already too few doctors who settle, do not add brakes.
Prescription Variations
Compulsory prescription drugs
Pharmacists are only allowed to deliver these medications upon presentation of a prescription that is less than three months old. The delivery of certain medicinal products subject to medical prescription may, however, be renewed by the pharmacist under certain conditions.
Drugs known as optional medical prescription
Drugs not subject to compulsory medical prescription may therefore be dispensed by a pharmacist without a prescription. Some of these drugs are freely available in community pharmacies. The consolidated list of these specialties is on the website. Pharmaceuticals the prescription or dispensation of which is restricted by their marketing authorization.
The marketing authorization for a pharmaceutical specialty may classify it in one of the following categories:
- Medicine reserved for hospital use;
- Hospital prescription medication;
- Drug with initial hospital prescription;
- Prescription drug reserved for certain specialist doctors;
- Drug requiring special monitoring during treatment
Rx drug Prescriptions
In Canada, when doctors issue prescriptions, they must respect the list for pharmaceutical specialties. The prescriptions not conforming to the list are possible but framed.
A pharmaceutical specialty may not be subject to a prescription that does not comply with its marketing authorization if there is no suitable alternative medicine with a marketing authorization and provided that the specialty does not comply with its marketing authorization, the purpose for intended use of a temporary recommendation for use or, failing that, the prescriber considers it essential, in the context of data acquired from science, the use of this specialty for improve or stabilize the clinical condition of a patient. A doctor must refer to the prescription as prescription out of marketing authorization and inform a patient of this off-label use by presenting the advantages and risks of this prescription.