Intermedix South Africa in collaboration with CompuGroup Medical SA (CGM SA), a subsidiary of CompuGroup Medical SE, has developed an e-scripting solution that is helping over 1,000 South African doctors ensure medication adherence among their patients.
The iCanScript™ e-scripting solution makes use of Advanced Electronic Signature (AES) to streamline the prescription process. With this functionality, doctors are able to create a digital script and sign it with a password or PIN using their personal AES. Doctors go through a fingerprinting process authenticated by the Department of Home Affairs before being issued with their personal AES certificate to use when digitally signing all their medical and clinical documents.
Once the doctor has created the digital script using their AES, the patient then selects an e-script-enabled pharmacy of their choice for collection or delivery of their prescribed medication. The pharmacy prepares the script on receipt of the digital script, and the doctor receives an electronic notification once medicine has been dispensed to ensure knowledge of the patient’s medication compliance.
“There is a study that shows that there is a R12.5 billion (5.6% of total health expenditure) avoidable cost opportunity and that significant contributors to this are non-adherence and medication errors. Non-adherence is the largest cost, where, on average, a patient only fills 7 out of 12 prescriptions each year. Some don’t even fill the first one,” said practising pharmacist and CEO of the Independent Community Pharmacy Association (ICPA), Jackie Maimin.
“With e-scripting one can see exactly what is happening with a prescription. For non-adherence, the avoidable cost opportunity is estimated at R5.6 billion – this is where patients don’t take their medication and end up in hospital or require other expensive interventions. Dispensing errors also creep in when pharmacists can’t read the script or misread it in terms of the actual medication or strength. With e-scripting there is no chance of a translocation error,” continued Maimin.
With e-scripting doctors can be assured that patients receive the correct medication. With the iCanScript™ platform doctors can access medicine databases and view generic substitutions, allowing them to create legible, accurate and cost-efficient scripts.
The platform also helps reduce co-payments as the doctor, who has access to the formulary medication approved by medical aid schemes, can select appropriate medication that is approved by the patient’s medical scheme. In addition, access to detailed digital records allows doctors to review historic prescriptions on a patient’s profile for quick review of compliance and re-issue of repeat prescriptions. Prescriptions cannot be altered once signed with an AES.
For the pharmacist, there is improved workflow efficiency as a result of the automated delivery of the e-script into the pharmacy practice management system. There is also improved customer service as prescriptions and prescribed minimum benefits (PMB) claims are prepared before the patient collects the medication. In addition, there is the potential for reduced medical errors as digital scripts are highly legible and require less typing input from the pharmacist when filling the script.
According to Pierre Marais, an attorney who specialises in South African healthcare legislation, the iCanScript TM e-scripting model ensures satisfactory controls for the safe dispensing of medicine. “These safeguards include the integrity of the medicines prescribed, easy detection of any amendment to the original prescription as intended by the doctor or tampering with the signature of the doctor.
The prescription is kept in a readily accessible manner for reference purposes and is therefore lawful with complete or full impunity for doctors, against charges of unprofessional conduct or unethical conduct by the HPCSA in terms of rule 17 of the Ethical Rules for Doctors.”
Chief Architect and Product Manager of Intermedix South Africa, Marius van der Westhuizen, believes that all parties in the health ecosystem are now for the first time connected and accountable as part of a multi-disciplinary team taking care of the patient’s health outcomes.
“The patient is co-responsible for their healthcare and is involved in their healthcare journey; the pharmacist together with the patient drives adherence and the doctor can see what the patient is taking, leading to improved patient care and health outcomes.”
“In addition, there is no cost for issuing the AES to doctors or for the use of the e-scripting technology, as it is imbedded in the practice management software. We are proud to have finally found a solution to the great disconnect in South African healthcare to ensure improved health outcomes for patients by bridging the gap between doctor and pharmacist,” concluded van der Westhuizen.