Pharmacists, physicians dig in their heels regarding stance on PrescribeIT

Pharmacists in Ontario’s Grey & Bruce counties received notice last week that at least one regional physicians’ group will respond to any pharmacies who do not use the PrescribeIT electronic prescription service that they will no longer accept faxed requests for prescriptions. The notice, which was sent via fax to area pharmacies, states: “PrescribeIT protects patient safety by enabling clinicians to prescribe and dispense with confidence. PrescribeIT has advantages, some of which include fewer medication-related errors, less risk of losing prescriptions and lower risk of privacy breaches due to fax transmissions. . . . Our physicians will not be responding to fax requests for scripts. If our patients choose to use a pharmacy that does not use PrescribeIT, they will need to attend the office to pick up a prescription. It’s the patient’s responsibility to ensure they have adequate medication.”One of the recipients of the message, Southampton pharmacist-owner Kristen Watt, who is also vice chair of the Ontario Pharmacists Association, is one of the pharmacy owners who has decided not to renew her contract for PrescribeIT which is implementing a 20 cent per-transaction fee to pharmacies effective January 2025.Read: Why I made the difficult decision to quit PrescribeITIn a LinkedIN post, Watt responded to the message saying: “Letters like these do not foster collaborative care. Nor do they put the patient first. The costs of providing care should not be borne by any professional. But in this case; it’s especially insulting for the costs to be levied against pharmacy alone.”Watt, who also moderates a group chat for the area’s 68 pharmacies, formulated a response on behalf of her colleagues in the area. As of Dec. 8, 28 area pharmacies had signed the letter which reads:“You may have received messages from many of the region’s community pharmacies indicating they were turning off the PrescribeIT functionality. What you may not know is this is due to unfair business practices by Canada Health Infoway, the company operating PrescribeIT. For the past 7 years of use, this product has been free for all users, funded by federal grants. This fall, Canada Health Infoway informed all pharmacy users that a fee for continued use would be levied starting January 1. Despite PrescribeIT being a tool used by clinicians on both ends of prescribing, the fee is being levied only against community pharmacies.“Like family medicine, the funding for community pharmacy has been eroding over time. We have not had a provincial dispensing fee increase in over 12 years. (Physicians have) suggested we charge the patients the fee for the prescriptions received by PrescribeIT. This would be a logistical nightmare not only for us, but your reception staff, we suspect, when we inform your patients they're being charged due to the prescribing platform you use.”Further, community pharmacy does not find PrescribeIT is protective of patient safety, nor does it lead to fewer medication related errors. We can provide many examples of nonsensical quantities, discordant directions, missed dose changes and more. We do not find a decreased risk of privacy breaches as we are not familiar with any fax related privacy breaches in community pharmacy but are aware of many Health Info Custodians, in the form of health software, reporting privacy breaches.”We express concern around your approach to this platform at this time, specifying that you’ll continue to provide the ability for patients to obtain repeats without visiting your office, only if the pharmacy complies with your platform needs. At present, without a comprehensive EHR or referral system in place, we understand your office continues to send and receive many faxes and so it's not your ability to fax that is at question here. We encourage you to review your stance in the interest of professional collaboration and patient care.“We all wish for a functional EHR that reduces the administrative burden on all medical professionals. We also wish for adequate funding to cover all of our patient care activities. Community Pharmacy cannot bear the cost of enhanced communication alone, as is what is happening with PrescribeIT at this time. We encourage you to send your concerns about this platform, its utility and funding to Canada Health Infoway, the provincial Ministry of Health as well as the Federal Ministry of Health. Should you wish to discuss further, we can make ourselves available for a virtual roundtable. We appreciate your collaboration.” Responding to Watt’s post, one pharmacist, Randy Luckham, reminded others that when the PrescribeIT platform was announced in 2019, it was made clear that eventually there would be a payment system in place for pharmacies. However, while some decided against committing to a “free-for-now” platform, many others felt they had not choice but to sign on for fear of losing patients to other pharmacies who used the system.

Pharmacists, physicians dig in their heels regarding stance on PrescribeIT

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