Sunday, May 15, 2016

e-Prescriptions: A lousy idea whose time has come.


New York State recently passed a law requiring ePrescriptions. In a display of commendable restraint, I will refrain from commenting on the number of our law makers currently under investigation and/or headed for jail. Instead, I will tell you what happened to me when I went mano a mano with the new system.

On Friday morning my doctor's office e'd a prescription for eyedrops in advance of minor eye surgery.

The assistant handling the paperwork wanted to know which drugstore I wanted to use. I wanted to use the least expensive one since I know from experience that in my neighborhood there can be a price difference of as much as 50% between pharmacies for the same drug. When I asked how much these drugs cost, she told me that she didn't know. She insisted I provide a pharmacy number so I had to take a guess.

Did I make a lucky guess? Or not?

I don't know because it is now Sunday and the pharmacy has neither called to alert me to pick up nor delivered the prescription. Was the prescription received? Was there an error in the doctor's office? A mix up at the pharmacy? Was there a computer glitch?

Calling seems to offer an opportunity for confusion since my name is a common one and I wasn't told the name of the eyedrops (or whether several different kinds of eyedrops were prescribed). Instead, I will call the doctor's office on Monday morning, find out what drugs were prescribed and, armed with a bit of information, contact the pharmacy.

What would happen if this Rx were urgent? Which, fortunately, it's not. Still, I have to wonder what would happen to a patient facing an urgent situation.

The proponents of e-prescribing contend that it prevents errors. Really? I have never once had an error in a prescription handed to me by a doctor and taken by me to a drugstore. No friend or family member has ever mentioned a prescription error and I have never read a newspaper, magazine or internet story about the scourge of prescription errors.

E-prescriptions are slower than written or printed prescriptions. I can't remember ever not receiving an Rx the same day I handed it to a pharmacist.

E-prescriptions infantilize the patient who is deprived of information and control. Kept in the dark by this opaque system, we are not clued in to the name of the drug, the number of different drugs if relevant, and, since we don't see the Rx, we have no way of knowing if the prescription delivered to us is, in fact, ours or has been correctly filled.

We have no way to compare prices and do not know how much the drug(s) will cost until we get the bill. Then and only then—surprise! surprise!—will we be allowed to participate in our own health care.

I have learned my lesson. The next time I need a prescription, I will insist the doctor write down the name(s) of the drug. I would advise other patients to take the same precaution.

How patients will be able find out the price of a drug before designating a pharmacy is a significant unaddressed issue. When did anyone anywhere in the world ever buy something without knowing the price in advance?

Welcome to medicine, twenty-first-century-style.

If all patients are forced into this system, why aren't all pharmacies forced to charge identical prices? Where were patient advocates and consumer advocates when New York State passed this inefficient and potentially health-threatening law? Where is the company like Amazon that will disrupt this entire system by offering transparent prices and quick, reliable delivery?

9 comments:

  1. I'm sorry you're going through this. I've never had a problem with e-prescriptions, but my doctor is always good about telling me what I'm getting and, as you say, writing it down for me, and my pharmacy (Walgreens) will call, either me or the doctor, if they have any questions or concerns.

    When states are forward-thinking enough to allow people to buy drugs of all types over the counter, maybe Amazon will get into the business. Don't expect that to happen anytime soon, though...

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    1. John—Thanks for sharing your positive experiences. I'm glad to hear that e-prescriptions can work well. This is a new law in NYS and the first time I've encountered it so perhaps all the glitches haven't yet been worked out by doctors, pharmacies—or patients. From now on, I will certainly have the Rx written down for me before I leave the doctor's office!

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  2. I am with you 100% on this, Ruth. E-prescriptions are so slow they can be life-threatening. They're not required by law in California, but most medical conglomerates insist on them. I suppose it helps their legal department.

    Once, after a particularly barbaric breast biopsy, I had to wait at the pharmacy for almost two hours for the e-prescription for antibiotics and painkillers to come through. I passed out twice, soaked in blood, as the anesthetic wore off and I didn't even have an aspirin.

    Luckily an acquaintance came into the store and took me out to her car so I could sit down and rest while I waited. And she gave me some aspirin and water. I might have died. Nobody could do a thing.

    My doctor is so disgusted by the whole "everything has to be electronic" thing he's leaving the conglomerate and setting up his own practice. But I suppose he's fighting a losing battle.

    Think how easy it's going to be for terrorists to disrupt our entire civilization once we're entirely dependent on electronic everything.

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    1. Anne—What an awful experience! Fortunately, my situation is not as dire as your was but it is Monday afternoon and I still don't have the eyedrops nor have I heard from the pharmacy or my doctor's office.

      No wonder your doctor is so fed up. From what I hear, he's not alone.

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  3. HI,how are you? my name is Sergio Rios Peritore, i live in Argentina, i try to make make family tree, and i soo in a web page , one study of Angelo Peritore Born in 1838 in Licata Itale, made for Ruth Harris, are you this Ruth Harris? sorry for my english.

    Thank you very much

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    1. Hi Sergio, Sorry, but I'm not the Ruth Harris you're looking for. It's a very common name in English so there are many of us with that name. Good luck in your search!

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    2. thaks you Ruth! i will search your book in my country for read one of them

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  4. Most state guv'ments have this kind of stupid mentality. In CT, our guv'nor said out of one side of his mouth that he wanted to keep local businesses in business. Out the other side, he gave control of the state employee prescription program to CVS, based in Rhode Island, and eventually has forced everyone to switch from their local or non-CVS pharmacy to either CVS or SilverScript (also owned/run by CVS).

    Father Nature's Corner

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    1. G. B.—Keeping patients out of the loop is an invitation to error (and maybe worse). Doesn't anyone think this through? And let's not even go into CVS raising prices which is probably the basic reason anyway.

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