Inter-professional Use of Electronic Communication
Electronic means of communication among providers are resulting in startling changes in the delivery of health care. Many providers are using e-mail to better coordinate care of individual patients. Research has shown that pharmacists and physicians who are within the same health care system can facilitate communication by using electronic mail . Unfortunately, use of e-mail among providers related to the care of a patient has the same privacy and system security concerns and risks of HIPAA (Health Insurance Portability and Accountability Act) violations as does use of e-mail between providers and patients. If you send or receive patient information to anyone via your computer, either with computer-generated fax or e-mail, you are required to be HIPAA compliant.
Uses of electronic communication go beyond communication among different providers caring for a patient within a given health care system. Services are available for online “second opinions” from specialty experts using physicians from institutions . In some states, telemedicine networks are being established to provide consultations in nearly all specialties, including radiology, pathology, oncology, pharmacy, surgery, psychiatry, and behavioral health. Integrated computer systems provide health care professionals access to patient-specific data from a variety of sources and sites of care.
Pharmacy services to remote rural areas or underserved areas of inner cities include automated dispensing at remote sites with no pharmacist present but with a distant, off-site pharmacist “checking” and authorizing the filling of the prescription. Patients with questions can have audiovisual contact and consultation with the pharmacist at the distant site .
Technology has advanced to the point that electronic monitoring of medication use and home monitoring of physiological parameters such as blood pressure, blood glucose, and International Normalized Ratio (INR) can be used, with results transmitted to providers electronically .
The electronic transfer of monitoring data can allow providers to consult with patients and other providers in such a way that problems are identified quickly and timely adjustments of therapy are possible.
Computerized Physician Order Entry (CPOE) along with Clinical Decision Support Systems (CDSSs) are available in many health networks. A CPOE system is designed to reduce medication errors by providing prescribers with a menu of drugs and default dosages from which to pick. Such a system can reduce certain types of medication errors such as those caused by the illegibility of handwritten orders, similarity of drug names, and misspecification of dose. They can also improve patient safety by providing readily accessible information on patient allergies, concurrent medications, and lab results at the time an order is written. Pharmacy has a long history of answering unsolicited inquiries using various forms of communication. The e-mail “Ask Your Pharmacist” (AYP) programs are just an extension of that tradition.