PrescribeNET, a national electronic prescription infrastructure, is a simple solution to cure. The healthcare industry can take advantage of the digital India push.
India faces massive challenges for quality healthcare delivery. Simple and scalable solutions are the need of the hour. India has have demonstrated the ability to leverage technology to implement successfully new initiatives. eg., cashless online transactions (UPI) and biometric-linked identification (Aadhar). What if we could do something similar in healthcare? Like, the link between the doctor and patient, the prescription?
The problem
An estimated 4 billion prescriptions are issued by Indian doctors each year. A majority does not conform even to the most basic quality standards as given by the WHO. Common problems include unnecessary medicines and irrational or even harmful medicinal combinations. Handwritten prescriptions are often illegible, lacking vital information about diagnosis and test results, making it hard to reconstruct the rationale behind the medicines prescribed. They are also prone to be misplaced, making it impossible to build a history of the patient’s illness. But what if prescriptions were generated and stored electronically? And what if E-prescriptions could be sent to permanent central storage where they could be audited for quality? Could this be a first step towards moving healthcare towards a more ideal state?
The solution
The technology to implement E-prescriptions is mature – some 60 per cent of prescriptions in the NHS (UK) are issued electronically. The software runs on smartphones and the data can be easily transmitted using existing infrastructure.
Let us look at the workflow that can be built around PrescribeNET, a national electronic prescription infrastructure. Each prescription will have a unique electronic ID generated on-demand by PrescribeNET. Demographic details on the prescription will be automatically captured from the unique patient ID assigned to every Indian, which like the PAN, can be linked to your Aadhar. The E-prescription will have all the necessary fields with options for the doctor to customise as per the requirements of the practice and any incomplete or erroneous fields will be automatically flagged. This includes warnings for incompatible drugs or incorrect doses. Manually kept text entry can be made simple by providing drop-down menus. The doctor’s smartphone will automatically send a link for the patient’s use at any time to retrieve the prescription from PrescribeNET. The patient will have exclusive control over prescription access. The patient shares an E-link to the prescription with the pharmacist for drug distribution. Exhaustive information about the dispensing pharmacist and of the dispensed drug is also scanned and linked to the prescription, which now constitutes a complete record.
This workflow is complete and the expected error rate will be negligible with the process that automatically red flags the errors. If doctors do not self-correct these errors (for example, prescribing antibiotics when not required), then the real-time scanning of incoming prescriptions by AI tools running on the PrescribeNET server will flag such occurrences and trigger warnings.
Added value
Additional benefits can be derived from PrescribeNET. The National Centre for Disease Control can set up auto-alerts to flag any unusual prescription trends suggestive of emerging epidemics. For example, a sudden surge in prescriptions for antibiotics will trigger an alert and an investigation. A localised spurt in cancer cases can be investigated for possible local causes, like environmental contamination.
Since batch numbers of drugs prescribed are available, the data can be used to alert the regulator to drug failures resulting from manufacture problems or counterfeit drugs. When new drugs are introduced, the regulator will be able to keep an eye on emergent issues relating to drug side effects. The relative efficacy of drugs for a specific disease can also be studied. The huge wealth of data is a good source for research, which can spur innovation.
Implementation costs of such a system nationwide will more than be compensated by costs saved by avoiding needless, irrational and harmful medicines. Indian skill sets in Information Technology, specifically AI and blockchain, can be applied, making this a world-class system with comprehensive maintenance of E-health record for all.
