In article <[log in to unmask]>, Ahmad Risk
<[log in to unmask]> writes
>
>I have been more puzzled than interested.
>
>Are we not talking about 2 different things here?
>
>1.  Management systems for medical review of repeat prescribing and
>chronic disease,  and:
>
>2.  Repeat prescribing 'dishing out' management systems
>
>The former requires running scheduled computer audits at set intervals
>along the lines:  "find hypertensives on treatment x,y or z who have no
>U&Es recorded in the past 12 months"  Or:  "find patients with heart
>failure who are *not* on ACE inhibs *and* have no CXR,*and* have no
>recorded U&Es,  *and* so on...".  Or:  "find patients on lithium who
>have no lithium levels recorded past n months".... etc. etc.
>
>The latter becomes much easier if the former is done right,  right?
>
But even the former doesnt need to be done to get it right - but perhaps
as a check (nicer word than the au... word) to ensure that it is right.

The system I have used (and liked) is that the GP authorises when sees
pt - for say 3 or 6 or 12 months - after which no more scripts until
review (could be done by nurse in nurse led clinic I guess).  No-one
else in practice has password ability or permission (electronic and
physical) to re-authorise repeats or initiate acutes.  

Thus, every script that is signed has been subjected to adequate Dr
review - and a patient cannot 'escape'.  Staff have o hassle cos they
simply are unable to do the patients any 'favours'.

With adequate warnings on repeat script slips - what's the problem?

**Also** a knock on is that Drs will tend to tee up the repeats for a
patient so that they expire at the same time - avoids the
recetionist/pharmacist being inundated with a request for this this
month, and the other the next month - and month by month a different
item expires - 

ie it improves service to pt and less hassle for staff.


**Also** it can lead to better recording - ie review of IHD when in with
back pain so that repeats can be updated instead of allowing to run out
in a months - oh, there we are then - LESS appointments as well.

Sounds good all around to me.

I think practice that falls short of this very basic standard is sub-
standard practice in a tortological sort of a way ;) 


Cheers (hic!) :)
-- 
Jelly Bean              [log in to unmask]

When you get fed up surfing....
....go find some waves.


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