Mary,

"ETP will increase patient safety by reducing prescription errors and
providing better information at the point of prescribing and dispensing.
This also creates the opportunity to reduce adverse drug events where the
patient responds poorly to medication."
In conjuntion with Medication Use Review (MUR) 

>If ETP explicitly does not offer decision support, isn't this a backward
step and 
>increase risks - at any rate in the short term ?
I thought it was an add on to your existing systems?

"Over 649 million prescription items were issued in 2003-2004 and this
figure is growing at a rate of about six per cent a year. ETP will support
the increased volume of prescriptions while giving prescribers, dispensers
and patients greater choice and convenience. The system will be more
efficient and will save costs and time."

>Does this mean we will be able to prescribe things we can't prescribe at
the moment? ;->
No but it means that you can avoid that brain numbing half an hour when you
sign all the repeats. It means that I might get to see the prescription
before the patient arrives and get to plan my work rather than forever
playing catch up.

>Some of the advantages seem a bit doubtful:
>For pharmacists:-
>" Reduced reimbursement, administration and postage"
>I didn't know that this was part of a pay cut!
>Jeff?

A slow movement away from a dependency on script numbers - we all realise
that ETP will eventually be to automated prescription warehouses. Pharmacy
has to reinvent itself.

>When do you suppose there will be an announcement about reduced
prescription charges?
Hopefully a reduced charge paid by a greater proportion of the population.
The exemption system neads review - and politically it can only be done just
after an election so that the storm can die down before the next election.

> And *surely* this is a benefit to the patient
Maybe not a diebetic patient ;-)

>And as to how the removal of decision support during prescribing will
reduce >"inappropriate prescriptions" - well, I must be missing something
here!
Currently I am tempted to only query the outright dangerous prescriptions.
Given the time - see above about getting the scripts in advance of the
patient and with MUR (and the payment) I'd be querying innapropriate as
well.

NB I don't think MUR works well in it's current form - One 20 minute
interview per year isn't enough for many patients.

Regards

Jeff





MaryH


In message <[log in to unmask]>, Adrian Midgley
<[log in to unmask]> writes

>"Electronic Transmission of Prescriptions (ETP) is a new service that 
>will make it easier for GPs to issue prescriptions..."
>
>I think ETP is on the whole quite a good idea, in fact if it had not 
>been for serial intransigence on everyone else's part I do not doubt 
>GPs would have introduced it several years ago. But while I don't see 
>any noticeable excess work involved in it, the statement above strikes 
>me as a flat lie.
>
>It is the first sentence in the NPfIT (pardon me, Connecting for 
>Health) page on that "new" service.
>
>I'm unconvinced that those of us who prescribe are going to find we 
>have _a lot_ less re-keying to do as a result of ETP, either.  I don't 
>envisage any decrease in re-keying for prescribers from it. And having 
>found that in line 3, I'm more sceptical than I otherwise might be 
>about the other half of the line, that tells me that (compared to the 
>existing system of printing from a dictionary of prescribable item, on 
>a terminal with access to the World Wide Web,and a bookshelf behind me, 
>I'm going to get "access to better and clearer information".
>
>If the Advertising Standards Authority saw something being sold in such 
>terms, elsewhere, what reaction would they have?
>
>http://www.connectingforhealth.nhs.uk/programmes/n3/etp/
>
>I suppose it is possible that the advertising copy there was simply 
>written by somebody who has not noticed that GPs do not in general 
>write their prescriptions by hand (nor thought that those ones that are 
>hand-written now are _exactly_ those ones that are likely to continue 
>to be hand-written when ETP is in place, in fact looking at the later 
>part of the page it becomes clear that it isn't written from a position 
>of knowledge of general practice at all, but this is not good.
>
>--
>Adrian Midgley <[log in to unmask]>
>

--
Mary Hawking