Garth Rattray | Fast-track support systems for telemedicine ­­–­ Pt 2

Under the current Pharmacy Act, if an asthmatic patient travels to Trelawny but does not have the usual rescue inhaler that is urgently needed to abort an oncoming asthma attack; and if his/her physician is in St Andrew, the physician is prevented from calling in or otherwise sending in a prescription for the life-saving medication unless there is a certainty that the hard copy will get from St Andrew to Trelawny, to the said pharmacy no longer than 36 hours after the electronic copy is sent.

The same goes for a diabetic patient in urgent need of insulin, or someone in excruciating pain, or a shut-in with a fulminant infection in need of antibiotics. And, with the COVID-19 precautions and restrictions, the inability to pick up prescriptions or to leave the safety of home is very real. Such patients are being forced to venture out in search of medical aid. Fortunately, some pharmacists have been finding ways to help patients in dire need but who are being denied valuable or urgent healthcare because of an out-of-date Pharmacy Act. God bless their souls.

Additionally, many doctors will write prescriptions and, as part of their way of carrying out a telemedicine consultation, leave the script at the front desk for a relative/friend of the patient to pay for the service and collect the prescription to deliver to the pharmacy. However, if the script is called in or sent in electronically before it is picked up, some unscrupulous patients send to the pharmacy to collect the medicines and never pay for the telemed service or collect the original script. In such instances, the doctor is left holding the bag, and the (kind) pharmacist is in trouble with the law.

URGENT REVIEWOF THE ACT

So, when I saw a recent letter from the Pharmacy Council of Jamaica to,“All Pharmacist and Pharmacy Owners” (that’s verbatim), addressing ‘Electronic Prescribing In Jamaica’, I figured that it would remind pharmacists that accepting prescriptions electronically, without follow-up hard copies within thirty-six hours, is not permitted.

However, given the ongoing need for physicians to be able to submit scripts using electronic means only, and with the COVID-19 pandemic causing confinement for one reason or another, I had hoped that the letter would also state that the Pharmacy Council is well aware of the need for urgent review of the act, and that it is strongly committed to vigorous lobbying for a speedy amendment.

I say this because, in previous discussions with someone on the council, it was revealed that they were trying to get the law updated, but Parliament is yet to act. Instead, the letter only went to great lengths to admonish those who participated in sole telemedicine electronic prescribing and warned everyone not to contravene the Pharmacy Act and regulations. Needless to say, I was profoundly disappointed.

Although the process for making a health insurance claim for a telemed consultation may be initiated online, there is currently no system to directly and totally submit such insurance claims online. And, telemed indemnification is a concerning problem for many doctors already covered for face-to-face consultations.

Our doctors have always been severely hampered by the limited ability to assist patients at a distance. And, in a world where COVID-19 is the number one health scare, but by no means the number one health problem, patients need to remain as safe as possible while seeking healthcare. Jamaica is behind the curve when it comes to the essentiality of telemedicine.

There are circumstances wherein Parliament fast-tracks laws whenever there is an urgent need for them. If our country is serious about fighting COVID-19 and providing a user-friendly healthcare system, we must facilitate all the components that go into making telemedicine efficient and viable.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.