Research shows that approximately 50% of patients do not take their medications as prescribed. The treatment of chronic illnesses commonly includes the long-term use of medication; however, the therapeutic benefits are often not achieved or maximized if patients don’t take them or are not adhering to the prescribed regimen.
The factors contributing to poor medication adherence vary, but in general can be summarised into three categories:
- Those related to patients; for example, lack of understanding, inadequate involvement in the treatment decision–making process.
- Those related to care providers; such as prescribing complex regimens, insufficient explanation of usage, ineffective communication about adverse effects.
- Those related to health care systems; for example, limited access to care, visit time limitation, and lack of health information technology.
It is recognized that poor medication adherence contributes to suboptimal clinical benefits; increasing adherence may have a more significant effect on health than any improvement in specific medical treatments (Sabate, WHO, 2003).
How to make patients cooperate? What is a valuable tool to assist patients in forming adherence habits? The solutions need to be multifactorial and sustainable, they need to integrate coordinated efforts between care providers, patients, and health care systems.
The medications are prescribed by doctors in an EHR/EMR system; therefore, EHR/EMR has a role and responsibility to launch such a medication adherence platform:
Recommended workflow and data scope include:
- Prescription information generated in EHR/EMR. The EHR/EMR has appropriate interaction checks, allergy checks, cumulative dose checks, etc.
- Medication collection information in EHR/EMR or in linked pharmacy dispense system. In China, medication collection status is recorded into the EMR / EHR system since the vast majority of pharmacies are inside and operated by the hospital.
- Once the patient collects the medication, prescription information includes generic and brand names, usage instruction (before/after a meal, etc.), time of taking medication, side effects will be available to patients on their mobile phone, or online.
- The time of taking medication can be automatically added to the schedule.
- The patient will be alerted when the time is due.
- Patients can easily record the outcome, e.g., when medication is taken, what are the adverse reactions, etc.
- The patient’s administration record can be submitted to their care manager or primary care doctor for review, the treatment plan and regimens can be adjusted based on the report outcomes.
Depends on the local health systems, bring payers to such a platform could enforce adherence. Pay for adherence, pay for real treatment, pay for outcomes can be achieved based on seamless data.
These are wonderful examples of how information technology (IT) can actually improve care and care coordination with the prescribing physician. That is the goal of IT investments in the healthcare process. Too often IT becomes a burden to the care process.