How can Prescribing Workflows work with Virtual Care?

Question: How can physicians providing virtual care, or otherwise working remotely, support requests for new or changed prescriptions?

Context: The COVID-19 pandemic has shifted many patient interactions to "virtual" modes. These include physicians managing prescription refills from remote locations without access to clinic devices (printer, scanner, facsimile) or support staff. The prescriber needs to order medications in the record of care (Connect Care) while getting prescription information to the intended pharmacy.

Answer: Working remotely can be frustrating. It is unlikely that Alberta Health Services (AHS) help desk staff are able to support devices that are not AHS-provisioned. The CMIO portfolio will continue to learn about and support remote workflows for physicians. So, the important "answer" is to ask physicians to share problems with us ( so we can share-back here.

As of July 25, 2023, AHS and AHS partner facilities using the Connect Care clinical information system can send prescriptions directly to community pharmacies via an electronic fax process ("eFax"), without the need for a printed prescription or handwritten signature. Accordingly, outpatient prescriptions get from prescriber to pharmacy by four possible pathways:
  1. Sent directly from Connect Care to the patient’s preferred pharmacy (as set in their profile) via electronic fax.
    • There are two steps for this pathway: confirm/enter the patient's preferred pharmacy (or pharmacies); and change the order class to "Fax" (the default is "Print") and select the destination pharmacy (or pharmacies). As the screens where these steps occur depend on the context (ambulatory, ED, or outpatient), see the tip sheet for further details.
    • Please note the Connect Care eFax workflow cannot be used for prescriptions for drugs classified as Type 1 under the Tracked Prescription Program (TPP); these prescriptions still require the use of a paper TPP secure prescription form.
  2. Printed and (manually) signed prescription handed to patient who takes it to a pharmacy of choice.
  3. Printed and signed prescription faxed from the physician to the intended pharmacy.
  4. Documented prescription telephoned by the physician to the intended pharmacist.
If the first option (direct electronic fax) is not possible, the key is to be able to “print” the prescription locally so that it can be managed at the remote location where the prescriber is working; the second option therefore does not work with virtual care. The third option can be adapted to virtual Connect Care workflows, and the last option is a fall-back that can be used in any context.
We will post again with suggested workflows when support staff are (remotely) available to help.