e- Prescriptions Open the Door to Convenience, Efficiency, and Safety
From convenience, saved time, and reduced potential of prescription fraud to protecting patient data, this digital prescribing solution scores many wins.
At Christine McGinley’s last physical, her doctor gave her a handwritten prescription — which she promptly lost. “I don’t know what shocked me more — the fact that I needed the prescription, the fact that I lost it, or the fact that it was handwritten in our digital world,” she says.
Though health tech has evolved substantially, prescriptions are a lagging area. Many are still done by paper or fax transmission, which causes problems such as lost or misplaced prescriptions, delays from dropped faxes, missed phone calls or illegible physician handwriting, and potential for prescription fraud.
Just finding time to drop off and pick up a prescription can be challenging, as Poonam Khanna found when her busy schedule prevented her from getting to a pharmacist for a prescription that she needed to start taking immediately. “I couldn’t help thinking that an e-prescription through PrescribeIT® would have made things a bit more convenient,” she says.
PrescribeIT® is a national e-prescribing service that was developed by the Canada Health Infoway,
an independent, federally funded non-profit organization focused on enhancing digital health information and services for Canadians. PrescribeIT® lets prescribers like physicians and nurse practitioners electronically transmit a prescription directly from an electronic medical record to the patient’s pharmacy of choice.
“From a patient perspective, e-prescribing is a simple digital solution that supports medication management and patient safety,” says McGinley.
Aside from making prescription transmission more convenient, PrescribeIT® does away with phoning, faxing, and writing replacement prescriptions — freeing doctors to spend more time on patient care. It also reduces the risk of medication errors and lost or misplaced prescriptions for patients and enables faster and more efficient communication between physicians and pharmacists to discuss a patient’s medication plan and ensure medication safety and adherence. With many built-in security and privacy safeguards, PrescribeIT® reduces the risk of prescription fraud and protects patient data from commercial use.
Anne Papmehl
This article was sponsored by Canada Health Infoway
Making Health Care Simple — Because Canadians Deserve Better
While Canada’s public health-care system is considered amongst the best in the world, Canadians are also woefully aware of our health system’s gaps in care. SRx Health Solutions is a network of clinics, pharmacies, and medical professionals working together to help create better patient outcomes for Canadians. The network was founded in 2013 to address gaps in care, expand pharmacists’ role and maximize on their capability, and provide innovative, sustainable, and integrated solutions to revolutionize health care for Canadians. Through patient support programs, pharmacy services, nursing services, clinical trials, diagnostics testing, and more, SRx supports all aspects of a patient’s health-care journey.
A patient-centric approach No two patients are the same, and SRx understands the importance of supporting each patient with the unique levels of support and involvement best suited to them. “There are some patients who prefer to take their health into their own hands, and we look to offer ways to support them by making health care simple — for example, with virtual care, pharmacogenomics, preventative health, free delivery, self-service, and so on,” says Adesh Vora, President and CEO of SRx Health Solutions. “On the other hand, some may require more assistance and need help finding coverage for their drugs, learning about their condition, administering their treatment, receiving daily or frequent check-ins, and so on.”
A patient-centric approach makes the biggest difference in people’s lives.
By creating patient-centric solutions, SRx enhances patient care and truly improves Canadians’ wellness. “A patient-centric approach makes the biggest difference in people’s lives,” says Brock Clancy, the network’s Vice-President of Patient Services and Operations. “Having personalized access to a full team of integrated health professionals — such as pharmacists, nurses, clinicians, and patient support program coordinators — who are committed to developing a support plan that works for each patient alleviates major stress, contributes to better outcomes, and bridges gaps in the Canadian health-care system.”
and automation to enhance access and care — including with its very own fully integrated and customized technology platform, which is used by all facets of the company. “Our technology uses AI to better predict when patients and physicians might require more assistance from our team along their medical journey,” says Clancy. “Automation is paramount to the functionality of our patient support program as we’ve found ways to make life easier for patients, physicians, and caseworkers to take care of the necessary tasks to get patients onto specialty medication.”
The network also plays a key role in expanding the role and maximizing on the capability of pharmacists. It does this by fostering an environment of learning and skill-building. “We empower our team to be clinical pharmacists (performing duties beyond just dispensing and processing orders), thereby optimizing treatments, enhancing the patient journey, and working closely with physicians and other health professionals,” says Vora. “We further leverage technology to allow for automation wherever possible, thereby ensuring that our pharmacists can provide hands-on personalized support to each and every patient.” Combined, these efforts result in better health outcomes.
Just over two million Canadians will experience irreversible vision loss from retinal disease. Age-related macular edema, diabetic retinopathy, glaucoma, and cataracts are some of the conditions that increase the risk of sight loss.
One misconception about retinal eye disease is that it’s an inevitable part of aging or diabetes. But with early assessment, treatment, and monitoring, this doesn’t have to be the case. “Many retinal diseases are preventable and treatable. It doesn’t have to take over your life and the earlier you catch it, the greater the chance of good outcomes,” says Dr. Jane Barratt, Secretary General of the International Federation on Ageing (IFA).
Advances and innovation in treatment lead to better outcomes
Continued innovation and advancements in ophthalmology have resulted in more Canadians with retinal eye diseases living independent and productive lives. One of the most common treatments for people with age-related macular edema or diabetic retinopathy is anti-vascular endothelial growth factor (anti-VEGF) therapy. “This is a state-of-the-art and very important treatment that works to slow down
Why Timely Access to Care Is Essential to Prevent Vision Loss
vision loss and support people with retinal eye diseases,” says Dr. Barratt.
As a patient advocacy organization, the IFA believes that people who need biologic anti-VEGF therapy should continue to have access to it. “Biosimilar anti-VEGFs are being introduced on the market, and while there’s nothing currently suggesting that biologic anti-VEGFs won’t be available, we’ve seen non-medical mandatory switching in provinces where biosimilars have been used to treat other conditions,” says Dr. Barratt.
In the field of ophthalmology, data on the implications of switching is currently lacking. “This evidence is critical to inform policy development to ensure patients are receiving safe, appropriate, and effective treatment for their condition,” says Dr. Barratt. “We feel it’s important that physicians are not only up to date with the evidence around biosimilars in ophthalmology, but that there are patient and clinician conversations about the most appropriate treatment for that individual and that the patient has a choice.”
A need to broaden treatment access and options
Another challenge is cost. Not all eye care is covered under the Ontario Health Insurance Plan (OHIP). “Some treatments for retinal diseases, such as laser, steroids, and anti-VEGF, are covered, but much of it is private,” says Dr. Barratt. “To adequately address the multiple ways and barriers to access treatment, we’ve got to expand the vision health options and to do that, we need effective policies that are informed by evidence,” says Dr. Barratt.
The lack of access has consequences. “It affects the whole social and economic fabric of society. People may lose their jobs, their personal system of care, and their identity, and there’s a marked increase in mental health issues for people with vision loss,” says Dr. Barratt.
With the progressive nature of retinal eye diseases, it’s critical to catch them early, and that requires access to assessment and treatment. That can be challenging in Ontario. In addition to the recent pandemic lockdowns, which prevented many people from receiving timely eye care, leading to devastating vision loss, Ontario has a complex health-care system. For example, a patient with diabetes may be required to start with a diabetologist before being referred to an ophthalmologist, which can take additional weeks or months. In the meantime, there’s potential for further vision deterioration.
Tania Amardeil
Anne Papmehl
Vision loss from certain retinal diseases is preventable. But it does require patients to have equitable access to assessment and treatment.
Dr. Jane Barratt Secretary General, International Federation on Ageing
This article was made possible with support from a research-based pharmaceutical company.
Continued Lack of Treatment Access for Adults with SMA Is Causing Hardship
Spinal muscular atrophy (SMA) is a rare and serious neuromuscular disease that causes progressive loss of strength and motor function throughout an individual’s life. It affects children, teens, and adults, and prior to the availability of treatment, diagnosis meant either an early death or a lifetime of progressive disability — from difficulty breathing to never developing the ability to walk.
Although approved treatment is available in Canada that can slow down and even reverse disease progression, it remains inaccessible to most Canadian adults over 25 with SMA. Only the province of Quebec funds treatment for SMA patients of all ages.
Disease progression leads to diminished quality of life
Without access to treatment, adults with SMA continue to lose function over time, resulting in loss of independence, personal hardship, and a diminished quality of life.
Bryce, age 29, from Bowmanville, Ont., was diagnosed with SMA when he was 16. Initially, the disease progressed very slowly. “I was clumsy and couldn’t do sports, but I could still climb fences, get up off the ground, and run around,” he says.
All I want in life is to be able to work and support my family. I don’t think that’s a lot to ask, but without treatment, that’s impossible to ask.
Today, while still able to walk, Bryce sees the disease progressing more rapidly than before. Without treatment, he fears he will lose that ability and that he won’t be able to hold his job as a sleep technologist for much longer. “I love my job, but every day I go to work, I can see it slipping away more and more,” he says. He's extremely discouraged that his age prevents him from accessing the treatment he needs. “It makes you feel less like a human and more like a price tag, a number, or a burden.”
Kyle Vezzaro, 34, from Ottawa, has been confined to a power wheelchair since age 13 due to SMA. Through VHA Home HealthCare, he can live independently, but like Bryce, his age disqualifies him from public access to treatment.
He has a degree in political science and would one day love to run for public office, but his declining energy levels prevent him from holding a full-time
job. He feels that having access to treatment would enable him to do so much more and is disappointed that Canada’s health system isn’t meeting the needs of the adult SMA community. “More and more countries provide full access to treatment and Canada doesn’t and yet we claim to have the best health-care system in the world,” he says.
Jared Wayland, 34, of St. Catharines, Ont., is an active voice in the SMA community. He applied over three years ago for special access to treatment with the Ontario Ministry of Health, but so far has been denied. “It’s exhausting and frustrating trying to make people understand that this is a time-sensitive issue for everybody with SMA. Our lives are on the line.”
In January 2022, Jared became a first-time father, and even in that short time, he noticed a further decline in his functionality. “I might go to grab something from the cupboard, and my arm isn’t moving the way it used to, and with my job as a graphic designer, I’m finding it more difficult to control the mouse,” he says. As a result, he fears being unable to work or help his wife Sydney with caring for the baby and their home. “I pride myself on being independent and it’s really important to me to make sure I’m pulling my weight both with the baby and around the house,” he says.
Despite real-world evidence, adults continue to be denied access
With over 25 countries providing treatment to all SMA patients, regardless of age, why do so many adults in Canada’s SMA community face barriers to access? “A lot has to do with the reimbursement review process,” says Durhane Wong-Rieger, President and CEO of the Canadian Organization for Rare Disorders. “Canada tends to be reluctant to extrapolate clinical trial data to benefits,” she says.
Yet, real-world evidence accumulated over the years has been reviewed and accepted in other countries to support expansion of SMA treatment access to adults. According to Susi Vander Wyk, Executive Director of Cure SMA Canada, the problem is that Canada only considers clinical trial data when making its funding evaluations — something she says shouldn't apply to treatments for rare diseases like SMA.
“Rare diseases cannot be painted with the same brush as non-rare diseases; real-world evidence must be admissible as valuable data that proves the benefit to the patient,” says Vander Wyk. “In Canada, we have patients on treatment right now who not only had their progression halted but actually had their loss of function reversed.”
That’s why Vander Wyk’s and Wong-Rieger’s respective organizations are advocating for a Rare Disease Drug Strategy to change the way in which decisions are made about treatment availability and what constitutes a benefit to the patient. “This information is readily available, the data is there to support it, and Canada’s experienced clinicians support access, and yet patients with a progressive disease are being made to wait. It’s devastating to watch,” says Vander Wyk.
Treatment access could unlock patients’ hopes and dreams Having access to treatment would mean a lot for the SMA community. “We have wants, hopes, and dreams just like everybody else. The only difference is that many of us require life-changing treatment to accomplish our dreams,” says Kyle. “There are some extremely bright individ -
We have wants, hopes, and dreams just like everybody else. The only difference is that many of us require life-changing treatment to accomplish our dreams.
uals within the SMA community and I think if we could break the chains and let them loose, it would be better for Canada and for the world,” says Kyle. For Jared, finally having access to treatment could also remove a major source of stress and frustration in his life. “I think mental health is something that’s overlooked in a lot of this,” he says. “After years of all this advocacy work, which takes time from my family, my work, and my plans with no progress, I think my mental health would 100 per cent improve.”
Bryce also believes that having access to treatment would change his life dramatically for the better. “I’m very much on a downhill progression now, and access to treatment would stop or, at the very least, slow the progression of my disease. I don’t expect any treatment to give me all my strength back, but just slowing down the progression would let me live a quality life and not feel like I’m a burden on my family,” he says.
A simple message to decisionmakers
Bryce’s message is simple: “All I want in life is to be able to work and support my family. I don’t think that’s a lot to ask, but without treatment, that’s impossible to ask.”
Bryce Age 29, Bowmanville, Ont.
PHOTO COURTESY OF PATIENTVOICE
PHOTO COURTESY OF JARED WAYLAND
Kyle Vezzaro Age 34, Ottawa, Ont.
Jared Wayland Age 34, St. Catharines, Ont.
Durhane Wong-Rieger President & CEO, Canadian Organization for Rare Disorders
Susi Vander Wyk Executive Director, Cure SMA Canada
PHOTO COURTESY OF KYLE VEZZARO
How 2 Type 1: Navigating the World of Type 1 Diabetes
New video series from Diabetes Canada offers accessible and actionable information to help people better understand and manage diabetes.
Rosalind Stefenac
Brooks Roche was diagnosed with type 1 diabetes 21 years ago, just shy of his fourth birthday. Every day since, with the help of his caregivers, he has had to administer insulin, monitor his blood sugar, and carefully plan all his meals and activities to make sure his body can function properly. “I was trying to do all this, along with all the other learnings that are necessary in growing up and just finding my place in the world,” he says. “It’s been a huge skillset to learn and a huge burden on me, my parents, my caregivers, teachers, and friends.”
In living with this disease most of his life, Roche says he was always struck by how diabetes management focused solely on good health outcomes. “It was about how doing this makes you a so-called ‘good diabetic’ and doing that makes you a bad one, but there are dozens of other factors that can have an impact,” he says. “If you divide a person’s health outcomes into good or bad, inherently they’re going to feel judged.”
That’s why Roche, Manager of Patient Knowledge and Connection at Diabetes Canada, was particularly excited to be part of a team responsible for developing a new tool for people with type 1 diabetes that takes a different approach to managing the disease. The 12-part series, called How 2 Type 1, was launched by Diabetes Canada on YouTube in August 2022 and features short informational videos using visual metaphors and easy-to-understand concepts to cover a variety of important subjects for people with type 1 diabetes and their caregivers.
one has a life that dominates their focus, they’re telling us they just don’t have time.”
The fact that type 1 diabetes affects people at a much younger age than type 2 means they’re also consuming information differently, says Dr. Vallis. “They’re going to online forums for information and want their doctors to text them,” he says. “They don’t see themselves among the older people with type 2 diabetes typically waiting for an appointment in an endocrinology clinic.”
With type 1 making up only 5 to 10 per cent of the overall prevalence of diabetes cases in Canada, Dr. Vallis says this group of patients often feels like second-class citizens, with treatment protocols that don’t apply to them. Whereas people with type 2 diabetes are being encouraged to exercise more and eat better, he says most people with type 1 are already very active.
We’ve been talking at people with diabetes as health-care providers, and instead, we want to work together and empower them.
- Dr. Michael Vallis
Topics range from accepting you have the disease and knowing the basics of how it affects the body to how you can maximize the positive effects of exercise and tap into the mind-body connection to better manage care.
Dr. Michael Vallis, a registered health psychologist and Lead of the Behaviour Change Institute in Halifax, N.S., was consulted in developing the video series. He expects it will help fill a gap in how information is relayed around type 1 diabetes. “We’ve been talking at people with diabetes as health-care providers, and instead, we want to work together and empower them,” he says. “With the traditional ‘teach and tell’ model, people are either good or bad students and since every-
“They’re tremendously motivated; however, they’re also at high risk of burnout because it tires them out and they can’t do it perfectly,” he says.
“There’s also a lot of evidence that shows the more you criticize yourself for your past failures, the harder it is to get back on track.”
Dr. Vallis says the research shows that 60 per cent of people with diabetes live with diabetes distress, including the emotional burden of living with the disease and the fatigue associated with constant monitoring. “With type 1, it’s great that you can monitor blood glucose every five minutes now, for example, but that’s a lot of data that gets pushed onto people to digest.”
In this series, short videos under five minutes each are meant to inspire curiosity so that people will go back to talk to their health-care providers about concerns — and seek further information and tools available through Diabetes Canada at diabetes.ca “It’s about creating some compassion for the challenges of diabetes and taking out any notion of judgement,” says Dr. Vallis.
Roche admits that living with type 1 diabetes can sometimes be a lonely and misunderstood place. “I think this video series can be a powerful tool for changing the conversation around type 1 diabetes, and in some small but significant way, it’ll help reduce the stigma associated with this condition,” he says.
Sharing Insights to Improve Diabetes Care
A variety of experts, including people living with type 1 diabetes (T1D), came together to collaborate on the making of the How 2 Type 1 video series.
This group included:
DR. PETER SENIOR
• Endocrinologist
• Professor, University of Alberta
• Director, Alberta Diabetes Institute
• Board Chair, Diabetes Canada
MATTHEW STEIN
• Director, The Diabetes Leadership Foundation Lives with T1D
We’ve all missed out on a lot over the past few years due to the pandemic. And now, with the availability of COVID-19 vaccines, many of us are catching up with the activities we enjoy and the people we love.
But there’s something else that you may have missed — routine vaccinations. No matter your age, we all need to ensure that our routine vaccinations are up to date to help reduce the spread of infectious diseases in communities.
Routine immunizations reduce illness, death, and the spread of disease. Despite this, vaccine-preventable
diseases can still pose a threat. For example, measles is a disease that can spread very easily from person to person if not enough people are fully immunized. In addition, many of these diseases can cause severe complications and harm, especially for those who cannot get immunized due to medical conditions.
Children who get vaccinated on time receive the protection they need as early as possible. Vaccines strengthen their immune systems and prepare their bodies to fight disease before being exposed to a vaccine-preventable disease.
As you get older, there are other vaccines available to protect you from diseases such as influenza, pneumonia, shingles, and tetanus.
If you’re living with a chronic condition like diabetes or COPD, staying healthy is especially important. Keeping up to date with vaccines is one easy thing you can do to protect your health and the health of those around you.
Immunizations are an essential part of your health record. Therefore, keeping a copy of your immunization record and those of your children in a safe place is important. Suppose you cannot locate your immunization record. In
How Ontario’s Pharmacists Provide Better Access to Vaccines
Independent pharmacies help keep Ontarians healthy and protected, all while reducing the burden on our health-care system.
Independent pharmacies play an important role in keeping Canadians healthy and supporting immune health. Ontario pharmacists have administered over 8.8 million COVID-19 vaccines to date and over 1.7 million flu vaccines this season. Further expansion of their scope of practice to facilitate Ontarians receiving even more routine immunizations and vaccinations is much needed.
Getting more Ontarians vaccinated During the pandemic, there has been a decrease in routine vaccinations.
Pharmacists already have the skills to administer vaccines and are wellsuited to be part of the solution. By increasing the list of vaccines that pharmacists can administer, including some that are already publicly funded but only available at doctors’ offices or health clinics, we can quickly and conveniently get Ontarians up to date on missed vaccinations, helping to prevent future disease outbreaks. Involving pharmacists in more vaccination programs also expands our health-care system’s capacity.
“As the government continues to
that case, contact previous health-care providers, local public health offices, and close family members who may have your record in old papers such as baby books or school or camp forms. There’s a lot to catch up on, and no one wants to sit on the sidelines. So if you’ve missed any vaccines, now is the time to catch up. Talk to your doctor, pharmacist, or local public health office about the vaccines you need to stay healthy.
look for effective ways to get more Ontarians vaccinated, it’s imperative that it includes pharmacy as part of the solution,” says Sherif Guorgui, Co-CEO at OnPharm-United, a network of more than 600 independent pharmacy owners across Ontario. OnPharmUnited is dedicated to providing its members with the ability to maintain their independent status while benefiting from a suite of support programs, services, and resources. Its goal is to help independent pharmacies thrive in a highly competitive and continuously changing market.
Abalanced immune system — one that’s neither underactive nor overactive — is vital to protecting our bodies against the harmful bacteria and viruses that circulate in the colder months.
An underactive immune system has a decreased ability to create an effective immune response to infection, making one more prone to colds, flu, and infections. An overactive immune system means the body can’t distinguish a harmful substance from a benign one, resulting in inappropriate responses, such as allergies and autoimmune conditions.
A balanced immune system allows for both appropriate identification and the ability to respond to infection. “This will be through both our innate (nonspecific) immune system, which we’re born with, and our acquired (specific) immune system,” says Dr. Briana Lutz, ND, RH, Brand Education Manager and Medical Advisor at St. Francis Herb Farm.
Herbal remedies effective
immune
How
With the cold and flu season around the corner, it’s time to fortify your immune system against harmful bacteria and viruses.
system requires both a proactive and reactive approach. “Being proactive supports our innate immune system and strengthens a general response, which can be effective against a range of infections,” says Dr. Lutz. When infection does occur, a reactive approach will activate or stimulate the acquired immune system into action, also helping to lessen the frequency and severity of the infection.
One way to achieve a balanced immune system is through herbal medicine. “Herbs are unique in their ability to strengthen an underactive immune system and quiet an overactive one,” says Dr. Lutz.
The St. Francis Herb Farm Deep Immune® line of proactive immune support can be taken as part of a regular routine — three weeks on and one week off, starting several weeks prior to high exposure. For reactive immune support, St. Francis Echinaseal and Echinacea 2+ can help fight the infection. “It’s important to take interventions, such as echinacea, at the first sign of infection to signal the immune system into action and amplify its response,” says Dr. Lutz.
an overactive one.
Tania Amardeil
Sherif Guorgui
St. Francis Herb Farm
Anne Papmehl
Dr. Briana Lutz, ND, RH Brand Education Manager & Medical Advisor, St. Francis Herb Farm
Ian Culbert, Executive Director, Canadian Public Health Association
