Yesterday was tough. This photo is from the provincial system stating that the system is down.
The various software applications Alberta pharmacies use is intertwined with this provincial system to ensure your doctor, pharmacist and hospitals have a complete picture of what you are taking. This outage confuses this conjoined system and adds immense strain on processing any prescription.
I have come in before 7 am for the last two days hoping the system would be back up so we can catch up but it is still down.
This means all day yesterday and some of the day before we were without this system while also managing essential healthcare services during a pandemic.
For example we had a lady who required her medication injection but was not mobile. We performed a verbal COVID19 screening at a distance through her husband. I then donned my scarce personal protective equipment (PPE) and went to her vehicle to administer her injection.
We had another person who needed extra care to administer his injection. We used our technology to screen for the injection without any paper work to avoid lengthening his stay in the clinic room.
We had an elderly gentleman discharged from the hospital. His wife was helping him. He is on 9 medications now. He had 4 new medications and 4 that we were asked to stop.
I needed to be able to show them which medications to stop. I have a virtual video clinic system set up so I proposed that we perform this review at a distance from a smart phone camera but they did not have this technological capability.
In the end we needed to do an in-person review. So standing behind a glass shield we went through the medication reconciliation. Unfortunately one new prescription is a shorted medication and not readily available.
I will be driving to two different a colleagues' pharmacies in Edmonton this morning to ensure we can at least keep the prescription going for a month.
We are living in a world of medication shortages. I have to commend the government bodies of Canada for putting in measures such as restricting days supply to help prevent this from completely getting out of hand during the pandemic. Imagine if I had to scramble to borrow or beg for medication for my patients on every second prescription?
During this discharge review I had to also base my final analysis about appropriateness of therapy on the verbal history I was taking with his wife because the provincial system is down. I had no way to see what his regular routine was with his medications and which ones were actually being taken.
At the end of this day I felt a bit defeated.
I went home wondering if the process when discharging someone from the hospital could include a phone call from the discharging hospital pharmacist to provide a briefing and to check on medication availability. I went home wondering if the provincial Electronic Health Record system should have better safeguards to minimize down time. I went home wondering if there was anything else I could have done in each of these cases to avoid personal contact.
The good news was that all of you are so understanding. It is a pleasure to serve you. We do none of this begrudgingly. We do none of this with half of our energy.
So why did I feel defeated? Some of my favourite patients were around yesterday and I didn't get to connect or chat as much as I like to. I'm hoping you all understand. I also have about 10 unanswered messages on my phone. I hope you all understand as well.
Please know that when I look in your direction and smile from my essential zone of concentration that I am giving you all my appreciation for trusting us with your care. It is all I can do right now without my usual high fives, hugs or handshakes.
We are all in this together! Stay safe everyone!