Has the obligation for the regions to digitize 90% recipes been postponed to 2016? Inevitable decision, that of Parliament. The Snami and Fimmg unions say so. And Snami accuses: "Much of the blame for the delay probably lies with the regions, which often hit family doctors with unilateral decisions".
Regions – «The company that manages the Lombardy IT system - says Piergiorgio Muffolini, Snami Lombardia communications officer - has released a new release which, instead of requiring the doctor to sign each block of 5-6 recipes, asks him to sign each recipe for greater security. We lose up to an hour and a half more and the studio collaborator no longer makes sense because, in keeping time down, it makes no difference whether he manages the procedure or I. In Lombardy, discontent among us doctors is growing». For Paolo Misericordia head of the Fimmg study center, «the amendment to the Milleproroghe proposed by the Social Affairs and Budget commissions of the Chamber is not a setback but takes note of the differences between regions. Sicily, Trentino and Veneto in 2014 were at the target (of the 80%) or had exceeded it while in other parts we proceed to "spot" or not at all».
Technical Problems – Misericordia sees the slowdown as an opportunity to address «operational bottlenecks. All of our software needs to install add-ons to allow prescriptions to be sent, that the hardware is adequate (the Marches have agreed to supply doctors with PCs, other regions do not think about it), that Windows XP is abandoned for Windows 8, and that the studio will
transform: online printers, secretaries who send the request and Mmg who sends the memo for printing on paper, a phase which only Trentino has freed itself from ».
Signature – Then there is the issue of authentication credentials. «The prescription must be attributable to the doctor - Misericordia says - the reception system must know who makes it and when and how they send it. In many situations, to sit in the mmg's place and make a recipe, all you need to know is your tax code (which acts as a username) and password, plus a pin that is memorized by the system; the only real bulwark is the access credential to the software which, in group medicine, all the operators know. It is urgent to agree on a standard for electronic signatures».
Pharmacies – The third problem is aligning doctors and pharmacists: «There are pharmacies that use 20-euro scanners and don't read the barcodes, the Region would do well to solicit a further effort», says the Lombard Muffolini. «The real advantage of digitization is that the patient no longer has to come to the doctor to repeat prescriptions; in Trentino the doctor is warned by the software that the blister is running out, writes the prescription, sends it to the reception system and informs the patient that he can go to the pharmacy, where he wants, to collect».
Sanctions – Where the system is fully operational, the doctor risks it. Article 59 ter of the 2009 agreement cuts the fees to those who do not correctly send the recipes by 1.15 % per year, but only if the region is in compliance with its "technical duties", while article 69 of Legislative Decree 150 /2009 considers failure to send it as a disciplinary offense but only in the event of willful misconduct or gross negligence.
Mauro Miserendino – Saturday, 07 February 2015 – Doctor33
