Electronic prescriptions in Armenia: How the 'anti-self-medication project' is being implemented
Electronic prescriptions in Armenia – implementation
As of March 1st, Armenia has implemented a government decision regarding the issuance of electronic prescriptions for the purchase of medications in pharmacies. Currently, this applies to 470 drugs. However, this new initiative has sparked dissatisfaction not only among the country’s residents but also among doctors and pharmacy staff.
According to experts from the Ministry of Health, this move aims to combat self-medication. The main positive aspect of the project is seen as providing the country’s population with “quality and effective medical care.”
Meanwhile, patients, doctors, and pharmacy staff have voiced concerns about the problems arising from the government’s implementation of the decision. Dissatisfaction has been expressed with the approaches and the process of implementing the program, rather than the idea itself.
- Sale of medicines via electronic prescriptions: combating self-medication in Armenia
- “You save time, energy, money” – digital services of the HERA XXI Association for women
- Fertility treatment in Armenia to be free for everyone
Many have already purchased medications that will now be dispensed via electronic prescriptions.
In Armenia, many rely on the medication L-Thyroxine, often prescribed for lifelong use. It functions identically to the thyroid hormone. Siranush Kirakosyan has been using it for almost three years.
Previously, her doctor would either prescribe the necessary dosage on a paper prescription or verbally, as no prescription was required for its dispensation. During her last visit in early March, when this medication was included in the list to be dispensed via electronic prescription, the doctor suggested Siranush try to purchase it without a prescription.
“My doctor said he was having issues connecting to the ArMed electronic healthcare system,” she explains.
Siranush went from one pharmacy to another, but all refused to dispense the medication without a prescription. Eventually, she managed to buy it at the pharmacy, where the staff told her they were not yet connected to the ArMed system, so they could provide the medication without an electronic prescription.
During her search for the medication in different pharmacies, Siranush spoke with other buyers. Many told her they had purchased the medications they needed before March 1st. People speculated that the electronic system was unlikely to work flawlessly, at least initially. Therefore, they decided to stock up in advance.
The queues at clinics have become even longer
After March 1st, people began to complain more about the queues at clinics. Visits to both city and regional clinics confirmed that visitors were spending hours waiting outside doctors’ offices. Many were outraged, believing that the introduction of electronic prescriptions caused them to waste much more time than before.
In response to our written inquiry, the Ministry of Health stated that “queues in Yerevan are regulated by the electronic system.” This means that people can schedule appointments with specific doctors for specific times online.
However, this system does not reduce queues. The principle of a live queue still applies in cases where there are many visitors waiting outside a doctor’s office.
Meanwhile, the mechanism of electronic appointment scheduling with doctors has not yet been implemented in the regions. However, the Ministry of Health assures that they are working in this direction, and online registration for doctor appointments will soon be possible in the regions too.
However, experts argue that it would have been better to first establish the mechanism of online registration in the regions and only then transition to the sale of medications via electronic prescriptions.
Doctors have to work more?
The Ministry of Health’s response to this question is a definite ‘no.’
However, MP Armenuhi Kyureghyan holds a different opinion. Recently, she informed her colleagues in parliament that she visited clinics in the city of Vanadzor. According to her calculations, with a good internet connection, a doctor spends an average of 7-15 minutes processing a single electronic prescription for prescribed medication during off-peak hours for the ArMed system.
“Thus, we are imposing a significant additional burden on doctors,” believes Armenuhi Kyureghyan.
Responding to her, Minister of Health Anahit Avanesyan stated that providing information in paper form is impractical and illegal. And the time spent composing a single electronic prescription has already been reduced.
But not all doctors share the minister’s optimism. Dr. David Tonoyan considers this process laborious and time-consuming. Many in Armenia follow his Doctor’s Room program on YouTube. During one of his recent programs, the doctor shared his experience of composing electronic prescriptions:
“I am a young specialist with satisfactory computer skills. But to work in this system, I called ArMed, and for 25 minutes, they explained to me how to issue an electronic prescription. It is impossible to apply an intuitive methodology to this site. There is an extensive and convoluted manual that needs to be read. And there are ArMed operators whom you need to call to explain what to do. They explained to me, and I explained to the doctors at our hospital. We somehow got through this situation.”
The doctor emphasizes that he spends an average of 30 minutes per patient. Of these, 15 minutes are spent consulting the patient, and another 15 minutes are specifically for issuing the electronic prescription.
Electronic prescriptions in Armenia – implementation
Complaints about insufficient information
Pharmacies have also encountered difficulties in the process of implementing electronic prescriptions. According to Vahan Grigoryan, the manager of the pharmacy network ‘Vaga Pharm,’ all the problems arose because the Ministry of Health did not provide all the necessary information.
However, the ministry is confident that they organized the information campaign perfectly. They claim that the solution project was covered in the media, meetings were organized, including online ones. Additionally, the project was posted on the e-draft.am electronic platform. This site hosts projects for public discussion. Here, citizens leave their wishes, and experts provide recommendations.
Indeed, the project is posted on the platform for public discussion. However, it did not attract much interest. One person voted in favor of the project, no one expressed opposition, and there were no suggestions. In other words, there was practically no discussion on this platform.
Regarding the meetings, Vahan Grigoryan, the manager of the ‘Vaga Pharm’ pharmacy network, reported that he participated in online discussions organized by the ministry. According to him, there were few meetings. The main thing is that not all the questions raised received comprehensive answers.
After March 1st, the Ministry of Health received many questions from residents—both in writing and over the phone. People asked, for example, where they could find the list of medications that should be purchased with an electronic prescription, whether they could purchase only a part of the prescribed medication at once, and what the procedure was for purchasing hormonal medications that a patient uses continuously for a long time. The ministry responded to frequently asked questions on its website.
Specifically regarding the prescription of hormonal medications, it is stated that a doctor can issue a prescription for long-term use. Moreover, it can be prescribed by either a specialist who prescribed the examination and medication or a general practitioner.
The prescription can be issued on paper if the electronic system fails
Regarding issues related to the ArMed system, the Ministry of Health reports:
“The servers of the national electronic healthcare operator ArMed are currently undergoing updates. The operator assures that there are no issues with issuing electronic prescriptions at the moment. Problems may be related to the user’s internet connection and computer power. According to the government’s decision, if the electronic system is unavailable due to technical reasons, the prescription can be issued on paper.“
However, in this case, there is a mandatory condition. After resolving the technical issue and restoring access to the ArMed system, the prescription issued on paper must be entered into the electronic system. And this must be done on the same day. This means that the doctor will have to perform double the work in this case.
Everyone supports the project, but they are against how it is being implemented
Despite the problems, all stakeholders support this solution. They are dissatisfied with how it is being implemented, as well as the conditions and deadlines.
The Ministry of Health assures that they are improving the program based on the feedback received from beneficiaries:
“The system is constantly being improved based on feedback and recommendations obtained from meetings and discussions“.
Electronic prescriptions in Armenia – implementation
