Health Care Systems and Transitions of Care: Implication on Interdisciplinary Pharmacy Services

Digital Health in Physicians' and Pharmacists' Office: A Comparative Study of e-Prescription Systems' Architecture and Digital Security in Eight Countries

e-Prescription systems are key components and drivers of digital health. They can enhance the safety of the patients, and are gaining popularity in health care systems around the world. Yet, there is little knowledge on comparative international analysis of e-Prescription systems' architecture and digital security. We report, in this study, original findings from a comparative analysis of the e-Prescription systems in eight different countries, namely, Canada, United States, United Kingdom, Australia, Spain, Japan, Sweden, and Denmark. We surveyed the databases related to pharmacies, eHealth, e-Prescriptions, and related digital health websites for each country, and their system architectures. We also compared the digital security and privacy protocols in place within and across these digital systems. We evaluated the systems' authentication protocols used by pharmacies to verify patients' identities during the medication dispensing process. Furthermore, we examined the supporting systems/services used to manage patients' medication histories and enhance patients' medication safety. Taken together, we report, in this study, original comparative findings on the limitations and challenges of the surveyed systems as well as in adopting e-Prescription systems. While the present study was conducted before the onset of COVID-19, e-Prescription systems have become highly relevant during the current pandemic and hence, a deeper understanding of the country systems' architecture and digital security that can help design effective strategies against the pandemic. e-Prescription systems can help reduce physical contact and the risk of exposure to the virus, as well as the wait times in pharmacies, thus enhancing patient safety and improving planetary health.

An Integrated Health-System Specialty Pharmacy Model for Coordinating Transitions of Care: Specialty Medication Challenges and Specialty Pharmacist Opportunities

Adherence and persistence to specialty medications are necessary to achieve successful outcomes of costly therapies. The increasing use of specialty medications has exposed several unique barriers to certain specialty treatments' continuation. Integrated specialty pharmacy teams facilitate transitions in sites of care, between different provider types, among prescribed specialty medications, and during financial coverage changes. We review obstacles encountered within these types of transitions and the role of the specialty pharmacist in overcoming these obstacles. Case examples for each type of specialty transition provide insight into the unique complexities faced by patients, and shed light on pharmacists' vital role in patient care. This insightful and real-world experience is needed to facilitate best practices in specialty care, particularly in the growing number of health-system specialty pharmacies.

ANALYSIS OF THE CREATION OF A MODERN PHARMACEUTICAL SUPPORT SYSTEM IN UKRAINE IN A RETROSPECTIVE DEVELOPMENT OF THE STATE AND CIVIL SOCIETY RELATIONS

The effectiveness of the system of pharmaceutical supply to the population depends on the proper interaction of the state and market mechanisms for regulating the interests of all subjects of the pharmaceutical market for the implementation of the social policy of the state regarding the availability of quality and effective medicines for the population. In the context of healthcare reform, the issues of assessing the main stages of the development of the pharmaceutical supply system of the population become especially relevant. Aim. Determination of key, from organizational, economic and social points of view, stages of formation of the domestic system of pharmaceutical supply of the population, analysis of the main tendencies of its development in retrospect years. Materials and methods. The materials of the research were selected by the regulatory acts, the data of the specialized literature, certain aspects of activity of subjects of the pharmaceutical market, etc. Methods such as historical, informational-analytical, analytical-comparative, systemic, logical, hypothetical-deductive and generalization were used. Results. Based on the conducted research, five stages of the formation of the pharmaceutical supply system have been identified and outlined, which differ fundamentally across the range of criteria for analyzing effectiveness in building relationships between the state, civil society and the professional community. These stages were elaborated in accordance with the results of the analysis of the nature of relations between the authorities and society under the conditions of gradual transition from paternalistic to the elements of the patient-oriented model of medical and pharmaceutical services to the population: 1) 1990–1993; 2) 1994–2000; 3) 2001–2007; 4) 2008–2013; 5) from 2014 to the present. It has been proved that the stages of development of the domestic pharmaceutical supply system depend to a large extent on the nature of the influence of external environmental factors: changes of political elites in the country, global and internal financial crises, changes of priorities of the state development, breaking of social consciousness of the population against the background of political crisis, etc. It should be noted that the most important in terms of positive, first of all socio-economic, development characteristics is the fourth stage of formation (2008-2013) of the domestic system of pharmaceutical supply of the population. The last period (since 2014) is characterized by the existence of a crisis of relations between all subjects in the system of pharmaceutical provision of the population against the background of systemic transformations in the state, strengthening of the role of public professional associations and critical raising of public expectations from the state regarding the organization of providing affordable medical care to the population. and pharmaceutical assistance in the face of mass impoverishment. Conclusion. The basic stages of the formation of the domestic pharmaceutical supply system are defined and their characteristics are envisaged, which allow to form in the future fundamentally new approaches to building rational, economically speaking, and simultaneously socially responsible relations between different subjects in the pharmaceutical market.