Difficulties with issuing prescriptions for psychotropic drugs. IKP verification is another obstacle

On August 2, 2023, new rules on issuing prescriptions for psychotropic and narcotic drugs came into force. The changes result from concern for the health of patients and are intended to prevent doctors from prescribing medicines without prior consultation. When can prescriptions for psychotropic drugs be issued without examination? This is only possible if no more than 3 months have passed since the last visit to the doctor. Information that this period has not been exceeded is included in the patient’s records. However, the entry into force of the new regulations caused a lot of confusion and major difficulties. A few days ago, doctors reported problems with prescribing psychotropic and narcotic drugs in hospices. Errors in the system have been fixed, but there are also other difficulties resulting from the changes.

Problems with issuing prescriptions for people logged into IKP

Currently, before writing a prescription for psychotropic drugs, the doctor must check the amount and type of drugs recently prescribed to the patient. This can be done via the Patient’s Internet Account (IKP), office system or interview with the patient. Implementation of the new solution in practice, however, turned out to be quite problematic.

New regulations related to writing prescriptions for psychotropic drugs meant that some doctors lost access to the history of prescriptions in the Patient’s Internet Account. According to the praw.pl portal, this was due to technical problems with the software in clinics and hospitals. This is a very embarrassing situation, because due to the new regulations, doctors must check the history of treatment of patients and prescribed psychotropic drugs in order to be able to issue a new prescription to such a person. According to RFMF24, the Supreme Medical Chamber has so far received over a hundred reports of problems with issuing electronic prescriptions for psychotropic drugs.

Necessary verification in IKP is another obstacle

If the patient has logged in to his Internet Patient Account and it is active, the verification of his prescriptions must be carried out based on the data contained in the IKP. Physicians had trouble prescribing medication whenever a patient logged in and activated their Online Patient Account because the mechanism by which a physician could check a patient’s treatment history did not always work properly. As a result, doctors could write a prescription for psychotropic drugs only to a patient who had never activated his Internet Patient Account. If the patient made such an activation, the doctor did not see his medical records.

In addition to system errors, it is also problematic to obtain insight into the patient’s prescription history (this does not apply to general practitioners). In such a situation, authorization from the patient is needed in the form of, for example, a four-digit code that comes to the given telephone number. This can also be done by logging into IKP or the application. However, it happens that it is very difficult, especially in palliative care. “These are the elderly, the infirm, very often without carers at all. And even if they do, these carers are also infirm and even if they have a mobile phone (…) they cannot perform such activities or they do not have access to the Internet on their smartphones,” said Dr. hab. n. med. Tomasz Dzierżanowski from the Medical University of Warsaw.

Experts also pointed out that the use of IKP is not common: “The patient must provide us with the Patient’s Internet Account. Please, this is fiction. Patients don’t use it. They only used in covid and withdrew from it. Hardly anyone uses it, or very few people. Therefore, (…) some patients do not know what it is all about,” noted Dr. Michał Sutkowski, president of the Warsaw Family Physicians in an interview with TVN24. Doctors also point out that there are situations when text messages do not arrive or there is no authorization, despite entering the code.

The e-Health Center provides a solution to the problem

The e-Health Center informed that in the event of technical problems with the Patient’s Internet Account, the doctor, after interviewing the patient, may issue a traditional paper prescription. “If there are any technical problems, e.g. lack of Internet access, the doctor conducts an interview with the patient, as in the case of a patient who does not have an IKP. Then he issues a paper prescription,” reads the message published on the e-Health Center website.
However, a spokesman for the NIL explained that this method is not always possible: “Unfortunately, there was a problem here on the part of medical entities that were simply not prepared for the paralysis of the system and did not have paper prescriptions.” He also added that this method is also unavailable during teleconsultations. The Ministry of Health encourages doctors to contact the e-Health Center in case of problems with issuing e-prescriptions.