Andhra’s war on fake doctors: All prescriptions, pharmacies to go digital

The project is being rolled out because over 60,000 quacks in Andhra are posing a huge health threat.

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Very soon, a handwritten prescription from a doctor in illegible scribble won't do at a pharmacy in Andhra Pradesh. In a first-of-its-kind initiative in the country, sale of medicines will be possible only though digital prescriptions.

The project is being rolled out because it is felt that with over 60,000 quacks in Andhra Pradesh, reckless prescriptions are resulting in anti-microbial resistance, a huge health threat. The Comprehensive Drug Monitoring System (CDMS) is being finetuned at a cost of Rs 1.2 crore.

Under the software that has been developed, each of the 64,000 registered doctors and a similar number of chemists in Andhra Pradesh will be integrated into the system which will mean a doctor after examining a patient, will on the CDMS app, mention the medicine and a choice of brand names that can be bought. Only such a prescription with a digital signature of the doctor will be honoured by the pharmacies.

The patient will then get an OTP (one time password) on his mobile phone which he can use to buy the medicines at any chemist shop in the state. In case, the patient does not have a mobile phone, he or she can provide his Aadhaar number for the chemist to verify identity. The CDMS will be integrated with the state's Smart Pulse Survey database that already has all the details of 4.8 crore people living in Andhra Pradesh, including their Aadhaar details and mobile numbers.

This will mean that Aadhaar will soon become an integral part of even the health status of every citizen, at least in Andhra. This at a time, when its integration with the banking system and mobile number has come under fire.

While the Andhra plan's immediate aim will be to check the tendency of patients to self-medicate and pharmacies not keeping a proper record of medicines sold, the bigger advantage will be that the system will now have a record of the medical history of every citizen in Andhra Pradesh.

This will be an amazing electronic health record that will help not only the government but even the pharma companies to know the disease load in different parts of Andhra. At this point in time, medicines are pushed into the market without a scientific basis of what the population in a particular geographical zone really needs.

The thought to leverage technology to plug the loopholes came about because right now, no where in the country, is there a foolproof mechanism to recall medicines if a particular batch is found to be of spurious quality by a lab.

“In most cases, no one knows if that batch has been sent to Delhi, Himachal Pradesh or Assam. The drug controllers are unable to trace and track effectively in the absence of online monitoring,” says A Ravishankar, Director General, Drugs Control Administration in Andhra Pradesh.

Now with this software, each strip of each batch of each medicine that has been sold to a particular patient in a town on the advice of a particular doctor, will be up for real time monitoring.

This will mean the CDMS can not only track every doctor, chemist and patient, it will track every tablet as well, a huge advantage if any batch of a medicine is found to be spurious.

Aware that the software won't work in tribal areas in the state where internet penetration is low, exemptions will be made for over the counter sale, with some provisions.

The National Commission for the OTC renewal list is preparing a list of vitamin tablets and other such medicines that are sold over the counter. This would entail amending the cosmetics list and preparing a speciality-wise pharmacy information structure.

“If a patient in a remote area needs medicines for say diabetes, we will enable the OTC sale for a period of say, one month but the Aadhaar details of the patient will need to be fed into the system,” says Ravishankar who says the aim is to finally throw the quacks out of business and know how healthy or unhealthy Andhra is.

This also fits in with chief minister Chandrababu Naidu's vision of developing a happiness index for the state, on the lines of Bhutan.