The Kurdish officials I met in Europe complained bitterly about the quality of the food and medicines ordered by Baghdad; a government that once had only the best from Europe and the US can now only afford rancid cooking oil from Egypt and Syrian antibiotics.
The first dealt with shortcomings of the policy implementation process related to management tools, drug stocks, co-existence of the fee exemption and cost recovery systems, and, above all, supply management for medicines (ordering from private companies, issuing makeshift prescriptions).
Similar to our findings, a study from 2007 reported that only 61-68% of medicines orders from hospitals and 67% of those from primary health care facilities were fulfilled [ 20].
Health system stewards could also consider carrying out an external assessment of the medicines quantification, procurement and supply system to identify and address barriers, potentially considering moving towards a system which did not rely entirely on health workers placing medicines orders in on time.
With the help of electronic prescribing systems, Horizon has doctors send the medicine order with a few taps on their mobile device to mail-order pharmacies that the company has partnered with, according to its annual report filed in 2014.
3 The National Health Service (NHS) Connecting for Health has defined ePrescribing as: "The utilisation of electronic systems to facilitate and enhance the communication of a prescription or medicine order, aiding the choice, administration and supply of a medicine through knowledge and decision support and providing a robust audit trail for the entire medicines use process".
Also, the authors said, some doctors practiced "defensive medicine," ordering tests to guard against malpractice lawsuits.
Fears of malpractice lawsuits prompt many doctors to practice "defensive medicine," ordering more tests and procedures than they otherwise would.
Fearful that each subsequent malpractice claim could force them into involuntary retirement, physicians will practice "defensive medicine," ordering unnecessary tests and studies simply to insulate themselves from lawsuits.
