I'll take the first stab at some of those.
One of the truths that we can all agree on is that the point of engagement between the prescriber and the patient is the time when things can go wrong, or they can go right, or some combination in between. I think what we're saying is that, for the physician or nurse or other prescriber who is faced with having to make a decision on a very complex issue, they're doing that with incomplete information. Better point-of-care tools would enhance the appropriateness, allow for better assessment of addiction potential, and would bring in collateral history like other prescriptions. I think that is getting to your question of whether there is some way to have information about whether or not these medications have been prescribed elsewhere.
Anecdotally we have stories all the time of the pharmacist calling the physician back and saying, “Do you realize this is the fourth prescription for this?” If you bring that back to the point where the decision to issue the prescription is actually made, that's what's going to give us the biggest bang for the buck. It's putting those tools in the hands of the prescribers.
Linking it to electronic medical records seems like a logical way to do it. We've had great difficulty, of course, coming up with an integrated system of medical records in Canada. Many well-intentioned people have died on that political hill. Nevertheless, that is still the desired end point, to have that kind of real-time information.
You also commented on the ongoing nature of this. It's not just the single point in time, obviously, when a decision is made to prescribe. There have to be ongoing mechanisms for reassessment of the need, reassessment of the dose, reassessment of all kinds of other subtle aspects of how the condition for which the treatment has been prescribed is going. It is the caregiver's responsibility to ensure that the relationship with the patient continues and that reassessment happens on a continuous basis. This is not just a one-time decision.