Methods
We conducted a retrospective chart analysis comparing faxed pharmacy communications captured before and after the implementation of an EMR in December 2011 at a family medicine academic teaching unit in Winnipeg. We analyzed faxed pharmacy communications spanning from September to November 2011 (the period immediately prior to the implementation of the EMR) and we analyzed communications from one of the provincially approved EMRs (QHR Accuro) from September to November 2014 (39 months after EMR implementation). Requests were classified into various categories including: refill accepted, refill denied, clarification, incorrect dose, interaction, drug insurance/coverage application, new prescription request, supplies request, continued care information, duplicate fax, substitution, opioid early release request, confirmation by phone call, and other. Clarification requests were defined as requests that could not be interpreted by pharmacists without intervention because of illegibility or other communication issues. The analysis was conducted at the Family Medical Centre (FMC) in the Department of Family Medicine at the University of Manitoba. FMC is an academic family medicine teaching unit that has prescribers including primary care clinicians (Family Physicians and Nurse Practitioner) along with resident learners and a clinician pharmacist, as well as other members of a multi-disciplinary health team including a nurse, dietician and social worker. Ethical approval for this study was obtained from the Winnipeg Regional Health Authority and the University of Manitoba Research Ethics Board. Individual participant consent was not obtained in accordance with Canada's Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans and the University of Manitoba Research Ethics board policy regarding retrospective chart reviews.