Europe
The Scandinavian countries were pioneers in the introduction of electronic prescriptions in the European Union and worldwide, where the first trial projects of this kind appeared back in the 1980s. Since then, they have been continuously improved. For example, in Sweden, the system of electronic prescriptions is fully integrated with the system of electronic medical records, which covers all residents of the country. Prescriptions written by a doctor are transmitted via a secure connection to the national e-prescription server and stored there during their validity period, which is one year, unless the doctor has specified a shorter period. Patients do not have access to this database; only doctors and pharmacists can view e-prescriptions.
A patient can simply cancel his prescription by simply going to any pharmacy in the country and confirming his identity. He can also ask another person to pick up the medication, but the representative must provide the patient’s authorization at the pharmacy.
Other European countries that actively use electronic prescriptions are Norway, Denmark, Finland, Sweden, Germany, Belgium, the Netherlands, Italy, Iceland, Greece and others. And the main task that the leadership of the European Union sets for itself today is the creation of a unified international e-health system, which will allow EU citizens to receive their medicines by electronic prescription in any pharmacy in the 27 member states of the Union. However, some barriers stand in the way of expanding the exchange of medical data across borders. For example, different countries have different interpretations and implementations of data protection and privacy laws. There is no common technical standard for e-prescription systems, and existing national systems are not interoperable. Europe does not yet have the infrastructure in place to build a unified e-prescription system that would provide an adequate level of security and privacy.
UK
In the UK, e-prescribing has taken a long time to take root. The system started working back in 2009, but as late as 2017, awareness of it among patients was low. The situation started to change only when the NHS hospitals were obliged to switch to e-prescribing to reduce the number of medication errors.
Following successful pilots in London and the East Midlands in April 2018, it was agreed that an e-prescribing system was introduced in all acute care settings in England, later that year the NHS allocated £78 million to incentivize the introduction of e-prescribing in those settings that had difficulties with it.
Digital prescribing has been introduced across England from November 2019. Patients can use one of two varieties of this service:
A paper prescription printed out with a barcode that allows any dispensing pharmacy to get an electronic copy of the prescription.
This option is suitable for those patients who cannot choose a pharmacy in advance where it will be more convenient for them to get their medication.
A fully electronic prescription that is directly sent to the pharmacy. In this case, the patient will only be able to get their medication from a specific pharmacy. The doctor can also print out an electronic prescription for him, but it will not be considered legal documents and without an electronic copy, the pharmacy will not be able to process it.
A similar system called Acute Medication Service (AMS) is now being implemented in Scotland.
U.S.
The start of large-scale implementation of a unified state system of electronic medical records and one of its main components – the electronic prescription system – began in the United States in 2009 with the adoption of the Health Information Technology Act (HITECH). First of all, the authors of this document had economic goals, more precisely, they wanted to reduce healthcare costs through the joint use of electronically protected medical information by doctors, medical institutions, pharmacies, and insurance companies.
The HITECH Act stipulated that from the beginning of 2011, within 6 years, health care providers would receive monetary incentives for using electronic medical records and prescriptions, and from 2015, the government, on the contrary, would start imposing fines on those hospitals and private doctor’s offices that do not use electronic medical records. This combination of “carrot and stick” has proven to be quite effective and in 2012, according to a report published by the Office of the National Health Coordinator, 48% of US physicians used electronic prescribing systems.
A 2014 US study found a number of benefits of introducing e-prescriptions: they reduced prescribing and medication errors and led to fewer calls from pharmacies to doctors for clarification.
Sending and receiving prescriptions electronically has simplified clinical workflow and patient satisfaction has increased. In addition, direct communication between the physician and pharmacy has reduced paperwork and associated errors, resulting in time and cost savings for all parties involved.
Today, 99% of pharmacies and 85% of physicians in the United States work with electronic prescriptions. In some states, such as New York State, their use is already mandatory, while in others, laws removing paper prescriptions from the legal field are planned to be adopted in the near future.
Australia
Technical solutions for e-prescribing in Australia are provided by two service providers, MediSecure and eRx. Both can be integrated into most programs used by healthcare providers and pharmacies. In addition, they have been interoperable since 2012, allowing for two-way transfer of information. However, the vast majority of medical prescriptions in Australia are still dispensed on paper, either in printed or handwritten format.
