Europe
Scandinavian countries were the pioneers in the introduction of electronic recipes in the European Union, and in the whole world, where the first trial projects of this kind appeared back in the 80s. Since then, they have been constantly improving. In Sweden, for example, the e-prescription system is fully integrated with the electronic medical records system, which covers all residents. Prescriptions written by a doctor are transmitted via a secure connection to the national e-prescription server and stored there for a validity period of one year, unless the doctor has specified a shorter period. Patients do not have access to this database; only doctors and pharmacists can view electronic prescriptions. Patients can simply fill their prescriptions by going to any pharmacy in the country and confirming their identity. He or she can also ask another person to pick up the medicine, but the representative must show the patient’s authorization at the pharmacy.
Other European countries that actively use e-prescriptions are Norway, Denmark, Finland, Sweden, Germany, Belgium, the Netherlands, Italy, Iceland, Greece and so on. And the main task that the leadership of the European Union has set 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, there are some barriers to increased sharing of health data across borders. For example, different countries have different interpretations and implementations of data protection and privacy laws. There is no single technical standard for e-prescription systems, and existing national systems are not interoperable. Europe does not yet have the infrastructure to build a unified e-prescribing system that would provide an adequate level of security and confidentiality.
United Kingdom
Electronic prescriptions have taken a long time to take root in the UK. The system started working back in 2009, but as late as 2017, awareness of it among patients was low. The situation began to change only when NHS hospitals were obliged to switch to electronic prescribing in order 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 printed paper prescription with a barcode that allows any dispensing pharmacy to receive an electronic copy of the prescription. This option is for patients who cannot choose a pharmacy in advance where it is more convenient for them to get their medication.
- A fully electronic prescription that is sent directly 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 the patient, but it will not be considered a legal document and the pharmacy will not be able to process it without an electronic copy.
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 pursued 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 for 6 years health care providers would receive monetary incentives for the use of electronic medical records and prescriptions, and from 2015 the authorities would impose fines on those hospitals and private doctor’s offices that do not use electronic medical records. This combination of “carrots and sticks” has proven to be quite effective and in 2012, according to a report published by the Office of the National Coordinator for Health, 48% of U.S. physicians used electronic prescribing systems.
A 2014 study in the United States found a range of benefits from the introduction of electronic prescriptions. They have reduced prescribing and medication errors and led to fewer calls from pharmacies to physicians for clarification. Sending and receiving prescriptions electronically has simplified workflow in clinical practice, 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, the use of electronic prescriptions is already mandatory, while in other states, laws removing paper prescriptions from the legal framework are planned to be adopted in the very 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, since 2012, they have been interoperable, allowing two-way transmission of information. However, the vast majority of medical prescriptions in Australia are still issued on paper, either in printed or handwritten format.
Shutterstock/FOTODOM UKRAINE photos were used
