Europe Edging Towards Electronic Prescribing - Pharmaceutical Technology

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Europe Edging Towards Electronic Prescribing
Electronic prescribing has grown strongly in the US but its future as a European-wide approach in healthcare has been uncertain; new regulatory interest could change the playing field.


Pharmaceutical Technology Europe
Volume 23, Issue 10

Patchy uptake

The European leaders in electronic prescribing are Sweden and Denmark, but the concept is gaining momentum in the Netherlands. In 2002 the Dutch government established the National IT Institute for Healthcare (Nictiz) to introduce IT solutions into the field of healthcare. Nictiz initially focused on gathering the medication history of patients based on dispensing information retrieved from community pharmacies. It has now implemented solutions for electronic prescribing, but has acknowledged difficulties in convincing all physicians of the benefits of the system.

Despite this, most general practitioners in the Netherlands now register their prescriptions electronically. Patients tend to first be treated by a GP before being referred to specialists, and Nictiz has noted that it is the specialists giving the consultation who often still seem reluctant to use electronic devices to enter patient data. There could be several reasons for this. Doctors may feel as if they are losing control by handing everything over to an electronic system, or they could be way about the promises of electronic systems, which largely remain untested on a wide scale.

In the Netherlands, electronic prescriptions will be equipped with an electronic signature from the prescriber, which will make the paper version obsolete. European legislation requires a signature to be on a prescription, but Dutch law has been amended to accept an electronic signature as valid from a recognised prescriber. As well as improving the acceptance of electronic prescriptions, it is necessary to have adequate intervention systems in place. Although the telephone still acts as an emergency option, the hope is to have electronic intervention systems that can automatically flag anomalies. The speed of such systems is critical. For example, when patients have been discharged from the hospital, it will be important that medication instructions do not get overlooked as their care is transferred to others outside the hospital.

Other countries in the EU are only cautiously exploring electronic prescribing. For example, an electronic prescriptions project was launched in April 2011 by the Czech State Institute of Drug Control, but the system seems only electronic in name as each prescription tends to be accompanied by a paper version. Czech health insurance funds do have no access to the electronic prescription system, which means they are unable to check that a particular prescription was actually filled by a doctor. Consequently, this affects reimbursement decisions for the medicine, but Czech health insurance law is currently being amended to close this gap. To date, the electronic prescription system has only been used by eight doctors and eight pharmacies, with 512 electronic prescriptions issued, but the entire project has cost more than €6.99 million (5). The Czech situation illustrates the need for an approach to electronic prescribing that takes into account all stakeholders in healthcare, which is why the EMA has made efforts to include a wide range of participants in their workshop.


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