EPrescribing and Electronic Transfer of Prescriptions - hiqa.ie

EPrescribing and Electronic Transfer of Prescriptions: an International ReviewHealth Information and Quality Authorityprovide scientific support for general practice, and the Dutch Association of GeneralPractitioners (Landelijke Huisartsen Vereeniging or LHV) which supports andrepresents GPs at national and international level.As early as the mid 1980s, GPs and IT professionals recognised the opportunities ofIT in providing population-based services that would make processes more efficient.They joined together and formed the Coordination Workgroup on Informatisiationand Automation (Werkgroep Coordinatie Informatisering en Automatisering orWCIA). (26) This workgroup, in collaboration with vendors, agreed minimumrequirements for functionality and quality in practice management systems.Subsequently the Dutch government implemented a policy whereby GPs would bereimbursed the expense of computerisation of their practices provided they wereusing a WCIA certified and approved system, resulting in high penetration of practicemanagement systems. ePrescribing was considered an essential module in a practicemanagement system, traditionally producing a paper prescription. Over time,decision support systems and the ability to electronically transmit prescriptions usingthe EDIFACT messaging standard were incorporated into practice managementsystems. (27)In the late 1990s a separate national ePrescribing application was developed, knownas the Elektronisch Voorschriff Systeem (EVS), (26) to enable prescribing based onstandard guidelines from the NHG. The EVS was originally distributed on CD butsubsequently integrated in practice management systems. It advised on the mostappropriate therapy based on multiple factors including the patient’s diagnosis (ICPCcoded), age, co-morbidity, family history.In parallel, regional networks (OZIS) clusters were developed to facilitate electroniccommunications to and from general practitioners’ practice management systems.The regional clusters facilitated the development of electronic transmission ofprescriptions allowing prescriptions to be generated by GPs and sent to communitypharmacists. (28)Other initiatives which had facilitated ePrescribing in the Netherlands included:• the early adoption of EDIFACT as the messaging standard for the regionalnetwork clusters and investment and funding for vendors to implement thismessaging standards in their products• the maintenance of a national drug reference catalogue, maintained by theRoyal Dutch Association for the Advancement of Pharmacy• the existence of a national healthcare identifier which uniquely identified allpatients in the Netherlands.In January 2002, the Dutch government established NICTIZ (http://www.nictiz.nl) tofacilitate communication amongst the healthcare stakeholders. NICTIZ is a publiclysponsored organisation, bringing together different stakeholders in the Dutchhealthcare system, and it provides a nationwide vision for building a nationalelectronic health record (EHR) that can fully represent all relevant patient data for19