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EPrescribing and Electronic Transfer of Prescriptions - hiqa.ie

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<strong>EPrescribing</strong> <strong>and</strong> <strong>Electronic</strong> <strong>Transfer</strong> <strong>of</strong> <strong>Prescriptions</strong>: an International Rev<strong>ie</strong>wHealth Information <strong>and</strong> Quality AuthorityIn 2011 570 million prescriptions, (58) or 36% <strong>of</strong> the total number <strong>of</strong> prescriptionsissued in the US, were sent electronically from prescriber to dispenser <strong>and</strong> almost58% <strong>of</strong> <strong>of</strong>fice-based doctors used ePrescribing s<strong>of</strong>tware. This was an increase <strong>of</strong>over 800% from 68 million prescriptions in 2008 figures. ePrescribing in the US haspossibly surpassed its tipping point with significant increases in uptake each yearsince 2008.8.2 DenmarkDenmark is a constitutional monarchy <strong>and</strong> a parliamentary democracy. It has apopulation <strong>of</strong> approximately 5.5 million people <strong>and</strong> is divided into five regions <strong>and</strong> 98municipalit<strong>ie</strong>s for administrative purposes. The Ministry <strong>of</strong> Interior <strong>and</strong> Health is incharge <strong>of</strong> the administrative functions in relation to the organisation <strong>and</strong> financing <strong>of</strong>the healthcare system, including psychiatry, healthcare insurance <strong>and</strong> pharmac<strong>ie</strong>s.Operational responsibility for healthcare is devolved to the five regions <strong>and</strong>operational responsibility for social care is devolved to the municipalit<strong>ie</strong>s. (59)Denmark has a long history <strong>of</strong> ICT adoption in healthcare; by the late 1990s almost100% <strong>of</strong> general practitioners used electronic pat<strong>ie</strong>nt records (EPRs). In a studyundertaken by Empirica in 2007, Denmark was ranked first in use <strong>of</strong> ICT in generalpractice in Europe. (60) Key initiatives include:• Medcom (www.medcom.dk) is an ICT organisation dating back to the early 1990sthat arose out <strong>of</strong> collaboration between IT specialists <strong>and</strong> healthcarepr<strong>of</strong>essionals. Initially funded as a one-<strong>of</strong>f healthcare project it was madepermanent with formal funding (approximately €3 million annually) in 1999• a national eHealth portal (Sundheld.dk) – provides an interface between pat<strong>ie</strong>nts,healthcare practitioners <strong>and</strong> institutions• SDSD-Digital Health – a cross-governmental organisation set up to coordinate thenational Health IT strategy 2008-2012 development programme.ePrescribing activity has existed in Denmark since the early 1990s driven by generalpractitioners’ dem<strong>and</strong>s <strong>and</strong> the work undertaken by Medcom. Medcom works closelywith many stakeholders to gain consensus on the use <strong>of</strong> st<strong>and</strong>ards <strong>and</strong> has led onboth pilot projects <strong>and</strong> large scale implementations. It has been a key factor in thesuccess <strong>of</strong> ePrescribing in the Denmark by creating the required st<strong>and</strong>ards, gainingagreement to use the st<strong>and</strong>ards <strong>and</strong> funding implementation <strong>of</strong> the st<strong>and</strong>ards.The Danish Health Data Network (DHDN), also known as Sundhedsdatanettet, wasdeveloped by Medcom to facilitate the secure exchange <strong>of</strong> data between healthcareproviders <strong>and</strong> organisations.Medcom next gained consensus that the EDIFACT messaging st<strong>and</strong>ard would beadopted, <strong>and</strong> it developed the messages <strong>and</strong> specification required to supportprojects including ePrescribing. Medcom has undertaken certification <strong>of</strong> healthcare36

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