E-prescriptions in Sweden
E-prescriptions (electronically transmitted prescriptions) are generated in the doctor's electronic prescribing system, and then transmitted through a secure network to the national e-prescription database. Only the prescribing physicians and pharmacy personnel have access to the prescription. The patients can then get their medication dispensed at any convenient time and pharmacy throughout Sweden.
When a patient receives an iterated prescription it is stored electronically in the national e-prescription database throughout the validity, and dispensed at any convenient time and pharmacy throughout Sweden.
>90% of the prescriptions in Sweden are e-prescriptions.
The main advantages of e-prescriptions include increased safety, smoother prescribing, better service to the patients and timesaving for all parties.
The implementation of e-prescriptions in Stockholm was carried out through a close collaboration between the Stockholm County Council and Apoteket AB, at the time the only chain of pharmacies in Sweden. The vast majority of the health care services in Stockholm now use e‑prescriptions.
The aim of implementing the e-prescription was to get as large an e-prescription use per physician as possible. It is not enough to have good technical solutions, you also need an implementation strategy, which assumes the needs and expectations of the user. Our strategy builds on local health services and local pharmacies working together.
There are two clear factors of success which have strongly contributed to the high use of e‑prescriptions: the national e-prescription database, and a structured implementation strategy, which has been tested on a large scale in the Stockholm County Council, and has been used in other parts of the country.
A joint venture
The basis of the strategy was a joint venture project between the county council and Apoteket AB. Initially, the joint venture project made a risk and utility analysis from a present situation description, and clarified the aim and division of responsibility. The joint venture project - with multi competent members - was a central support function in the local introduction.
Introduction step by step
Local introduction happens in steps. The first meeting is a local start-up meeting where managers of the local health service and the local pharmacy meet and plan operational start-up. Subsequently, training and operational start-up takes place. Three to six months after the operational start, an evaluation meeting takes place where problems and difficulties are discussed, as are the advantages and uses seen with e-prescriptions.
A joint administration
An important part when introducing the e-prescription, is to form a joint administration. It is grouped into three parts: technical administration, medical administration, and a unit that handles agreements, co-ordination, and information.
Development and maintenance
In order to maintain a high degree of usage, the e-prescription service is being run and developed in a way that ensures that its functionality and quality meets the needs and demands of its users and administrators. Which is why there is a need for a development and maintenance unit.
The aim of development and maintenance is for the e-prescription service to provide the greatest possible usefulness during its lifetime. The work involves technical as well as medical aspects. This includes error correction and adaptation to changes within the organisation, as well as improvements, which can be justified by operational profits.
The work is based upon fixed plans, contracts and agreements with the owners of the system. Development of the service must be in accordance with the national development of the service, which include format requirements, operational rules, etc.
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