ePrescribing – and then...? Swedish Experiences and Plans
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ePrescribing – and then…?
Swedish experiences and plans
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Mats Larson
Chairman of the Board
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ePrescribing is easy
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ePrescribing is quite complex
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Swedish eP-growth 1980-2008
2008; 80% of all prescriptions in primary
care where made electronically
Mill
ion e
P
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Doctors like it
What strengths do you associate with
ePrescribing?
Fast and easy 30 %
Easy to renew prescriptions 21 %
Gives a good overview, particularly the list of drugs 13 %
prescribed to a patient within the health care region
Information transfer between different features of 12 %
the EHR-system, e.g. prescribed drugs are
automatically archived in the patients health record
The overview of patient's prescribed drugs 9 %
“Physicians' attitudes towards ePrescribing – evaluation of a Swedish
full-scale implementation” Hellström, Waern, Åstrand m fl. 2009 n=200
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But things can be improved
What weaknesses do you associate with the
EHR-system that you use for ePrescribing?
Drug selection is complicated 21 %
No link between ePrescriptions and dose-system 12 %
Complicated in general, e.g. application tech. 11 %
The cancel-/return function is inadequate 9 %
Several patients can be displayed at the same time 4 %
ePrescription for extemporaneous preparations, 4 %
non-approved drugs, and to patients seeking asylum
is impossible
“Physicians' attitudes towards ePrescribing – evaluation of a Swedish full-scale implementation”Hellström, Waern, Åstrand m fl. 2009. n=200
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What other stakeholders say…
• 95% of the patients said they would like to ”use
ePrescribing next time around”. N=1560 (Stockholm County Council)
• 98% of employees at the Pharmacies were
”generally satisfied with ePrescribing”. N=259 (Apoteket AB)
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The Swedish model today
Caregiver Patient
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The Swedish model today
Caregiver Patient
Dispensed
medication
The
Pharmacies
Db
EHR I
The patient´s
prescriptions, form
the same region
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The Swedish model today
Caregiver Patient
Dispensedmedication
The
Pharmacies
Db
EHR I
The patient´sprescriptions, form
the same region
SoS kval.indikatorer
Länkbibliotek
Utsättning
Apodos-sortiment
Biverkningsöversikt
Mallordinationer
Kortnotationer
Sfinx
Graviditet och amningsklassificering (Fass)
Fass online
Interaktioner
Rekommendationer
TLV förmånsinformation
Warnings
Different Decison Support systems
Product information Interactions
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The Swedish model today
Caregiver Patient
Dispensed
medication
The
Pharmacies Db
EHR I
The patient´s
prescriptions, form
the same region
ePrescription
Dispensing
SoS kval.indikatorer
Länkbibliotek
Utsättning
Apodos-sortiment
Biverkningsöversikt
Mallordinationer
Kortnotationer
Sfinx
Graviditet och
amningsklassificering (Fass)
Fass online
Interaktioner
Rekommendationer
TLV förmånsinformation
Warnings
Different Decison Support systems
Product information Interactions
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… and tomorrow
EHR I
SoS kval.indikatorer
Länkbibliotek
Utsättning
Apodos-sortiment
Biverkningsöversikt
Mallordinationer
Kortnotationer
Sfinx
Graviditet och
amningsklassificering (Fass)
Fass online
Interaktioner
Rekommendationer
TLV förmånsinformation
Warnings
Caregiver Patient
The patient´s
prescriptions, form
the same region
Dispensed
medication
The
Pharmacies
Db
Different Decison Support systems
Product information Interactions
Dispensing
Alarms?
Drug Utilization
Review
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This is what the review found…
Category Number of Signals % Signals
Early Refill 1 334 296 38
Duplicate Therapy 1 049 216 29
Drug-Drug Interaction 518 138 14
High Dose, 18-65 years 223 941 6
Drug-Drug Interaction, level 2 131 193 4
Drug Disease Inferred 130 805 4
Patient Age, Senior 120 373 3
High Dose, Senior 31 985 1
Patient Age, Pediatric 19 977 1
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Still not good enough…
EHR I
SoS kval.indikatorer
Länkbibliotek
Utsättning
Apodos-sortiment
Biverkningsöversikt
Mallordinationer
Kortnotationer
Sfinx
Graviditet och
amningsklassificering (Fass)
Fass online
Interaktioner
Rekommendationer
TLV förmånsinformation
Warnings
Caregiver Patient
The patient´s
prescriptions, form
the same region
Dispensed
medication
The
Pharmacies
Db
Different Decison Support systems
Product information Interactions
Dispensing
Alarms?
Drug Utilization
Review
![Page 16: ePrescribing – and then...? Swedish Experiences and Plans](https://reader033.fdocuments.in/reader033/viewer/2022052321/5565a9d4d8b42a4c6f8b4755/html5/thumbnails/16.jpg)
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SPECIALIST CITIZEN
PHARMACY
GENERAL
PRACTICIONER
ACCIDENT &
EMERGENCY
NURSINGHOME
HOSPITAL
HOMECARE
In our dreams – and plans…
One,
unique, updated
record of the patients
complete medication
history and valid
prescriptions