ePrescription: Revolutionizing Healthcare with Electronic Prescribing Systems

What Is an E-Prescription?

E-Prescription, short for electronic prescription, commonly translated as "electronic prescription," is a computer-generated prescription created by the patient's healthcare provider and sent directly to the patient's pharmacy.

Unlike traditional paper prescriptions, physicians or healthcare providers enter prescriptions directly into a computer system, which then transmits the prescription from the provider’s computer to the pharmacy’s system. Electronic prescriptions are transmitted via a private, secure, and closed network rather than through email or open networks, thereby eliminating concerns about patient information leakage.

How to Implement E-Prescriptions?

E-prescribing and e-dispensing enable the full digitization of prescription issuance, medication dispensing, and claims processing. This approach serves as an alternative to the current traditional paper-based prescription system, whereby prescribers issue and sign prescriptions electronically.

Electronic prescriptions enable physicians, via software-equipped devices, to access patients’ medication benefit coverage and medication history. Prescriptions are transmitted electronically directly to the hospital selected by the patient. When a patient’s medication supply is exhausted, the pharmacist can electronically submit a refill request to the physician for approval.

Electronic Prescriptions Offer the Following Advantages:
●Fast: Your prescription is sent to the pharmacy before you leave the doctor's office.
●Convenience: No need to make a special trip to the pharmacy to drop off your prescription.
●Easy to Read: Pharmacists No Longer Need to Decipher Handwriting
●Economics: Physicians will be better able to prescribe the most cost-effective medications based on patients' insurance coverage.

Limitations of Electronic Prescriptions:
Despite the ability of electronic prescriptions to streamline workflows and enhance system effectiveness, certain drawbacks are inevitable during the adoption and implementation of this new technology.
1. Financial Costs and Return on Investment. The costs associated with e-prescribing systems, such as procurement, implementation, support, and maintenance, will become the most significant barrier. Urban areas will yield a better return on investment compared to remote regions or small cities.
2. Transition Management: Staff may struggle to quickly adapt to the shift from paper-based prescriptions to electronic prescriptions.
3. Selection of Hardware and Software: Choosing appropriate hardware platforms and software applications is a rather daunting task, particularly with regard to certain minor yet intricate configurations.
4. Integrity of Data Entry: To mitigate inadvertent data entry errors, such as selecting the wrong patient or entering an incorrect medication dosage, software vendors should continuously review user feedback and adhere to best practices in user interface design.
5. Safety and Privacy: Patient information stored electronically in the system may be subject to certain errors, such as the inadvertent disclosure of protected health information on the internet due to inadequate security measures. Another concern is the authenticity of physicians’ signatures. Hospitals, clinics, and pharmacies should implement firewalls to safeguard information security, enforce strict computer access controls, and remain vigilant against signs of intrusion.
6. System Downtime: System downtime events may occur due to network-related issues, hardware failures, or power outages. Once such an issue arises, the use of electronic prescriptions will be paralyzed.

Current Status of Electronic Prescription Development Abroad

●Australia
Australia’s electronic prescription services are currently provided by two service providers: MediSecure and eRx. Both services can be integrated into many existing clinical and pharmacy prescribing systems. Since December 2012, they have become interoperable, allowing for mutual information exchange.

●Europe
The use of electronic prescriptions has been recognized in Europe as a key strategy for improving healthcare quality. The European Union aims to establish a cross-border e-health system, enabling EU citizens to access electronic prescriptions anywhere in Europe.

Nordic countries are leading Europe in the deployment of electronic prescriptions. E-prescriptions were introduced in Estonia in 2010, and by mid-2013, 95% of all prescriptions in the country had been converted to electronic format. Other countries, such as Norway, Denmark, Finland, Sweden, the Netherlands, Iceland, Greece, and the United Kingdom, have also widely adopted e-prescriptions. The European Union is promoting greater cross-border exchange of health data. Although there is a positive attitude toward the cross-border exchange of e-prescription data among various stakeholders, many obstacles remain to its implementation. Each of the 27 EU member states has its own data protection and confidentiality laws, as well as different healthcare policies. Consequently, the interoperability of cross-border data exchange imposes higher requirements on information security and privacy.

●India
In India, some private hospitals have begun to use electronic prescriptions. However, the most significant step was taken by the Government of West Bengal, which launched a comprehensive rollout of e-prescriptions across major government-run hospitals in August 2014, gradually replacing paper-based prescriptions. The greatest advantage of this system is that all patient medical history data is recorded on servers managed by the National Health Department, allowing for future retrieval when needed.

●Russia
With the development and application of Russia’s electronic healthcare systems, e-prescriptions have become part of a project known as EMIAS. EMIAS is a digital access system designed to improve the quality of medical care in public health facilities. The system provides patients with appointment scheduling services and various other offerings, including e-prescriptions. The government allows citizens to obtain pharmaceutical products free of charge or at discounted rates, depending on their respective eligibility categories.

Current Status of E-Prescription Development in China

As the Ali Health app is gradually rolled out in pilot regions across China, Ali Health has become the first player to intervene in the electronic prescription process within hospitals. Although this move is highly regarded by the industry and hailed as disruptive to traditional medication purchasing models, the promotion of electronic prescription platforms still faces obstacles and remains controversial due to factors such as the incomplete integration of medical insurance and the lack of standardized regulations.

Nevertheless, the number of early adopters of electronic prescription platforms is on the rise, including internet companies such as Alibaba, pharmaceutical manufacturers like Yiling Pharmaceutical, and pharmaceutical distribution enterprises. This trend appears to signal that electronic prescription platforms are gaining significant momentum.

Given factors such as policy regulation and qualification review, “a hundred flowers blooming” may be the dominant trend; however, most manufacturers, distributors, and community pharmacies are unlikely to participate in the deployment of e-prescription platforms, meaning that the majority of potential participants remain outsiders.

However, once electronic prescription platforms mature, the promising vision of benefiting the public and advancing healthcare reform remains worth anticipating.

By Xu Huiting | Edited by Mo Renying

VCBeat’s Chief Advisor for Glossary of Hot Terms in Internet Healthcare: Zhao Xinyuan, current CEO of Beijing Yingtai Kelong Technology Co., Ltd., and member of the Technical Guidance Committee of HL7 China.

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