Embed Size (px)
DESCRIPTION
ePrescribing – and then...? Swedish Experiences and Plans. Larson M. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)
Citation preview
ePrescribing – and then…?
Swedish experiences and plans
Mats Larson
Chairman of the Board
ePrescribing is easy
ePrescribing is quite complex
Swedish eP-growth 1980-2008
2008; 80% of all prescriptions in primary
care where made electronically
Mill
ion e
P
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
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
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)
The Swedish model today
Caregiver Patient
The Swedish model today
Caregiver Patient
Dispensed
medication
The
Pharmacies
Db
EHR I
The patient´s
prescriptions, form
the same region
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
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
… 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
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
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
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
