In 2010 the digital prescription (e-prescribing) was launched in Estonia. This country-wide project lasted 5 years and it's aim was to make e-prescribing of medicines possible in every doctors' office and filling in digital prescriptions in every pharmacy of Estonia.
It involved a big number of partners like governmental bodies responsible for different data registries, hospital and pharmacy software producers, hospitals, pharmacies etc. Project has already enhanced openness and transparency in the area of medicines' prescribing and more importantly has opened a whole new way for future developments which aim to share information and statistics and improve the medical care and also quality of decision making among policy makers.
Doctors can prescribe medications for patients using their computer software and forward an electronic prescription to the national database. The e-prescription is then immediately accessible in every pharmacy on a patient’s request.
Formerly, after telephone consultation the patient still had to visit the physician in order to take a prescription, today this is no longer necessary. It paves the way for more extensive future development of telemedicine. Patients have a possibility to follow the log attached to every prescription and see who and when has accessed the data. Doctors are most appreciative of the system feature that enables the automatic calculation of the correct rate of reimbursement on medications compensated by the Health Insurance Fund. Furthermore, the system can provide an overview of the prescriptions issued for a patient by other doctors and the actual purchasing information regarding these prescriptions.
Automated processing of this information in the future helps to evaluate the interaction of pharmaceuticals prescribed by different doctors, patient adherence to treatment recommendations, misuse of medicaments, etc. For pharmacists, things are simplified by the fact that the greater part of prescription data on prescription is already put into the system by doctor, which is why they are only required to add to prescription information on actually delivered medication and sales data. In most cases this can be done using a barcode reader. The prescription is then ready for e-invoicing to Health Insurance Fund. The state can now have online control over what is going on in the field of pharmaceuticals.
Data necessary for quality pharmaceutical care is readily (on-line) available at the point of care (physician can access patients full prescription history). Increased transparency of handling of prescriptions and delicate personal data by physicians, pharmacists, civil servants - patient can actually see the log-file for every prescription. Improved governance of the pharmaceutical sector - better possibilities of prompt inspection by watch-dog organizations, possibility to monitor and consequently change prescribing habits (e.g. generic vs branded prescribing of medicines). Changing of habits can be easily done using information technology (e.g. prohibit or encourage prescribing in any particular way a policy-maker has decided).
In May 2011, just 15 months after the launch, 84% of prescriptions are issued digitally. More than 95% of pharmacies are ready to process e-prescriptions. According to a survey "Citizens' satisfaction with health and healthcare" (n=1524) 92% of users of digital prescription are satisfied with the service. Evidence of doctors' usage of retrieval of patients' prescription history. Evidence of patients queries to find out the details about access to patient prescription data (who, why). Evidence of discovery of malpractice among physicians and pharmacists.
- The Estonian Health Insurance Fund earned Finnish quality innovation award for the development and implementation of the digital prescription system (11.11.2011)
- The digital prescription ranked first in the category of e-health and environment projects at a e-service contest (22.02.2011) and Estonia’s best e-services picked