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ePrescribing – and then...? Swedish Experiences and Plans

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ePrescribing – and then...? Swedish Experiences and Plans. Larson M. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

Publicada em: Saúde e medicina
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ePrescribing – and then...? Swedish Experiences and Plans

  1. 1. ePrescribing – and then…? Swedish experiences and plans
  2. 2. Mats Larson Chairman of the Board
  3. 3. ePrescribing is easy
  4. 4. ePrescribing is quite complex
  5. 5. Swedish eP-growth 1980-2008 2008; 80% of all prescriptions in primary care where made electronically Million eP
  6. 6. 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
  7. 7. 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
  8. 8. 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)
  9. 9. The Swedish model today Caregiver Patient
  10. 10. The Swedish model today Caregiver Patient The patient´s Dispensed prescriptions, form medication the same region The EHR I Pharmacies Db
  11. 11. The Swedish model today SoS kval.indikatorer Graviditet och Länkbibliotek amningsklassificering (Fass) Utsättning Fass online Interaktioner Apodos-sortiment Sfinx Rekommendationer Biverkningsöversikt T LV förmånsinformation Mallordinationer Warnings Kortnotationer Product information Interactions Different Decison Support systems Caregiver Patient The patient´s Dispensed prescriptions, form medication the same region The EHR I Pharmacies Db
  12. 12. The Swedish model today SoS kval.indikatorer Graviditet och Länkbibliotek amningsklassificering (Fass) Utsättning Fass online Interaktioner Apodos-sortiment Sfinx Rekommendationer Biverkningsöversikt TLV förmånsinformation Mallordinationer Warnings Kortnotationer Product information Interactions Different Decison Support systems ePrescription Caregiver Patient Dispensing The patient´s Dispensed prescriptions, form medication the same region The EHR I Pharmacies Db
  13. 13. … and tomorrow SoS kval.indikatorer Graviditet och Länkbibliotek amningsklassificering (Fass) Utsättning Fass online Interaktioner Apodos-sortiment Sfinx Rekommendationer Biverkningsöversikt TLV förmånsinformation Mallordinationer Warnings Kortnotationer Product information Interactions Different Decison Support systems Caregiver Patient Dispensing The patient´s Dispensed prescriptions, form medication the same region Drug Utilization Review The EHR I Pharmacies Db Alarms?
  14. 14. 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
  15. 15. Still not good enough… SoS kval.indikatorer Graviditet och Länkbibliotek amningsklassificering (Fass) Utsättning Fass online Interaktioner Apodos-sortiment Sfinx Rekommendationer Biverkningsöversikt TLV förmånsinformation Mallordinationer Warnings Kortnotationer Product information Interactions Different Decison Support systems Caregiver Patient Dispensing The patient´s Dispensed prescriptions, form medication the same region Drug Utilization Review The EHR I Pharmacies Db Alarms?
  16. 16. In our dreams – and plans… GENERAL SPECIALIST CITIZEN HOSPITAL PRACTICIONER One, unique, updated record of the patients complete medication history and valid prescriptions ACCIDENT & NURSINGHOME PHARMACY HOMECARE EMERGENCY
  17. 17. Mats Larson Mats.Larson@Caritea.com

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