e-Prescription and e-Dispensing on a cross-border scale

Purpose: 

To support the processes of prescription and dispensation through the electronic exchange of supporting data for citizens who are travelling inside Europe

Relevance: 

This Use Case represents a high level of consensus on what constitute European eHealth services, as this use case was described by the Directive 2011/24 of 9 March 2011 on the application of patients’ rights in cross-border healthcare. Benefits in both medical and economical terms can be gained from increased quality of care (e.g. improved patient safety) when they travelling abroad and still are able to pick up (lost/forgotten/other necessary reasons) medication and to decrease the effort of gathering/exchanging health information.

Domain: 
Medication
Scale(s): 
Cross-border
International
Context: 
  • e-Prescribing is defined as prescribing medicines through the support of software by a health care professional who is legally authorised to do so, so that the medicine can be dispensed at a pharmacy;
  • e-Dispensing is defined as the act of electronically retrieving a prescription and reporting on giving out the medicine to the patient as indicated in the corresponding ePrescription.

Once the medicine is dispensed, the dispenser will report, via software, information about the dispensed medicine(s) to the prescription provider. To appropriately define the context of the use case relevant aspects require consideration. These aspects include:

  • Is an existing prescription filled out in a different European country from where it originated or is a new medicine prescribed in a country visited by the patient?
  • The different legislative contexts in the various European countries have led to the decision of the epSOS project that information about a newly prescribed medicine, in a country visited by a patient, will not be transferred back to the country in which the patient resides.

The use case which is described below is one (the most common situation) of 5 possible scenarios that are described within epSOS D3.1.2. Other scenarios that the prescription is written and dispensed in country B, or a prescription written in country B dispensed in another country (C). More extensive information about this use case and ePrescription requirements can be found in epSOS Deliverable 3.1.2. Information about the profiles can be found in epSOS D3.A.1 EED II. Information about identification, authentication, authorisation, and consent sharing can be found in epSOS D3.6.

Information: 
Consent – information about patient’s consent
Prescription – information necessary to prescribe the medication
Dispense – information about the dispensed medicine(s)
Participants: 
Prescriber – person responsible for the prescription of some medication
Dispenser – person who can hand over the medication to the patient
Patient – person who gives consent and requests medication
Functional process flow: 
  • (With reservation that preconditions are met – can be found in D3.1.2.)
  • The patient visits an epSOS Health Professional and gives his/ 23 her consent to share his/her medical information in country A
  • The patient then travels abroad where s/he requires medication in another epSOS pilot country
  • S/he visits a pharmacy that is participating in the epSOS network
  • S/he identifies himself/herself to the pharmacist/ staff at the pharmacy
  • Pharmacist is identified, authenticated, and authorised.
  • The patient asks for his/ her ePrescription. By doing so, the patient gives the dispenser/ pharmacist his/ her consent to access his/her personal information
  • The pharmacist requests the patient’s ePrescription via the pharmacy’s computer in a secure way
  • The prescription is received by country A via the NPC, NCP checks patient consent, is translated by the semantic services, sent back to the NCP of country B
  • Pharmacist receives the ePrescription both translated in his own language as an original copy of the prescription.
  • The requested medication is then dispensed to the patient
  • The dispensed medicine information is sent back to country A
Related realisation scenarii: 
e-Prescription and e-Dispensing on a cross-border scale in the epSOS Project
Source: 
Antilope