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e-Prescription and e-Dispensing on a cross-border scale in the epSOS Project

Updated

Related use case

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

Scenario context

e-Prescription has been used by the epSOS project as the overall term for supporting the processes of prescription and dispensation through the electronic exchange of supporting data for citizens who are travelling inside Europe.

Actors/Roles

  • Consent checker
  • Identity checker
  • Prescription provider
  • Prescription viewer
  • Dispense provider
  • National Contact Point (NCP)
  • Semantic services
  • Transaction Logger

Transactions

  • (Record consent)
  • (Record e-Prescription, in country A)
  • Authenticate end-user (patient, in country B)
  • Authenticate end-user (pharmacist)
  • Query and retrieve e-Prescription
  • Send e-Dispense (back to country A)
  • Log all transactions

Technical process flow

  1. The Consent Source records the patient’s consent
  2. The ePrescription Consumer shows the epSOS ePrescription to the patient
  3. The pharmacist logs in to the ePrescription Consumer.
  4. The pharmacist selects the patient in the ePrescription Consumer
  5. The pharmacist retrieves the patient’s ePrescription via the pharmacy’s computer in a secure way. The requested medication is then dispensed to the patient
  6. Information about the dispense is written and sent

Associated profiles, standards, and HL7 FHIR Implementation guides

  • Policy: —
  • Care process:
    • [XCPD] Cross-Community Patient Discovery
  • Information:
    • [PRE] Prescription document,
    • [DIS] Dispensation document
  • Infrastructure:
    • [XCA] Cross-Community Access,
    • [XDR] Cross-Enterprise Document Reliable interchange(reference: epSOS D3.A.1_EED_II),
    • [ATNA] Audit Trail and Node Authentication
    • [CT] Consistent Time
  • Access control:
    • [BPPC] Basic Patient Privacy Consent
    • [XUA] Cross-User Assertion

Availability of testing tools

Gazelle test platform for testing NCPs at https://gazelle.ehds.eu.

Possible issues

  • The epSOS Use Case does not provide guidelines for the implementation of the Use Case. This may lead to different approaches in the participating countries.
  • Not all the drugs are allowed to be included in epSOS. E.g. Given that European countries have different legislation about possible replacements in drug dispensation, Andalusia didn’t allow to dispense some kind of medicines.
  • In some countries, the reimbursement is also an important part of the medication system.
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