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 electroni...
Doctors like it

 What strengths do you associate with
 ePrescribing?
 Fast and easy                                      ...
But things can be improved

 What weaknesses do you associate with the
 EHR-system that you use for ePrescribing?
 Drug se...
What other stakeholders say…

• 95% of the patients said they would like to ”use
  ePrescribing next time around”. N=1560 ...
The Swedish model today




        Caregiver   Patient
The Swedish model today




                    Caregiver            Patient


       The patient´s
                      ...
The Swedish model today

                                                                                                 ...
The Swedish model today

                                                                                                 ...
… and tomorrow

                                                                                                         S...
This is what the review found…

 Category                         Number of Signals   % Signals
 Early Refill             ...
Still not good enough…
                                                                                                   ...
In our dreams – and plans…

                  GENERAL
  SPECIALIST                                CITIZEN    HOSPITAL
    ...
Mats Larson
Mats.Larson@Caritea.com
ePrescribing – and then...? Swedish Experiences and Plans
ePrescribing – and then...? Swedish Experiences and Plans
ePrescribing – and then...? Swedish Experiences and Plans
ePrescribing – and then...? Swedish Experiences and Plans
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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)

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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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