ePrescribing – Integrating Primary Care, Hospitals, Pharmacies in Spain (Andalucia)

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ePrescribing – Integrating Primary Care, Hospitals, Pharmacies in Spain (Andalucia). Piña Vera MJ. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

Health & Medicine

ePrescription in Andalucía
(Receta XXI)
María José Piña Vera
Andalusian Health Service

Andalusia

Andalusian population
• 8.302.923 inhabitants
• 17,8% of the Spanish
population

e-Prescription (Receta XXI)

CENTRALIZED DISPENSED
DIRAYA
MEDICINES DATABASE

BDU
HSDC
BDP
Dispensed FARMA
medicines

Network
Network

Prescriptions

Dispensed
medicines

USER
INSTRUCTIONS
Medical office (PC-SC) FORM
DIRAYA

ePrescribing: advantages

USERS:
• Avoids unnecessary visits to the clinics to repeat
prescriptions

PRACTITIONERS:
• Minimizes activity prescription in health centres:
entire treatment prescribed by specialists
• Releases personnel from bureaucratic tasks
• Increases time devoted to patients
• Possibility of better support for rational
prescription

ePrescribing: advantages

PHARMACISTS:
• Significant promotion of Pharmaceutical Care
• Reduction of management expenses and billing
in prescriptions

HEALTH ADMINISTRATION:
• Improves follow-up and control of rational use of
drugs (RUD)
• Correct assignment of responsibility in RUM
among levels
• Decrease in fraud and better control of billing

Diraya Workgroup to improve
the ePrescribing
• Primary care Doctors
(8)
• Pharmacology
Technician (1)
• SAS IT Technician (1)
• Pharmacists from the
SAS Pharmaceutical
and Provision
Department (3)
• Pharmacists of the Andalusian
Council of Official Colleges
of Pharmacists

Implementation of Receta XXI

2003

Torreblanca

Population coverage IMPLEMENTED
< 25 % NOT IMPLEMENTED
25 - 50 %
50 - 75 %
75 - 90 %
> 90 %

Implementation of Receta XXI

IMPLEMENTED

NOT IMPLEMENTED

Implementation of Receta XXI
726 centres 1 hospital
2009
7.620.101 users (94,6 %)
3.188.240 patients 16.726 patients
5.398 doctors (92 %) 72.584 dispensed medicines
3.553 pharmacies (99 %)
206.228.769 dispensed
medicines

5,4%

Population coverage
IMPLEMENTED
< 25 %
NOT IMPLEMENTED
25 - 50 %
50 - 75 %
75 - 90 %
> 90 % 94,6%

Receta XXI: eDispensing Percentage
December 2009

Chronic treatments
58 %
71 %

Number of dispensed medicines

100.000.000
89.240.751
90.000.000
80.000.000
70.000.000 66.315.635
60.000.000
50.000.000
40.000.000
30.520.106
30.000.000
20.000.000
8.982.319
10.000.000 1.245.313
247.545
0
2004 2005 2006 2007 2008 2009

% ePrescriptions
120.000.000 60,00 %

50,31
100.000.000 50,00 %

80.000.000 40,00 %
39,71

60.000.000
www.ehr-impact.eu 30,00 %

40.000.000
20,00 %
19,46

20.000.000 10,00 %
6,10

0,88
0
0,18 0,00 %
2004 2005 2006 2007 2008 2009

Hand-written prescriptions Printed prescriptions

ePrescriptions % ePrescriptions

Progress of appointments by
Receta XXI in Andalusia
Number
of
appointments
60.000
56.552
47.910
50.000
Appointments reduction
40.000

30.000

20.000
15.28%
10.000
2006 2nd half-year 2007

Progress of appointments by Receta XXI
Area Sanitaria Norte de Córdoba
120.000

Appointments reduction:
100.000 95.766

81.121

80.000

 El Viso 30 %
sep-05
60.000 53.378

41.809 sep-08

 Espiel 27 %
40.000
24.444 23.388
17.009 17.059
20.000

 Hinojosa 22 %
0
POZOBLANCO HINOJOSA EL VISO ESPIEL

 Pozoblanco 16 %

Prescriptions precautionary cancelled
by the pharmacist (2009)

• 20.892.779 Prescriptions

• 11.349 Precautionary cancellations (0,05%)

• 10.762 Confirmed by the doctors

• 587 Activated by the doctors

Prescriptions precautionary cancelled
by the pharmacist (2009)

95%

Confirmed by the
doctor
Activated by the
doctor

5%

Conclusions

Continuous
updating
Unique Continuous
Electronic training
Health
Record
Quality
issues Interoperability

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