Questions/Answers
Question 1
Please describe the objective of the initiative introduced (200 words maximum)
Introduction of national solution with name ePrescription for medicine prescription and disposal on primary, secondary and tertiary level (with interaction checking) allows:
- Increased security for patients with reduction of mistakes related to medicine usage and systematic audit trails. It is enabled on national level by usage of the central medicine database where is the list approved by professional authority and available medicines with their characteristics. With various search methods through medicine list, it is simple and fast way to find proper medicine for particular patient.
- Prescribing without patient visiting the doctor
- Interaction of medicine checked on national level taking into account vulnerable patent’s state and health groups (as children, pregnancy, etc).
- Reviewing of patient history with overview and control on previously prescribed and dispensed medicines for all involved professionals
- Significant reduction of administrative costs and time by the IT supported processes and paperless prescription form
- Standardized records and data are perfect base for research analysis
Question 2
Please explain how the initiative is linked to the category and criteria selected (100 words maximum)
This initiative is in line with Goal 3: “Ensure healthy lives and promote well-being for all at all ages”. With all described objectives of ePrescription it promotes well-being in all ages taking into account that quite significant part of population uses prescribed medicines on daily basis (according to latest data in the period of last three years 90% of Slovenian population are users).
Question 3
Please describe in what ways the initiative is contributing to the implementation of the 2030 Agenda for Sustainable Development and the realization of the SDGs. Specify which SDG(s) it is relevant to. (100 words maximum)
This initiative is in line with 3.8 SDG:
The solution assures safe, secure, well-controlled standardized process with strict rules for all involved stakeholders on national level. ePrescription enables effective, efficient, interaction control, access to patient history of prescribed and dispensed medicine and convenient medicine prescription / dispensing based on the central data repository to all authorized professional stakeholders.
Question 4
The initiative must have positive impact on a group or groups of the population, especially the vulnerable (i.e. children, women, older persons, people with disabilities, etc.) within the context of your country or region. Please explain how the initiative has addressed a significant shortfall in governance, public administration or public service within the context of a given country or region. (200 words maximum)
Initiative is significant for all citizens using prescribed medicine (almost all population). It improves the public health service level and administration. The patients’ benefit is possibility to get prescription (especially for long-term chronically diseases therapy) without visiting doctors. That means that patient can get prescription on request (phone, mail) without risk of infections during his visit to doctor and reduction of time for that visit. Doctor can adapt the prescribing process to his own time preferences. Patient can get the medicine in the pharmacy based on personal healthcare card, which allows access to his prescription and dispensing history. The central prescription and dispense repository is base for the Patient Summary – document containing patient’s structured medical overview, which is accessible to all medical professionals.
Question 5
a. Please explain in which way the initiative is innovative in the context of your country or region (100 words maximum)
Initiative introduces firm, standardized and strict information processing rules, using of digital qualified certificate as a tool to authorize all significant transactions in the process assuring process consistency and reliable systematic audit trails on national level. ePrescription allows checking medicine contraindications and interactions on all health care levels in the prescribing and dispensing phase (except in hospitals).
b. Please describe if the innovation is original or if it is an adaptation from other contexts (100 words maximum)
ePrescription upgraded the process of exchanging information between previously existing partial IT solutions for healthcare organizations with adding the central repository, checking medicine contraindications and interactions, and strict processing rules on the information transformation. In addition, it is a source for Patient Portal (zVem) which allows patients to get information on prescriptions and dispenses.
Question 6
Has the initiative been transferred and adapted to in other contexts (e.g. other cities, countries or regions) to your organization’s knowledge? If yes, please explain (100 words maximum)
Due to fact that this is a national solution, there is no transferability within country. The implementation is taking into account country specifics related to various aspects, such as: law, social, health policies etc.
ePrescription provides a stable, reliable solution which can be used for different purposes. One of them is the cross boarder projects related to cross border transfer of prescriptions (in addition to patient summary) which extends patient flexibility and medicine availability by allowing prescription and dispensing in different countries.
Question 7
a. What resources (i.e. financial, human or others) were used to implement the initiative? (100 words maximum)
The project was financed by the Ministry of Health of the Republic Slovenia and co-financed by the EU from European Social Fund. Total value of annual maintenance is 297 T€.
The members of project team were from Ministry of Health, IT companies specialized in healthcare and professional public with medical and pharmacy profile. Currently ePrescription team consists of 2 internal and 6 external professionals.
b. Please describe whether and how the initiative is sustainable (covering the social, economic and environmental aspects) (200 words maximum)
The project results in term of sustainability are:
- lower usage of paper (92% of annually 17 M prescriptions is now issued electronically);
- lower transportation costs for patients and better utilization of time (patient and doctors) is result of the prescribing without patient visiting doctor (especially for permanent therapy);
- in-build option of medicine interaction’s checking (including vulnerable patient groups) reduces health complications for patients
Question 8
a. Has the initiative been formally evaluated either through internal or external evaluation?
Yes
b. Please describe the indicators that were used (100 words maximum)
Most important indicator is the ratio between issued electronic and paper prescriptions. In the beginning in December 2016 this ratio was 85% ePrescription of all issued. Nowadays it is 92% (some prescriptions are possible only in paper form and therefore it will never reach 100%).
c. Please describe the outcome of the evaluation (100 words maximum)
Currently the evaluation of the project outcome conducted by Ministry of Public Administration is in very first phase. Evaluation in progress - not available yet.
Question 9
The 2030 Agenda for Sustainable Development puts emphasis on collaboration, engagement, coordination, partnerships, and inclusion. Please describe what and how stakeholders were engaged in designing, implementing and evaluating the initiative. Please also highlight their roles and contributions (200 words maximum)
All stakeholders were involved in this national project. Special in-depth involvement and contribution was made by the Slovenian professional healthcare associations. They actively participate in the domain of their expertise. For each domain, there were defined main objectives, standardization, possible optimizations, improvements, upgrades and potential synergies. After the evaluation and approval, all agreed upon has been implemented successfully.
Question 10
Please describe the key lessons learned, and any view you have on how to further improve the initiative (100 words maximum)
The clear processes, well-prepared project, defined objectives, constructive and active involvement of all stakeholders are the keys for the project success.
The addition of the central database: repository of issued prescriptions and dispenses allows all participants easy and secure access to data in line with their authorizations with required audit trails.
Using existing local IT solutions allows smooth and simple application for professionals’ everyday usage.