Ever since its unfolding in 2006 began until January of 2010, they have been exempted in Spain more than 139 million electronic prescriptions and its implantation is of the 100 percent in six independent communities: Andalusia, the Balearics, Catalonia, Valencian Community, Extremadura and Galicia. In addition, “we are at the top in Europe, where we led project EPSOS, and in the world�, the director of the Agency of Quality of the National System of Health tells us, Pablo Rivero.

Its main characteristic is the advantage of the new technologies, which supposes great advantages with respect to the traditional prescription in support paper, mainly for the people with chronic diseases. And it is that the electronic prescription, besides making possible the prescription of one or several medecines and for a greater period of time, avoids unnecessary displacements of the patient to the health center. “One of the most outstanding advantages is indeed this, that the chronic people majors and patients no longer will have to go every week to the doctor to renew prescriptions nor to wait for tails�, she affirms Rivero.

Also, the director of the Agency of Quality of the SNS assures that the application of the electronic prescription, accompanied by digital clinical history, “allows us to have more controlled the polimedicados patients and to know if they retire medecines in the advised term�. Of this form, as much doctors as phamacists will be able to realize a better farmacoterapéutico pursuit of the patient regardless of the health center to which he goes, and to obtain data in real time on the processes of prescription and dispensation and the fulfillment of the treatments.

The electronic prescription also offers benefits for the National System of Health, “when releasing time of the family doctors (around the 20 percent), who will be able to thus visit other patients in their addresses and not simply to renew prescriptions�, indicates Rivero. In addition, it improves the security with respect to the medecine consumption, eliminating the possibility of drug duplicity and errors in the dispensation, and favoring the development of the programs of rational use of the medicine.

But this system would not be complete if it were limited the territorial scope of the independent community of habitual residence of the patient, since a significant digit of people resides temporarily in more than one or often travels by Spain. “In 2011 it is predicted that the implantation of the electronic prescription in all the national territory is completed and is feasible the interoperability between communities, in such a way that this one could be given in any pharmacy of the country�, indicates the director of the Agency of Quality of the SNS.

Also, one is working in a data base of sanitary cards at national level so that any citizen can be identified without allowable error in any point of Spain. Also a new Real Decree driven by the Main directorate of Pharmacy is prepared, with the basic requirements of the electronic prescription (data of the patient and the doctor, prescription and dispensation) for its regulation and standardization in all the autonomies and that, probably, will be presented/displayed at the end of this year.

How it works?

In the consultation

• The patient goes to the medical consultation and she is identified with his sanitary card, which credits its right to benefit and assures a precise and fast access to its clinical history.

• The doctor accedes electronically to the medecine catalog of the National System of Health to prescribe the most suitable treatment to the patient, who is registered automatically in his file. The catalog allows the unequivocal identification of drugs, under trade name or active principle.

• The prescription is generated of form electronic and been worth automatically with the electronic company/signature of the facultative one, storing itself in a data base of prescription.

• The medical delivery to the patient a leaf of instructions (or medication plan) in paper, with the information necessary to be able to follow the treatment correctly (name of the medicine, dose, frequency of the administration and anticipated time of duration).

• The patient will not have to return to the health center until the term of use of the treatment finalizes. In that visit, the doctor will value if he renews the prescription or varies the prescribed medication.

In the pharmacy

• In 2011, any pharmacy of the country will be able to consult electronically the orders of medecine prescription and to give them (until the moment, it is only possible within the independent community).

• In order to be able to retire drugs as it is them to the patient needing, it is obligatory to take to the sanitary card and the leaf of instructions (or medication plan).

• The phamacist realizes the identification of the patient through his card and accedes to his file to see pending prescriptions gather.

• The dispensation is registered automatically in the clinical history of the patient with the electronic company/signature of the phamacist, as well as the substitutions, if they were realized.

           PROJECT EPSOS           

Spain leads European project EPSOS of clinical exchange of information. The objective is to unfold the history of the patient on a large scale, so that the sanitary professionals can accede electronically to the essential data of a patient of another country and the pharmacies can grant prescriptions sent by other States of the European Union. The SNS and three independent communities (Andalusia, Castilla-La Mancha and Catalonia) are the beneficiaries of this initiative.
The project has an implementation time of three years and counts on a budget of 22 million Euros contributed to the 50 percent between the European Commission and the collaborating countries. Besides Spain, other 11 Member States participate: Germany, Austria, Denmark, Slovakia, France, Greece, Holland, Italy, the United Kingdom, Czech Republic and Sweden. 


             DIGITAL CLINICAL HISTORY                     

The project of Digital Clinical History in the National System of Health is based on guaranteeing to the sanitary professionals the access to that one excellent clinical information for the sanitary attention of a patient from any place of the SNS, assuring to the citizens who the consultation of its data is restricted to the people authorized for it. The purpose clearly is oriented to satisfy the needs with the citizens in its displacements by the national territory.
At present, the 98 percent of the centers of health of the SNS has a system of electronic clinical history (standard solution or development to size) and the 70 percent of the hospitals of the SNS count on an information system that incorporates functionalities of management of patients and clinical station implanted by the Service of Health within the autonomic project of electronic clinical history.
Recently, the Government has approved the Real Decree by which the minimum set of data of the clinical information in the SNS settles down, which facilitates the work of the sanitary professionals, when having a homogenous information on the patients who could be shared in all the National System of Health, in such a way that these could be taken care of in any place of Spain.