ELECTRONIC PRESCRIBING AND APPLICATION OF NEW TECHNOLOGIES IN THE SPANISH PHARMACY

1. ELECTRONIC PRESCRIBING ELECTRONIC PRESCRIBING AND APPLICATION OF NEW TECHNOLOGIES IN THE SPANISH PHARMACY Carmen Peña López Secretary General. General Spanish Council of Pharmacists

2. ELECTRONIC PRESCRIBING Spanish pharmacists have always backed the use of Communication and Information Technologies in benefit of the quality care TO PATIENTS The new technologies have been incorporated on demand for the new projects and professional challenges INTRANET: PRIVATE VIRTUAL NETWORKS PRESCRIPTION INVOICES INTERNET SECURITY COMPUTERISATION OF COMMUNITY PHARMACIES CORPORATE PORTALS: INFORMATION INSTRUCTION COMMUNICATION ELECTRONIC PRESCRIBING

3. ELECTRONIC PRESCRIBING • Electronic prescribing consists of incorporating the new information and communication technologies into the prescription, dispensing and invoicing processes for medicines, aimed at optimising the system’s quality in the patient’s benefit.

4. ELECTRONIC PRESCRIBING IMPROVEMENTSREGARDING TRADITIONAL PRESCRIBING • For the patients: • Improvement in quality care and therefore, the safety and efficiency of the patients’ treatments. • Chronic patients will avoid unnecessary visits and paperwork for the doctors’ surgeries in order to renew prescriptions.

5. ELECTRONIC PRESCRIPTIONS IMPROVEMENTSREGARDING TRADITIONAL PRESCRIBING • For the Administration: • Control of the prescription • Decrease in bureaucracy • Knowledge in real time of the evolution of expenditure on medicines. • Promotion of the rational use of medicines. • Safe, fast, reliable and confidential transactions.

6. ELECTRONIC PRESCRIBING IMPROVEMENTSREGARDING TRADITIONAL PRESCRIBING • For the pharmacist in the community pharmacy • The mistakes made when reading prescriptions are eliminated. • Active participation in pharmaceutical care and drug-monitoring plans. • Efficiency in the costs produced by management and invoicing. • Implication in new technologies. • Rapid information exchange with the doctors.

7. ELECTRONIC PRESCRIBING Regulatory Framework • Royal Decree 1.910/1984 (26-09) on medical prescriptions. • General Law 15/1999, of the 13th of December on personal data protection. • Law 41/2002, of the 14th of November, basic regulator of the patient’s autonomy and on the rights and obligations on the subject of clinical information and documentation. • Law 16/2003, on Cohesion and Quality of the NHS, which establishes the regulation and development framework within the National Health System. • Royal Decree 183/2004, of the 30th of January, which regulates the individual healthcare card. • Law 29/2006, of the 26th of July, on guarantees and rational use of medicines and healthcare products.

8. ELECTRONIC PRESCRIBING Promoting electronic prescribing (I) Law 16/2003, on Cohesion and Quality of the NHS, which establishes the regulation and development framework within the National Health System, for: • a) The error-free identification of users and patients (Healthcare Card). • b) The exchange of healthcare information between organisms, centres and services. • c) Electronic Prescribing. • d) The Communications Network (NHS Intranet) The development of these provisions and of the technical functionalities for their performance is a competence of the SpanishMinistry of Health.

9. ELECTRONIC PRESCRIBING Promoting electronic prescribing (II) RED.ES: It promotes the development of the Information Society with the producing of programmes defined in the ‘Plan Avanza’ for the convergence with Europe and between the different Autonomous Regions. Quality Plan for the NHS (2006): HEALTHCARE ON-LINE (141 mill €. For 2006-07) (Healthcare-industry framework agreement) The Autonomous Regions may benefit from the funds committed within the framework agreement for cooperation through the bilateral agreements signed between each Region and the organisation: Red.es, in coordination with the National Ministry of Health.

10. ELECTRONIC PRESCRIBING Situation in Spain • Electronic prescribing is already a reality in Spain: Andalusia: Prescription XXI Data for Seville in January 2007: • 606 community pharmacies (76% of the total) • 47 health centres. 679 doctors (53% of the total) • Since May 2006: 1,000,000 electronic prescriptions dispensed. • There are different Electronic Prescription projects, promoted by the Autonomous Regions, which are evolving at different rates and using different models, from the technological, functional and even operational points of view. • The Official Colleges and the Autonomous Councilsof Pharmacists ensure the quality of the system on a dispensing level.

11. ELECTRONIC PRESCRIBING 6 5 4   Patient Patient Healthcare Card Healthcare Card 9301082PEGA0 3 9301082PEGA0 3 48/11223344/55 10T 48/11223344/55 10T JOSE PEREZ GARCIA JOSE PEREZ GARCIA AVDA. BILBAO, 32 AVDA. BILBAO, 32  Situation in SpainFunctional Model for electronic prescribing HEALTH CENTRE COMMUNITY PHARMACY Pharmacist Prescribing Doctor Dispensing Pharmacist’s electronic signature Prescribing Doctor’s electronic signature Prescription Database Dispensing-invoicing Database AUTONOMOUS HEALTHCARE ADMINISTRATION OFFICIAL COLLEGE OF PHARMACISTS

12. ELECTRONIC PRESCRIBING Role of the Pharmacists College Organisation in Electronic Prescribing (I) 1 To guarantee the Universality, Quality and Accessibility to all community pharmacies 2 Tools: Facilitators for the project

13. ELECTRONIC PRESCRIBING Role of the Pharmacists College Organisation in Electronic Prescribing (II) 1 Guarantees of Quality: • The Pharmacists College Organisation plays an active role since it tries to move the representation and coordination task of the community pharmacists over to the field of the new technologies. • The dispensing process will be clearly affected, therefore the Pharmacy Colleges will monitor it to ensure its quality.

14. ELECTRONIC PRESCRIBING Role of the Pharmacists College Organisation in Electronic Prescribing (III) 2. Facilitators of the project • Accrediting the identity of the professionals: electronic signature. • Providing a secure pharmaceutical corporate network and suitable technological equipment for the community pharmacies. • Organising instruction activities for the adaptation of the pharmacists to the new technologies. • Supplying value added services over the network (Pharmaceutical Care, Long distance training, college services and medicine database). • Working as an operational back up for possible specific incidences in equipment and communications. • Arranging grants.

15. ELECTRONIC PRESCRIBING Role of the General Spanish Council of Pharmacists • SUPPORT FOR THE PHARMACIST COLLEGES TO UNDERTAKE THE ELECTRONIC PRESCRIBING PROJECT ON A NATIONAL SCALE. • TECHNOLOGICAL SOLUTIONS: NETFARMACIA: National Pharmacists Corporate Network Ensuring the inter-operability of pharmacy services between the different Autonomous Regions

16. ELECTRONIC PRESCRIBING Role of the General Spanish Council of Pharmacists • NETFARMACIA: Pharmacists Corporative Network It is set out as a large scale pharmacist corporative network that integrates the different networks of provincial colleges encouraging the interoperability on the dispensing level.

17. ELECTRONIC PRESCRIBING REFLECTIONS • Electronic prescribing is already a reality in Spain. • Homogenous criteria are needed to be set down in order to promote the interoperability between the different models guaranteeing the healthcare service regardless of the geographic mobility. • The Pharmacists College Organisation guarantees the universality, quality and accessibility of the dispensing in the patient’s benefit. • The Pharmacists College Organisation holds a key role as FACILITATORS of this system from the point of view of representing the pharmacist profession and as facilitators of the necessary technological infrastructure.

18. ELECTRONIC PRESCRIBING THANK YOU VERY MUCH