E-prescriptions Healthcare card system Italy Session 12: «e-services for all» First time-slot: introduction Healthcare card system E-prescriptions Italy Antonietta Cavallo - Manager “Tessera Sanitaria” project 15th May 2017

1 – organisation Healthcare card system (“Tessera Sanitaria” System) Built in 2003 (art. 50 DL 269/2003), implemented by MEF (in accordance with the Italian Ministry of Health ) Goal: strengthening national, regional and local instruments for the governance of public health spending Monitoring the prescriptive appropriateness either in pharmaceutical and specialistic field How: «Tessera Sanitaria» (electronic health card) is given to each citizen (access to online services) and provides unique identification Regional system implementation: online networking of all prescribers and all public and private health facilities nationwide (pharmacies, local health authorities, hospitals, clinics, laboratory)

2 - Project Background starting point (2003) Standardisation Registries Interconnection Interoperability Regions Investments Infrastructures CF-Unique code

3 - Actors involved Since 2009!!! 800 millions prescriptions/yr (100% - 200.000 prescribers) Drugs and medical services supply (100% - 18.000 pharmacies 11.000 health facilities) 800 millions prescriptions/yr regions ASL Local health authorities Ministry of health (NSIS) AIFA – Italian drug agency national registry

4 – e-prescription: why is it an innovative service? Since 2016 + Control strengthening heath expenditure + Prescriptive appropriateness national registry

5 - Joining Forces – Breaking Silos

6 – e-prescription: main results Initial phase of the system (from 2003) Registry (facilities, coding, prescriptions, etc), based on NSIS standards Alignment of citizen registry with national fiscal code registry Pharmaceutical and specialistic prescription (from 2009) Precise verification of the exemption for income (from 2011) Electronic prescription (from 2012) dematerialization of paper prescription (from 2013)

6 - “Tessera Sanitaria” - National Patient Registry (ANA) on-line service access TEAM (European insurance card) 100% population 60mln CF – unique code ANPR ANA national registry

6 – e-prescription: status Pharmaceutical: 92% paperless prescription Specialistic: 50% paperless prescription Nearing completion From march 1st 2016 Italian patients can spend pharmaceutical prescription nationwide national registry

Thank You Antonietta Cavallo Antonietta.cavallo@mef.gov.it