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

2. 2 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 PRESCRIPTION INVOICES INTERNET INTRANET: PRIVATE VIRTUAL NETWORKS CORPORATE PORTALS: INFORMATION INSTRUCTION COMMUNICATION SECURITY ELECTRONIC PRESCRIBING COMPUTERISATION OF COMMUNITY PHARMACIES ELECTRONIC PRESCRIBING

3. 3 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. 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. ELECTRONIC PRESCRIBING

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

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

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

7. 7 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. Regulatory Framework ELECTRONIC PRESCRIBING

8. 8 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 Spanish Ministry of Health. Promoting electronic prescribing (I) ELECTRONIC PRESCRIBING

9. 9 Quality Plan for the NHS (2006): HEALTHCARE ON-LINE (141 mill €. For 2006-07) (Healthcare-industry framework agreement) Promoting electronic prescribing (II) 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. 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. ELECTRONIC PRESCRIBING

10. 10 Situation in Spain Electronic prescribing is already a reality 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)606 community pharmacies (76% of the total) 47 health centres. 679 doctors (53% of the total)47 health centres. 679 doctors (53% of the total) Since May 2006: 1,000,000 electronic prescriptions dispensed.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. 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 The Official Colleges and the Autonomous Councils of Pharmacists ensure the quality of the system on a dispensing level. ELECTRONIC PRESCRIBING

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

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

13. 13 Role of the Pharmacists College Organisation in Electronic Prescribing (II) 1Guarantees 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 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. The dispensing process will be clearly affected, therefore the Pharmacy Colleges will monitor it to ensure its quality. ELECTRONIC PRESCRIBING

14. 14 Role of the Pharmacists College Organisation in Electronic Prescribing (III) 2. Facilitators of the project Accrediting the identity of the professionals: electronic signature. Accrediting the identity of the professionals: electronic signature. Providing a secure pharmaceutical corporate network and suitable technological equipment for the community pharmacies. 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. 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). 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. Working as an operational back up for possible specific incidences in equipment and communications. Arranging grants. Arranging grants. ELECTRONIC PRESCRIBING

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

16. 16 Role of the General Spanish Council of Pharmacists NETFARMACIA: Pharmacists Corporative Network 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. ELECTRONIC PRESCRIBING

17. 17 REFLECTIONS Electronic prescribing is already a reality in Spain. 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. 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 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. 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. ELECTRONIC PRESCRIBING

18. 18 THANK YOU VERY MUCH ELECTRONIC PRESCRIBING