Every day, German pharmacists fill 12 to 14 million prescriptions, which is inconvenient, since they spend a lot of time on these activities . In addition, manual filling of prescriptions often leads to errors and typos, which can result in incorrect treatment of the patient and negative consequences for his/her health. Therefore, the Federal Ministry of Health introduced electronic prescriptions to improve the efficiency and safety of medical care.
In this article, we explore how e-prescriptions work in Germany, look at their benefits and challenges, and examine how a new system impacts patients and doctors.
E-prescriptions: What Are They and How Do They Work?
An e-prescription is a digital form of prescription entry that replaces the traditional paper prescription in medical practice. It is an electronic document containing information about the patient, drug, dosage, instructions for use, and other necessary details. It’s stored and shared electronically between physicians, pharmacies, and other healthcare stakeholders.
Let’s take a step-by-step look at the process of creating an e-prescription.
Step 1. Issuing a Prescription
The doctor writes an e-prescription using certified software and a medical information system. As mentioned above, the prescription should contain information about the patient, the drug, dosage, and instructions for use. It is stored in the patient’s electronic patient record. This is a digital health passport where the patient’s medical history is stored, including prescriptions, test results, and other medical data.
Step 2. Giving the Prescription to the Patient
The patient receives an e-prescription, usually in the form of a unique numeric code. The patient can receive this code through a mobile app, email, or through online services. If a person doesn’t have a smartphone, the code can be printed on paper.
Step 3. Processing in the Pharmacy
When visiting a pharmacy, the patient presents his/her e-prescription using a digital code or a mobile app. The pharmacist scans the code or views the information in the app to access the prescription.
Step 4. Dispensing Medications
The pharmacist dispenses the medicine following the information specified in the e-prescription. If necessary, the pharmacist can interact with the doctor or perform additional checks related to the prescription. When the medicine is dispensed, the information about the completed prescription is updated in the electronic patient record. This helps keep health information up to date and track medication usage.
In general, e-prescriptions in Germany are aimed at improving efficiency and safety in healthcare, improving access to medicines for patients, and reducing bureaucracy in the process of issuing and processing prescriptions.
What Advantages Do E-prescriptions Offer?
E-prescriptions have many advantages over traditional paper ones, including:
Convenience and Efficiency
E-prescriptions allow physicians to write prescriptions quickly and accurately without the need to manually fill out a paper form. They also simplify the process of processing a prescription in a pharmacy. The benefits of using electronic prescriptions are seen not only in Germany. For example, the National Health Service calculated that e-prescriptions could save them £300m.
Safety and Accuracy
E-prescriptions reduce the risk of errors in the transfer of information between physicians and pharmacists as data can be transferred automatically and without loss. Every year, approximately 200,000 deaths in the United States are attributed to preventable medical errors and hospital-acquired infections. Speaking about these errors, medication prescribing and filling mistakes are among the most frequent occurrences. Also, e-prescriptions can contain additional information about the patient and his/her medical history, which helps doctors make more informed decisions when prescribing.
Better Access to Information
E-prescriptions can be linked to a patient’s electronic medical records, providing a more complete picture of their drug treatment. This can help doctors and pharmacists prevent drug interactions or provide additional information about dosage and directions for use.
Environmental Benefit
The use of e-prescriptions reduces the consumption of paper and other materials, which contributes to the preservation of the environment. Every day, over 200 million trees are felled for paper production, resulting in a staggering rate of one tree being cut down approximately every 2.5 seconds.
Do E-Prescriptions Have Any Disadvantages?
Despite some advantages, the introduction of e-prescriptions in Germany has come with several problems and challenges. Some of them include:
Technical Problems
The implementation of complex information systems and e-prescription software requires significant technical resources and integration with various healthcare systems. Technical glitches, faults, and compatibility issues may occur with these systems, which can hinder the smooth implementation of e-prescriptions. For example, the incompatibility of various devices is a common problem in healthcare.
Adaptation and Training
Physicians and healthcare professionals need time and training to master new e-prescription systems and adapt to changes in the prescription process. Some clinicians may need support and resources to successfully embrace these new technologies. In a recent survey conducted by the Mayo Clinic, 30,456 physicians were asked to assess the effectiveness and usability of their EHR software on a scale of 0-100. The findings revealed a strikingly low average score of 45.9%, indicating a significant correlation between symptoms of burnout and the underperformance of EHR software.
Infrastructure and Accessibility
The introduction of e-prescriptions requires a reliable and high-speed Internet infrastructure to enable efficient data transfer between physicians and pharmacies. Some areas may experience limited availability or poor Internet coverage, which can make it difficult to use e-prescriptions.
Data Security and Privacy
The introduction of e-prescriptions increases the importance of data security and the confidentiality of patient medical information. Measures must be taken to protect data from unauthorized access, hacker attacks, and information leaks. In September 2022, the Association of Statutory Health Insurance Physicians of Westphalia-Lippe (KVWL) suspended the introduction of e-prescriptions due to data safety concerns. The Federal Data Protection Commissioner feared that the project could give rise to the abuse of personal customer data in pharmacies.
Patient Acceptance and Trust
Some patients may experience resistance and distrust towards e-prescriptions and e-health systems in general. They may fear loss of privacy, difficulties in using the system, or prefer traditional paper recipes. It’s essential to ensure patient awareness and transparency in the implementation of e-prescriptions to build trust in the system.
All of these issues require attention and solutions at the level of the organization, government, and technology developers to successfully implement e-prescriptions and achieve their potential health benefits.
How to Solve the Problems Associated with the Introduction of E-prescriptions in Germany?
All of the above-mentioned problems are solvable. For example, one of the key components to the successful implementation of e-prescriptions is the training and support of physicians, pharmacists, and other healthcare professionals. Training should include not only the technical aspects of using the system but also the benefits for patients and ways to optimize the workflow.
Also, it’s necessary to have a reliable and efficient technical infrastructure to successfully implement e-prescriptions. This includes high-speed networks, reliable software, and support from IT professionals. Regular updates and upgrades to the infrastructure will help healthcare stakeholders cope with emerging problems and improve the stability of the system.
Software developers should pay special attention to the usability of the e-prescription system. A simple and intuitive user interface reduces training time and increases the efficiency of medical staff. Constant feedback from users and the involvement of clinicians in the development process can help improve the user experience.
Moreover, it’s important to remember about data security. To do this, it’s necessary to apply the latest cryptographic encryption methods, use secure information exchange protocols, and have authentication and access control mechanisms. At Elinext, we use methods, such as passwords, multi-factor authentication, access control, and user activity logging. You should comply with relevant legal regulations and data security standards, such as the General Data Protection Regulation (GDPR) and others as well.
E-prescriptions are a dynamic field; therefore, it’s important to constantly develop and update the system. Feedback from users, implementation experience, and new technologies should be introduced to improve the functionality, safety, and efficiency of the e-prescription system.
In general, solving the problems associated with the introduction of electronic prescriptions requires an integrated approach, including technical, educational, and organizational measures. Cooperation between software developers, healthcare institutions, doctors, and patients is a key factor in the successful implementation and use of e-prescriptions in Germany.
Final Word
E-prescriptions in Germany represent an important step towards the digitization of healthcare. They improve the accessibility and efficiency of healthcare, provide easier access to health information, promote collaboration between physicians and patients, and enhance data security and privacy.
Despite the challenges associated with the introduction of new technologies and changes in work processes, e-prescriptions represent a significant breakthrough in modern medicine. Germany continues to work on improving the system and expanding coverage to provide better healthcare for its citizens.
