National Health Models and the Adoption of E-Health and E-Prescribing in Primary Care – New Evidence from Europe

Abstract

Objective Recent research from the European Commission (EC) suggests that the development and adoption of eHealth in primary care is significantly influenced by the context of the national health model in operation. This research identified three national health models in Europe at this time -the National Health Service (NHS) model, the social insurance system (SIS) model and the transition country (TC) model, and found a strong correlation between the NHS model and high adoption rates for eHealth. The objective of this study is to establish if there is a similar correlation in one specific application area -electronic prescribing (ePrescribing) in primary care. Methods A review of published literature from 2000 to 2014 was undertaken covering the relevant official publications of the European Union and national government as well as the academic literature. An analysis of the development and adoption of ePrescribing in Europe was extracted from these data. Results The adoption of ePrescribing in primary care has increased significantly in recent years and is now practised by approximately 32% of European general practitioners. National ePrescribing services are now firmly established in 11 countries, with pilot projects underway in most others. The highest adoption rates are in countries with the NHS model, concentrated in the Nordic area. The electronic transmission of prescriptions continues to pose a significant challenge, especially in SIS countries and TCs. Conclusions There is a strong correlation between the NHS model and high adoption rates for ePrescribing similar to the EC findings on the adoption of eHealth. It may be some time before many SIS countries and TCs reach the same adoption levels for ePrescribing and eHealth in primary care as most NHS countries.

In this issue: tools and processes that translate knowledge into practice

“…His ideas build on those of 100 years before, and published in 1903, where the French philosopher Tarde described how imitation was the way that behaviours spread through groups 2. Roger’s treatise includes descriptions of innovators and early adopters – and many of us in informatics have talked about the importance of trying to engage in innovation (one of the purposes of this journal)3 and to encourage adoption; without necessarily routing our work in Tarde and Roger’s theories 4 , 5…”

In this issue: An innovative discipline needs a patient focus

“…Particularly as a systematic review suggests, patients do not have the opportunity to report their experience of adverse events 6. Continuing the prescribing theme, Brennan et al report how ePresribing adoption in primary care is more likely in those countries that have a state-run registration-based primary care system such as those found in the Nordic countries and the UK 7. There may have been scope for more patient involvement in the development of these processes.…”

Electronic prescription anomalies: a study of frequencies, clarification and effects in Finnish community pharmacies

“…Prescribing has been undergoing changes during the past few decades . Traditional handwritten prescriptions were superseded by computer‐based paper prescriptions at the beginning of the 21st century.…”

“…[2,3,8] Prescribing has been undergoing changes during the past few decades. [9][10][11] Traditional handwritten prescriptions were superseded by computer-based paper prescriptions at the beginning of the 21st century. Today, the most novel technology allows a paperless procedure in which prescriptions are not merely issued by computer, but also transmitted electronically from the physician to the community pharmacy for dispensing (e-prescriptions).…”