E.scripts will touch more Australians, more often, than any other clinical application
Replacing the simple printing of prescriptions with E.scripts involves the formulation of a prescription, supported by a relevant Clinical Decision Support System (CDS), and secure transmission of the prescription to the pharmacist, who then dispenses to the patient using associated software for data collection and reporting mechanisms.
Globally, a universal standard for a prescription platform is a priority for most advanced countries. Many issues faced by expert working groups vary between countries or regional jurisdictions. However, three common elements are:
- the technology platform;
- the clinical terminology content; and
- the governance structure.
Of the three, the first two are relatively common across national boundaries and jurisdictions, while the third, governance and legislation, is dependent on national and regional jurisdictional control. While the terminology is fairly common across borders, it is also complex due to the requirement to be consistent with other overlapping, patient-centric, clinical applications and services. As such, different names are used in different countries, which will require a naming framework and rules to be collaboratively developed.
Internationally, the harmonisation of prescription messaging standards involves substantial committee work in HL7 organisations and ISO/TC 215, Working Group 6 (Pharmacy Terminology).
Of all the health sector clinical documents, prescriptions are the most prevalent. In Australia, patients experience the prescription process in greater numbers than for any other clinical application. This process is federally regulated and highly subsidised and crosses all points of clinical care.
Prescriptions link three broad levels of data interoperability:
- the supply chain for unique, aligned and synchronised product identification;
- the clinical functionality of diagnosis, prescribing and dispensing; and culminating in
- the record of the transaction and the content of the transaction being seamlessly archived in a patient’s Electronic Health Record—alongside other patient record information.
The commonality and volume factors combine to make a prescription a fundamental application in its own right, as well as a transaction type to be integrated into the broader healthcare melting pot of data interoperability. Converting paper prescriptions to an electronic format is crucial, as the basis for all other clincal documentation.