The Spanish region of Extramadura has reported that trials of e-prescription sharing across Europe are going well, despite difficulties caused by Coronavirus.
The intention of the interoperability trials is to allow people living in rural border areas in Europe, as well as visitors and tourists, to obtain medicines from pharmacies in another country.
Extramadura shares a long border with Portugal. In some rural areas of both Portugal and Extramadura, the closest pharmacies are across the border. There are no border checks between the two countries, but until now different healthcare IT systems have made it difficult to obtain medicines across the border. This has meant that people have had to go through a time-consuming paper process which is costly to administer and vulnerable to fraud.
Extramadura is one of three Spanish regions which is developing and testing e-prescription interoperability with other European countries’ health service systems. The other two are the Canary Islands and the Basque Country. The Canary Islands are a major holiday destination for visitors from all over Europe. The Basque Country borders France and is a major route for European visitors travelling to Santiago de Compostela and other destinations on the Spanish Biscay coast.
Interoperability between Extramadura’s health IT systems and those of Portugal and other European countries is managed by Spain’s national health ministry in Madrid.
Each of the 17 self governing regions in Spain has its own health service, with independent IT systems. As a result, Spain’s national health ministry has had to connect together the regional systems so that e-prescriptions can be used nationwide. This process began in 2015, and does not yet cover every self governing region. Extramadura was one of the first pilots for interoperability between Spanish regions, and its integration with Spain’s national health service IT hub is well established.
Connecting with Portugal, France and other European countries is an extension of the integration that the country’s health ministry has already carried out between the regions.
E-prescription interoperability is already well advanced between Spain and a number of European countries, particularly Portugal, Croatia, Estonia and Finland. Other countries that are taking part in the EU-wide trials have not yet begun testing, including Italy, Romania, Lithuania, Slovakia and Slovenia.
Challenges in setting up healthcare interoperability between different European countries has included establishing a common language for information exchange, and coordinating timestamp data between different regions and time zones across Europe.
Information exchange within the EU e-prescriptions system has been established in English, with supporting documentation also in English. The use of a common language is vital as a complex set of rules has had to be established, which include banning types of drugs such as narcotics and allergy prescriptions.
Intra-EU narcotic prescriptions are banned due to the risk of unlicensed use and criminal activity. Allergy prescriptions and pharmaceutical compounds are also banned due to risks to patients from different countries commonly employing varying strengths or qualities of pharmaceutical raw materials, or different standard formulas.
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