Table 3 ePrescribing interoperability key findings

1. ePrescribing Interoperability & Patient safety

Interoperability is considered as an enabler of increased patient safety, for example, to ensure that a list of current prescribed medications is known to a new prescriber to avoid potential issues with polypharmacy or that a list of current medication is available during emergency care.

National Pharmaceutical

Record (G-Standaard) in the Netherlands provides a complete Prescribing History for the treating medical team (community or hospital based)

2. ePrescribing Interoperability & Integrated Care

Systems and services interoperability is considered to be a critical enabler of integrated care as a means of ensuring that information is effectively transferred and shared across the patient pathway and enabling effective oversight of quality and efficiency of care provision.

The effective integration of HIT systems in hospitals with laboratory services and external organisations have been found to be key facilitators in the successful embedding of ePrescribing systems.

Conversely, issues of interoperability and integration have recurrently been identified as potential important barriers to the acceptability and safe use of ePrescribing systems (5).

3. ePrescribing Interoperability, Care Pathways & Decision Support

Interoperability can be used as a mean to optimise local integrated care pathways to suit local care priorities / protocols and develop custom decision support systems

One US hospital used its own institutional capacities in biomedical research to develop local pharmacogenetic rules and then negotiated with the vendor to implement the pharmacogenetic rules in the ePrescribing system to support new prescribing process and workflows.

4. ePrescribing for full services Interoperability

In this scenario, interoperability goes beyond the simple sharing of data across different clinical systems and instead allows for the information to be usable by the end-users for the specific healthcare purpose at hand in a variety of settings & contexts.

Systems and stakeholders need to work in synch to ensure that full services interoperability is achieved.

National Pharmaceutical Record (NorPD) can be used in a variety of settings (e.g. pharmacy, primary or secondary care) and for a variety of purposes (e.g. routine care, emergency care, research and public health)

This is made possible by national legislation which enables patient data to be shared in a variety of context for a variety of purposes.