What Is Electronic Prescribing?

Electronic prescription (Electronic prescription) refers to relying on network transmission, using information technology programming, filling in drug treatment information during diagnostic activities, issuing prescriptions, and transmitting to the pharmacy via the network, which are reviewed, deployed, checked, and billed by pharmaceutical professionals , And as a medical electronic instrument for drug delivery and medical use in pharmacies. ^[1]

Chinese name: Electronic prescription
Foreign name: Electronic prescription

Function: Medical records
Scope of application: Medical

Electronic prescription compliance basis

According to the "Prescription Management Measures" (Order of the Ministry of Health of the People's Republic of China [No. 53]) ^[2]

Electronic prescription legality

According to Article 14 of the "Electronic Signature Law of the People's Republic of China" ^[3] : A reliable electronic signature has the same legal effect as a handwritten signature or stamp.

Status of domestic electronic prescription application

Many domestic hospitals registered online for diagnosis and treatment platforms have implemented this so-called telemedicine prescription a few years ago. For example, some private hospitals with military names have diagnosed and prescribed prescriptions to patients through the Internet several times and mailed them at the same time. Drugs, this has long been commonplace for some hospitals that rely primarily on Internet communication.

In June 2011, a hospital in Qingdao launched the full paperless electronic prescription, which compared with the paper prescription, saving two parts of time. The first is that the payment office no longer needs to type out drug details and calculate drug costs one by one. Instead, it is generated electronically. Second, after the payment office has clicked "OK", the medicine pick-up can start to place the medicine, and there is no need to wait for the patient to hold the receipt and prescription to start preparation. " "In the next step, the hospital is also preparing to implement the" electronic checklist ", which is the same as the electronic prescription."

On November 25, 2014, Ms. Chen uploaded a prescription issued by a doctor through a health Internet platform client, obtained a response from the pharmacy through a pharmacy bid, and bought two boxes of nifedipine sustained-release tablets for her mother. "The price of the medicine is 15.5 yuan per box, and I also get a discount through the pharmacy bidding using the client. I only paid 11 yuan for the two boxes of medicine."

On the afternoon of December 10, 2015, by connecting to an Internet hospital, a cardiovascular expert in a hospital conducted an "online consultation" with Ms. Huang, a local patient, and then opened the first "online prescription" since the establishment of the Internet hospital. Vascular drugs will be delivered to Ms. Huang's home through a third-party pharmaceutical company. After this process was all completed, this "online prescription" was also rated as "the first Internet hospital electronic prescription" by the industry, and it immediately exploded in the Internet medical industry.

E- Prescription Application Status

E-prescribing U.S. electronic prescription application process:

Minnesota proposed in the 2008 State Act that electronic prescriptions will be implemented in 2011. From 2009 to 2011, the proportion of medical service providers issuing electronic prescriptions increased from 38% to 82%, patient visits involving the need for prescription benefits increased from 26% to 88%, and qualified electronic prescriptions increased from 21% to 61%.

In 2011, more than 85% of healthcare providers issued electronic prescriptions in Massachusetts, 57% of prescriptions were transmitted electronically, and 71% of patient interviews involved prescription benefit needs. Since 2009, these numbers have increased by 57%, 32%, and 40%, respectively.

South Dakota: From 2009 to 2011, the adoption rate of e-prescribing by healthcare providers increased from 25% to 68%, and patient visits involving interest needs increased from 33% to 78%. The rate of e-prescribing among all prescriptions From 14% to 39%.

E-prescribing US e-prescribing security:

The United States is a country with separate medicines, and pharmacies all implement strict classification and management of prescription drugs and over-the-counter drugs. Sales of prescription drugs must be prescribed by an American doctor (electronic / paper). If a pharmacy sells prescription drugs without a prescription, or if a doctor prescribes drugs to a patient at will, it would constitute a felony. Every pharmacy can access the registration information of all doctors in the United States from a computer connected to the Internet. If you are not sure if the prescription is prescribed for a certain doctor, the salesperson needs to call the doctor for verification before selling the medicine.

A prescription issued by an American doctor, you can clearly see the name, license number, address, and phone number of the prescribing doctor when you look up; fill in the patient information in the middle, including name, date of birth, gender, address, phone number; next is the prescription area , Fill in the name of the prescription drug, as well as the relevant dosage, unit and other information; in order to ensure the authenticity of the prescription sign, in addition to signing the name, the doctor must press the fingerprint in the "doctor fingerprint area" in the lower left corner of the prescription sign to verify it, so that the prescription sign Be officially effective.

E-Prescribing E-Prescribing Application Urgently Needs Focus

The first is a technical problem, that is, the application of electronic signature technology to electronic prescriptions, so that any changes to the content and form of electronic signatures and prescription data can be found. This is also a technically urgent problem that needs to be solved in the construction of domestic hospital informatization. The second is the legal recognition of electronic prescriptions: This requires the national health authority and legal department to establish the legal status of electronic prescriptions in compliance with the electronic signature law based on the Electronic Signature Law and the health industry norms. Once a hospital has a prescription dispute, it can use electronic signature technology to realize the inversion of evidence, which can pave the way for the application of electronic prescription and solve the worries of hospital management and information development.

Electronic prescription electronic prescription safety guarantee

Data Integrity for Electronic Prescribing

Completeness means that the outpatient prescription information collected from the clinical information system can be recorded in real time. It should have a digital signature that meets the requirements of the "Electronic Signature Law". The content of the record should be tamper-resistant and non-repudiation, even if it is necessary for some reason. Modifications should record the modification person and modification time in detail. At the same time, complete technology and management methods should be used to ensure the safe storage of outpatient prescriptions. Therefore, it is necessary to establish an integrity protection mechanism for medical data, and use technical means to ensure that the entire life cycle process of generating, storing, and reusing outpatient prescriptions in the system is complete and accurate.

Authenticity of e-prescribing role

At present, the electronic prescription system generally adopts a "user name + password" method. With the deepening of the dependence of the diagnosis and treatment business on the information system, the disadvantages of this weak authentication method have gradually become apparent. At the same time, the weak authentication method is extremely simple to crack, which can easily cause destructive attacks on the prescription system and even threaten the life and health of patients. Therefore, it is particularly urgent to construct an electronic prescription system with high security and high reliability to ensure the authenticity of the logged-in user's identity.

Attribution of Medical Liability for Electronic Prescription

With the current e-prescribing in the medical service gradually replacing the traditional way of obtaining prescription drugs in hospitals, doctors have shifted from being responsible for a paper prescription to recognizing the description of a data message. Whether the responsibility of the data message is clearly related to the network Whether the prescription can completely replace the traditional paper prescription. Therefore, on the premise that the user's identity is authentic, a reliable digital signature needs to be combined to establish a responsibility identification mechanism in the hospital information system to ensure clear responsibility attribution of medical data, thereby eliminating the manual printing and manual signature of medical data to achieve The real significance of electronic prescription makes full use of the advantages of information technology.

The timing of electronic prescription medical behavior is credible

The accuracy and necessity of the generation, modification, and access of electronic prescriptions in medical management are inevitable. However, most of the current software systems use server time or Internet time. It is easy to cause inaccurate records of medical time due to inaccurate recording of the presence time. Therefore, on the premise of ensuring the time source is credible, all key behavior operations need to be time stamped and recorded to ensure the provision of credible time services.

Electronic Prescribing References

Zhu Shichun.Changes and related issues before and after the application of electronic prescription in hospitals [J] .China Pharmaceutical Affairs.2007,21 (3): 177-178.
Order of the Ministry of Health of the People's Republic of China No. 53. Chinese Government Network. 2007-03-13
Electronic Signature Law of the People's Republic of China. Chinese Government Network. 2005-06-27
"The Restlessness of the First Internet Hospital Electronic Prescription". Biology Valley. 2015-12-28
"Municipal hospitals take early tasting electronic prescription registration and take medicine in only 12 minutes" Peninsula Network. 2011-06-17
E-prescribing Honors: Three States Earn Top Marks for Adoption. Www.clinical-innovation.com. 2013-01-30
Bao Guofeng.Research and Application of Electronic Prescription Based on Electronic Signature [C] .Proceedings of 2006 Chinese Hospital Information Network Conference and China-US Hospital Informatization Forum