E-medication

The e-medication is an information system about the drugs prescribed and dispensed by a patient. The e-medication is part of the electronic health record (ELGA) in Austria . With e-medication, doctors, pharmacists and hospitals get an overview of the drugs prescribed and dispensed by a patient in pharmacies. This information can then be used to carry out a further (electronic) check for possible interactions and multiple prescriptions. E-medication is intended to increase patient safety.

Expected benefit

Many patients take different drugs at the same time or in quick succession. In cases where several drugs are required due to the clinical picture, multiple prescriptions and thus an overdose of an active ingredient can occur. Unwanted interactions can also occur. In some cases, all of this can pose a health risk to the patient; one speaks of undesirable drug effects . In fact, up to ten percent of all hospital admissions result from adverse drug reactions, in around a third of cases drug interactions are the reason.

The risk of undesirable interactions and unrecognized multiple prescriptions is particularly high in older and chronically ill patients. These are often treated by several (family and specialist) doctors, for whom it is difficult to get a reliable overview of all the other doctors' prescriptions. In addition, the patient can also buy non-prescription drugs in pharmacies. All of this increases the risk of undetected multiple prescriptions and undesirable interactions.

The aim of e-medication is to provide the doctor or pharmacist with as complete an overview as possible of all the drugs prescribed or dispensed by a patient and thus to minimize the risk of adverse drug effects due to multiple prescriptions and interactions. The attending physician or the dispensing pharmacist can therefore see all the drugs that have been prescribed for the patient or which the patient has bought in pharmacies. The recognition of multiple prescriptions and interactions should thereby be facilitated. This is intended to increase the safety of patients taking medication.

history

From April to December 2011, the pilot operation for e-medication took place in three regions of Austria. This was evaluated by the Medical University of Vienna and the Private University for Health Sciences, Medical Informatics and Technology . During the evaluation period, 5,431 patients as well as 41 general practitioners, 31 specialists, 50 pharmacies, 13 general practitioners with home pharmacies and four hospitals actively participated in e-medication. On average, during the evaluation period, a warning of an interaction occurred every second visit by a patient to a doctor or pharmacist. At every sixth visit, e-medication showed a warning that the therapy interval could be exceeded due to drug stocks. On every ninth visit it showed a double prescription warning.

With the evaluation of the pilot project e-medication, technical and organizational knowledge for an Austria-wide implementation could be gained. The results of the evaluation of the pilot operation resulted in the following recommendations, among others: e-medication is to be pursued further with the involvement of all professional groups concerned and taking data protection into account. It is most effective when there is compulsory participation of all affected health facilities and professional groups. For patients, however, freedom of choice must apply to participation. The results of the evaluation formed the basis for the planned nationwide use of e-medication throughout Austria.

As a result of the pilot project, it was decided that e-medication should no longer include a central test for interactions and interactions. Rather, the doctor or pharmacist should carry out these tests on their own responsibility with their own software.

With the resolution of the ELGA law in the National Council in December 2012, the main association of Austrian social insurance institutions was commissioned to implement e-medication across Austria.

Status of introduction

According to the Health Telematics Act (ELGA Act), the main association has to set up e-medication by the end of 2014 and operate it from this point in time. E-medication is to be introduced gradually. If the ELGA components are technically available, the earliest time to save medication data is:

January 1, 2015 for public hospitals, AUVA hospitals and care facilities
July 1, 2016 for pharmacies, freelance doctors, group practices, independent outpatient clinics - in a contractual relationship with social insurance
January 1, 2017 for private hospitals
January 1, 2022 for dentists, dental group practices and independent dental clinics.

The Austrian e-card system forms the technical basis for e-medication. The e-card served as an access key to the drug data. The entire project was approved by the Data Protection Commission.

In June 2014 it became known that the introduction of the ELGA and thus also of e-medication would be delayed by about a year.

Procedure for e-medication

All medically prescribed and dispensed or purchased medication at the pharmacy are saved in a personal medication account. This medication data can be called up and viewed by the doctor or pharmacist when prescribing a medication and when dispensing it at the pharmacy. The e-medication thus provides a comprehensive overview of all drug prescribed by a doctor or purchased without a prescription in the pharmacy, drug relevant to interaction of a patient. This information is only made available to the treating physicians in the private practice and in the hospital as well as to the dispensing pharmacist.

In addition, the information from e-medication can be checked for possible interactions and double prescriptions with the locally used software (e.g. the doctor information system or the pharmacy system). If these tests reveal abnormalities, the doctor can change the prescription or the pharmacist can consult the prescribing doctor before dispensing. This is intended to improve medication safety.

With the e-card as a citizen card or the mobile phone signature, a patient can view their electronic health record and thus also their medication data. It is also possible to hide individual drugs. People who do not have internet access can contact the ombudsman.

The e-medication does not replace the previous paper prescription.

Citizens can decide for themselves that they do not want to participate in e-medication (so-called "opt out"). This objection can either be submitted electronically via the ELGA citizen portal, which is anchored on the website www.gesundheit.gv.at, or in writing to an objection body.

Individual evidence

↑ ^a ^b ^c ^d ^e ^f Social security chip cards Betriebs- und Errichtungsgesellschaft mbH - SVC. What is e-medication? . Retrieved January 24, 2015
↑ ^a ^b ^c ^d ^e > e-Medication ( Memento of the original from January 28, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved January 24, 2015 @1@ 2

↑ Sonja Mayer. Caution interaction! ( Memento of the original from January 28, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. SpringerMedizin.at. Published September 11, 2012. Retrieved January 24, 2015 @1@ 2

↑ Drug side effects in the elderly . In: Austrian Medical Journal No. 21 of November 10, 2010. Online edition. Retrieved January 24, 2015.

↑ ^a ^b Social security chip cards Betriebs- und Errichtungsgesellschaft mbH - SVC. e-medication: Scientific evaluation confirms high patient benefit ( memento of the original from January 28, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved January 24, 2015 @1@ 2

↑ E-medication comes without an interaction test . APA notification dated February 28, 2014. Retrieved January 24, 2015.

↑ Die Presse.com. The start of ELGA is postponed. Published June 30, 2014. Retrieved January 24, 2015.

[SVC-1] ↑ ^a ^b ^c ^d ^e ^f Social security chip cards Betriebs- und Errichtungsgesellschaft mbH - SVC. What is e-medication? . Retrieved January 24, 2015

[BMG-2] > e-Medication ( Memento of the original from January 28, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved January 24, 2015 @1@ 2

[3] Sonja Mayer. Caution interaction! ( Memento of the original from January 28, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. SpringerMedizin.at. Published September 11, 2012. Retrieved January 24, 2015 @1@ 2

[4] Drug side effects in the elderly . In: Austrian Medical Journal No. 21 of November 10, 2010. Online edition. Retrieved January 24, 2015.

[SVC2-5] Social security chip cards Betriebs- und Errichtungsgesellschaft mbH - SVC. e-medication: Scientific evaluation confirms high patient benefit ( memento of the original from January 28, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved January 24, 2015 @1@ 2

[6] E-medication comes without an interaction test . APA notification dated February 28, 2014. Retrieved January 24, 2015.

[7] Die Presse.com. The start of ELGA is postponed. Published June 30, 2014. Retrieved January 24, 2015.