ePrescribing – Integrating Primary Care, Hospitals, Pharmacies in Spain (Andalucia). Piña Vera MJ. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

1. ePrescription in Andalucía
(Receta XXI)
María José Piña Vera
Andalusian Health Service

2. Andalusia
Andalusian population
• 8.302.923 inhabitants
• 17,8% of the Spanish
population

3. e-Prescription (Receta XXI)
CENTRALIZED DISPENSED
DIRAYA
MEDICINES DATABASE
BDU
HSDC
BDP
Dispensed FARMA
medicines
Network
Network
Prescriptions
Dispensed
medicines
USER
INSTRUCTIONS
Medical office (PC-SC) FORM
DIRAYA

4. ePrescribing: advantages
USERS:
• Avoids unnecessary visits to the clinics to repeat
prescriptions
PRACTITIONERS:
• Minimizes activity prescription in health centres:
entire treatment prescribed by specialists
• Releases personnel from bureaucratic tasks
• Increases time devoted to patients
• Possibility of better support for rational
prescription

5. ePrescribing: advantages
PHARMACISTS:
• Significant promotion of Pharmaceutical Care
• Reduction of management expenses and billing
in prescriptions
HEALTH ADMINISTRATION:
• Improves follow-up and control of rational use of
drugs (RUD)
• Correct assignment of responsibility in RUM
among levels
• Decrease in fraud and better control of billing

6. Diraya Workgroup to improve
the ePrescribing
• Primary care Doctors
(8)
• Pharmacology
Technician (1)
• SAS IT Technician (1)
• Pharmacists from the
SAS Pharmaceutical
and Provision
Department (3)
• Pharmacists of the Andalusian
Council of Official Colleges
of Pharmacists

8. Implementation of Receta XXI
2003
Torreblanca
Population coverage IMPLEMENTED
< 25 % NOT IMPLEMENTED
25 - 50 %
50 - 75 %
75 - 90 %
> 90 %

9. Implementation of Receta XXI
IMPLEMENTED
NOT IMPLEMENTED

10. Implementation of Receta XXI
726 centres 1 hospital
2009
7.620.101 users (94,6 %)
3.188.240 patients 16.726 patients
5.398 doctors (92 %) 72.584 dispensed medicines
3.553 pharmacies (99 %)
206.228.769 dispensed
medicines
5,4%
Population coverage
IMPLEMENTED
< 25 %
NOT IMPLEMENTED
25 - 50 %
50 - 75 %
75 - 90 %
> 90 % 94,6%

11. Results

12. Receta XXI: eDispensing Percentage
December 2009
Chronic treatments
58 %
71 %

13. Number of dispensed medicines
100.000.000
89.240.751
90.000.000
80.000.000
70.000.000 66.315.635
60.000.000
50.000.000
40.000.000
30.520.106
30.000.000
20.000.000
8.982.319
10.000.000 1.245.313
247.545
0
2004 2005 2006 2007 2008 2009

14. % ePrescriptions
120.000.000 60,00 %
50,31
100.000.000 50,00 %
80.000.000 40,00 %
39,71
60.000.000
www.ehr-impact.eu 30,00 %
40.000.000
20,00 %
19,46
20.000.000 10,00 %
6,10
0,88
0
0,18 0,00 %
2004 2005 2006 2007 2008 2009
Hand-written prescriptions Printed prescriptions
ePrescriptions % ePrescriptions

15. Progress of appointments by
Receta XXI in Andalusia
Number
of
appointments
60.000
56.552
47.910
50.000
Appointments reduction
40.000
30.000
20.000
15.28%
10.000
2006 2nd half-year 2007

16. Progress of appointments by Receta XXI
Area Sanitaria Norte de Córdoba
120.000
Appointments reduction:
100.000 95.766
81.121
80.000
 El Viso 30 %
sep-05
60.000 53.378
41.809 sep-08
 Espiel 27 %
40.000
24.444 23.388
17.009 17.059
20.000
 Hinojosa 22 %
0
POZOBLANCO HINOJOSA EL VISO ESPIEL
 Pozoblanco 16 %

17. Prescriptions precautionary cancelled
by the pharmacist (2009)
• 20.892.779 Prescriptions
• 11.349 Precautionary cancellations (0,05%)
• 10.762 Confirmed by the doctors
• 587 Activated by the doctors

18. Prescriptions precautionary cancelled
by the pharmacist (2009)
95%
Confirmed by the
doctor
Activated by the
doctor
5%

19. Conclusions
Continuous
updating
Unique Continuous
Electronic training
Health
Record
Quality
issues Interoperability
Peribanyez

20. Thank you for
your attention
Peribanyez