Electronic Prescriptions

Abstract

The health care industry is going through a major transition period in many ways. The boundaries between the private and public sector are undergoing major changes. We witness a period of “Medicalization”, referring to the fact that almost all human issues also are connected to health issues. Accordingly, the amount of medical and health-oriented knowledge is growing exponentially. Last but not least, the field is fast adopting application of modern information systems and communications, not least because of the emerging solutions on the Internet. Prescriptions and the messing around them on a manual basis is one of the characteristics of the industry that the young computer generation has hard to understand. At a first sight, this area seems to of quite operational character, has a lot of volume, and should not be too complicated. Also an ideal target for automatisation, not to speak even of process redesign However, the current development projects of electronic prescriptions have turned out to be difficult ones. Maybe not so much because of technology, but because of regulation and market acceptance by the dominant players: national authorities, doctors, pharmacies, pharmaceutical industry, and distribution chain in all. Typical feature of the healthcare appears to be several different actors with, at least partly, divergent interests. Compounding the interests of private sector (profit maximisation, efficiency) and public sector (cost minimisation, regulation, standardisation,) is an immensely complex task, furthermore actors are struggling for more influence on the value chain, This article studies the state of the art of electronic prescriptions. Our research questions are: What are the promises of electronic prescriptions What are the inhibiting factors at the way towards electronic prescriptions What could be done to speed up the adaptation of electronic prescriptions. Towards these ends, we review current literature on the issue, and take the Finnish initiatives towards a national electronic prescription system up as a case study. This enquiry was supported through expert interviews. This research uses multiple data gathering techniques. We use several, mainly qualitative methods in data gathering (Yin 1984, Patton 1988). The methods used are: Interviews of key persons Data sheets (for technical and financial data) Observations on case companies infrastructure and documents Interviews are used as main method of gathering data. Traits of action research are too present, as the research is done in connection with a development project aiming at a security concept product for electronic data interchange in health care. Such research has the following characteristics (Huit & Lennung, 1980): “Action research simultaneously assists in practical problem-solving and expands scientific knowledge as well as enhances the competence of the respective actors being performed collaboratively in an immediate situation using data feedback in a cyclical process aiming at an increased understanding of the totality of a given social situation primarily applicable for the understanding of change processes in social systems undertaken within a mutually acceptable ethical framework”.Our research results show, that the technology would be there, but because of unsettled interest and power ramifications, development is less than optimal. The field needs networking and concrete small steps in the form of prototypes. As a solution, we see no other possibility than a strong mandatory initiative by the market regulator, government.Key wordsHealth Care Information SystemsElectronic Prescription