Abstract
Recent research from the European Commission (EC) suggests that the development and adoption of eHealth in primary care is significantly influenced by the context of the national health model in operation. This research identified three national health models in Europe at this time - the National Health Service (NHS) model, the social insurance system (SIS) model and the transition country (TC) model, and found a strong correlation between the NHS model and high adoption rates for eHealth. The objective of this study is to establish if there is a similar correlation in one specific application area - electronic prescribing (ePrescribing) in primary care. A review of published literature from 2000 to 2014 was undertaken covering the relevant official publications of the European Union and national government as well as the academic literature. An analysis of the development and adoption of ePrescribing in Europe was extracted from these data. The adoption of ePrescribing in primary care has increased significantly in recent years and is now practised by approximately 32% of European general practitioners. National ePrescribing services are now firmly established in 11 countries, with pilot projects underway in most others. The highest adoption rates are in countries with the NHS model, concentrated in the Nordic area. The electronic transmission of prescriptions continues to pose a significant challenge, especially in SIS countries and TCs. There is a strong correlation between the NHS model and high adoption rates for ePrescribing similar to the EC findings on the adoption of eHealth. It may be some time before many SIS countries and TCs reach the same adoption levels for ePrescribing and eHealth in primary care as most NHS countries.
Highlights
Adoption of eHealth in Europe is an area of interest to many stakeholders
In Europe, according to the most recent data on eHealth in primary care,[1,10,56,57,58] approximately 97% of general practitioners (GPs) have access to the Internet and use a computer during consultations and 83% use these systems for recording clinical data such as prescriptions
Conclusions ePrescribing in primary care is spreading in Europe
Summary
Adoption of eHealth in Europe is an area of interest to many stakeholders. The European Union (EU), through its executive body the European Commission (EC), has been a very active stakeholder in promoting the digital agenda in health in recent decades.[1,2] Since 1989, the EC has invested over €1 billion in over 450 eHealth projects.[2]. The primary care sector has been a particular focus of interest as it is where most patients have their routine encounters with the health system and where the greatest volume of health services are provided.[15] The EC commissioned three major surveys into the adoption of eHealth in primary care in 2002,9 200716 and 201310 in 15, 29 and 31 countries, respectively. Taken together, this qualitative and quantitative research paints a rich and complex picture of the development and adoption of eHealth in Europe over the past two decades. It is clear from this work and other related literature[17,18,19,20,21,22,23,24,25,26,27] that many contextual factors influence the development and adoption of eHealth across all countries
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