General information about the system
AIS "Electronic Prescription" is designed to implement the technology of electronic prescriptions circulation in the healthcare of the Republic of Belarus and is a centralized system of electronic prescription and dispensing of medicines for treatment in outpatient and inpatient conditions, including preferential drug provision.
Basis for system development:
- event 21 "Creation of a full-scale system for circulation of electronic prescriptions in the Republic of Belarus using an electronic digital signature" of subprogram 3 "Digital transformation" of the State Program for the Development of the Digital Economy and Information Society for 2016 - 2020, approved by the Resolution of the Council of Ministers of the Republic of Belarus dated March 23, 2016 . No. 235;
- agreement between the Ministry of Health of the Republic of Belarus and the state institution "Republican Scientific and Practical Center for Medical Technologies, Informatization, Management and Health Economics" dated December 14, 2016 No. ЦТ21-ЭР. The consumers of the system are healthcare organizations of the Republic of Belarus providing medical services to the population (including departmental and private forms of ownership), pharmacy organizations of various forms of ownership, the Ministry of Health of the Republic of Belarus, healthcare departments of regional executive committees, the Health Committee of the Minsk City Executive Committee, and other interested management bodies and departments.
The main goals of creating AIS ER are:
- improving the quality of medical care for patients by reducing the doctor's working time spent on the implementation of medications and prescriptions;
- carrying out various types of information analysis (comprehensive accounting of the prescription of subsidized medicines in the context of healthcare organizations, patients, analysis of the cost of drug treatment, planning the procurement of medicines, etc.);
- ensuring the analysis of the correctness of the prescribed drug treatment;
- creation of prerequisites for more effective and safe drug therapy (excludes unreadability or misinterpretation of prescriptions, the computer system can use both expert advice on prescribing and warnings about the possible consequences of unwanted drug interactions, since the use of the AIS ER system allows the doctor to see all medicinal products prescribed to the patient, avoid erroneously indicated dangerous dosages, etc.);
- reducing the cost of treatment by reducing the complications of drug therapy (wrong choice of drugs, complications from the joint use of drugs, side effects), the use of analogues of original drugs - generics, etc .;
- elimination of the possibility of duplication of dispensing of subsidized medicines for one patient;
- exclusion of the possibility of counterfeiting both conventional and preferential recipes.
The following main functions are implemented in the AIS ER system:
- creation and maintenance of a register of electronic prescriptions;
- automation of the process of issuing prescriptions in electronic format by doctors of healthcare organizations with the subsequent transfer of information to a centralized storage of electronic prescriptions;
- automation of the process of dispensing medicines by electronic prescriptions in a pharmacy organization with the subsequent entry of information on dispensing into a centralized storage of electronic prescriptions;
- providing doctors with access to information about all drugs prescribed to a patient, including by other doctors and / or in other organizations;
- providing access to information on prescribed and dispensed drugs on-line to generate the necessary analytical materials.
When creating a full-scale AIS ER, the technology of the universal patient identifier was used, where plastic cards of patient medical care were adopted as carriers of identifiers.
The regulation on the circulation of plastic cards for medical services (identification plastic cards of patients) was approved by order of the Ministry of Health of the Republic of Belarus dated August 31, 2015 No. 863.
The card contains a unique number associated with the patient (individual) within the framework of medical information systems (hereinafter - MIS). To increase the speed of entering a unique number and minimize errors, a corresponding linear barcode is applied to the plastic card, which can be read by barcode scanners both in a pharmacy, when dispensing medicines, and in a healthcare organization, within the framework of various electronic services (appointment with a doctor at the reception, service using an electronic queue, etc.).
The numbering system of identification plastic cards of patients and the regulations for its use are based on STB ISO / IEC 7812-1-2013, STB ISO / IEC 7812-2-2013 and guarantees the uniqueness of the numbers.
With the introduction in the Republic of Belarus of Id-cards for identification, they are supposed to be used in the AIS "Electronic Prescription" in parallel with the patient's medical service card. It will be possible to identify a patient in the system both by the number of the medical service card and by the identification number of the ID card.
The information exchange within the AIS ER is based on the international open standard FHIR (Fast Healthcare Interoperability Resources), created by the international organization of the electronic medical document management system Health Level 7 (HL7), taking into account the experience of previous standards and modern web technologies.
How does the "electronic prescription" work?
With the introduction of Id cards, healthcare institutions and pharmacy chains must be equipped with Id card readers. To receive services through the Electronic Prescription system, a patient must obtain a medical service card. The card is issued at the health care institution to which the patient belongs at the place (address) of registration. In the medical information system, the number of the medical service card is automatically entered into the electronic outpatient card of the patient by scanning the barcode. The patient is registered in the AIS "Electronic Prescription" database. This allows a doctor to prescribe drugs electronically and then dispense them in pharmaceutical networks using a medical service card.
AWP "Registry" in healthcare institutions, as well as AWP of a pharmacist in pharmacies must be equipped with scanners for reading a barcode from a medical service card.
With the introduction of Id cards, healthcare institutions and pharmacy chains must be equipped with Id card readers.
An electronic prescription is signed with an electronic digital signature of a doctor and has the status of an electronic document.
If the doctor has not purchased the EDS means, he must, in parallel with the issued electronic prescription, give the patient a paper prescription. it is not enough to present a medical service card in a pharmacy to receive a medicine by electronic prescription without a doctor's EDS.
Dispensing of medicines according to electronic prescriptions in the pharmacy network.
AIS "Electronic Prescription" The pharmaceutical information system installed in the pharmacy network must ensure interaction with the AIS "Electronic Prescription" in terms of dispensing medicines under electronic prescriptions. When a patient contacts a pharmacy, the pharmacist scans the barcode of the medical service card, and the pharmaceutical information system displays the name of the prescribed medicine, its quantity, dosage, manufacturer of the drug and the price. After payment for the medicinal product, the fact of purchase is automatically recorded in the AIS "Electronic Prescription".