Electronic Prescriptions Project Schedule Under Threat

One of the key figures behind the development of electronic transmission of prescriptions (ETP) in the UK has publicly questioned whether the Department of Health (DH) can achieve its target of rolling out ETP nationally by 2006.

Ewan Davis, chairman of PharMed, which is leading the Transcript consortium — one of three approved ETP pilots in the UK — added that based on current progress it was highly doubtful if electronic prescription records will form part of an integrated electronic health record (EHR) within the next decade.

The first live data flows in the Transcript pilot only began in December 2001, and data flows in the Schlumberger-Sema and Pharmacy2U pilots are only just beginning, yet the DH timetable calls for evaluation in early 2002 and a national rollout in 2004.

"I think that is an early date from where we are today," Davis told an IBC conference on developing future pharmacy services in London this week.

He said that key barriers to ETP included: the protectionist views of many community pharmacists, who just want a quiet life; delays in developing common drug coding systems between GPs and pharmacies; and continuing delays in the delivery of any meaningful form of NHS PKI.

“The development of ETP is dependant on the development of an NHS-wide PKI that links to professional registration processes for GPs, nurses and pharmacists,” stressed Davis. "This is vital in order to identify pharmacists and GPs".

And the potential benefits of ETP are huge: to cut costs, deliver an improved service to patients, and better manage growing demand on pharmacists and GPs. Prescriptions are growing at 7-11% a year – involving over 600m items typically being keyed three times.

“Many of the benefits of ETP relate to repeat prescribing,” said Davis – 65% of all scripts are repeats. "The current growth in scripts cannot be managed with existing processes."

But based on existing barriers and the DH’s slow progress on other major IT projects the PharMed chairman is deeply sceptical about the official project timetable. Evaluation for the pilots is supposed to be completed by December 2002, with a decision on roll out made by April 2003, commencing in April 2004.

"For the DH that would be pretty good going," said Davis, who for perspective drew comparison with the glacial development of pathology messaging where the first messages flowed back in 1987 but is only now moving to national implementation.

Critical to the timetable will be the extent to which integration is attempted with the development of the integrated Electronic Health Record, which Davis described as many orders of magnitude more complex than the Electronic Patient Record.

"If we attempt to do it as an integrated part of the EHR we will not do it in the next 10 years," predicted Davis.