The electronic prescription was implemented throughout Italy in 2016, it represents the new tool through which the doctor prescribes medicines and specialist visits online, without using the classic paper form anymore. Let’s see how the dematerialised prescription works and what are the advantages of e-health, the digital transformation within the healthcare sector.
THE HEALTH INSURANCE CARD SYSTEM IN ITALY
To make the most of the advantages of the e-prescription, doctors need to connect to the Central health insurance card system (also called Sac in Italian) and enter their identification number, patient data, medicines or visits required. They can also add information about the patient’s health problem, as well as any exemptions and the priority code.
Guidelines for the electronic prescription
The dematerialised e-prescription will be identified with a unique national code (the electronic prescription number), which will be provided to the patient as a paper reminder for the withdrawal of medicines or for medical examination.
The reminder can be used only once and within 30 days of its issue, beyond which the prescription is blocked by the system and loses its validity. The pharmacist, after viewing the digital prescription thanks to the electronic prescription number and the tax code of the patient, will deliver the requested drug.
The validity of the electronic prescription
Since the e-prescription contains the patient’s personal data, the medicine or the referral and any exemptions, the health document has a unique identification code that allows the citizen to use it throughout the national territory and to benefit from the health service even in case of prescription loss.
What is the Electronic Prescription Number code and when is it valid?
The bar code identifying EPN, which indicates the Electronic Prescription Number, is a unique number containing 15 characters. They convey the region code and the reference lot. Thanks to the identification bar code, it is possible to trace the prescription even in case of loss, using the citizen’s health card.
Thanks to the e-prescription it is possible to buy medicament even outside the region of origin without losing the right to exemptions and without cost changes on the ticket.
What changes with the transition from the paper prescription to the dematerialised electronic prescription?
The role of the doctor and pharmacist
The doctor prescribes medicines, referrals or medical examinations electronically through the central health card reception system. Once the dematerialised prescription with a unique national code has been generated, the doctor delivers a paper reminder that is used to collect the medicines, to perform the medical examination or to book tests. The reminder works indiscriminately and in the same way throughout Italy, provided it is used within 30 days starting from the issue day.
What can be prescribed?
By the electronic prescription it is possible to request the administration of a maximum of 2 packs per medication. Exceptions are patients with chronic disease, who can obtain up to 6 packs per prescription. Thus, patients will be able to cover a maximum of 180 days of therapy, provided that the medication has already been used by the patient for at least 6 months.
This norm is valid only for specific chronic pathologies and is compatible with antibiotics in single-dose packaging, medicines administered by drip and interferons for those suffering from chronic hepatitis.
For medicinal products containing narcotic substances, a sufficient number of packs may be dispensed to cover a maximum therapy of 30 days. Only for the first prescription of a medicine, or in case of modification of the therapy, the prescription of only one package per prescription is allowed. Clearly, the same patient cannot receive multiple prescriptions of the same medication on the same day, unless he/she has to complete a therapeutic cycle within 7 days.
What cannot be prescribed?
The paper prescription has not yet completely disappeared, but is still used for some categories of medicines, such as drugs, psychotropic substances, medicines that must be collected at the hospital pharmacy or delivered during home visits.
The e-prescription is widespread almost everywhere in the Italian regions and the next objective is to adopt it also for specialist clinic services. At the same time, the dematerialisation of pharmaceutical prescription has already been completed.
The case of Campania
In February 2019, 85.73% of the prescribed pharmaceutical prescriptions were already in electronic format. The region that currently holds the primacy is Campania, where 94% of the prescriptions are online, with the complete elimination of paper support and the interconnection between the health insurance card system and doctors, pharmacies and healthcare facilities.
E-prescription without provision
In Trento, the paper reminder has disappeared and the citizen, with the consent of the pharmacies for access to electronic prescriptions, can also withdraw the medication by just showing their health insurance card.
Being able to do without the paper prescription is a real advantage especially for patients with chronic diseases, who can thus avoid long waits in the waiting room only to collect the hard copy of the prescription of their usual treatments.
To completely eliminate the reminder, it is necessary to identify a safe system that allows the pharmacists to dispense the medicine even when they are not able to access the electronic prescription due to line or computer problems.
The electronic prescription for veterinary medicaments
For a year now, the electronic veterinary prescription has also been mandatory for animals, whether pet or farm animals. Both the paper and electronic formats are usable.
The traceability information system of veterinary medicaments will also allow accurate data on the use of antibiotics on farms. Digitisation ensures greater protection of public health and healthier and safer food.
Also in these cases, to collect the medicine in the pharmacy, you just need to provide the prescription number or the tax code, and the personal identification code created by the system at the time of issue by the veterinarian.