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Review
. 2021 Feb;25(2):102-122.
doi: 10.1089/omi.2020.0085. Epub 2020 Sep 15.

Digital Health in Physicians' and Pharmacists' Office: A Comparative Study of e-Prescription Systems' Architecture and Digital Security in Eight Countries

Bader Aldughayfiq  1 , Srinivas Sampalli  1
Affiliations
Review

Digital Health in Physicians' and Pharmacists' Office: A Comparative Study of e-Prescription Systems' Architecture and Digital Security in Eight Countries

Bader Aldughayfiq et al. OMICS. 2021 Feb.

Abstract

e-Prescription systems are key components and drivers of digital health. They can enhance the safety of the patients, and are gaining popularity in health care systems around the world. Yet, there is little knowledge on comparative international analysis of e-Prescription systems' architecture and digital security. We report, in this study, original findings from a comparative analysis of the e-Prescription systems in eight different countries, namely, Canada, United States, United Kingdom, Australia, Spain, Japan, Sweden, and Denmark. We surveyed the databases related to pharmacies, eHealth, e-Prescriptions, and related digital health websites for each country, and their system architectures. We also compared the digital security and privacy protocols in place within and across these digital systems. We evaluated the systems' authentication protocols used by pharmacies to verify patients' identities during the medication dispensing process. Furthermore, we examined the supporting systems/services used to manage patients' medication histories and enhance patients' medication safety. Taken together, we report, in this study, original comparative findings on the limitations and challenges of the surveyed systems as well as in adopting e-Prescription systems. While the present study was conducted before the onset of COVID-19, e-Prescription systems have become highly relevant during the current pandemic and hence, a deeper understanding of the country systems' architecture and digital security that can help design effective strategies against the pandemic. e-Prescription systems can help reduce physical contact and the risk of exposure to the virus, as well as the wait times in pharmacies, thus enhancing patient safety and improving planetary health.

Keywords: Blockchain; digital authentication; digital health; digital security; e-prescription; privacy; system architecture.

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Conflict of interest statement

The authors declare they have no conflicting financial interests.

Figures

FIG. 1.
FIG. 1.
PrescritbeIT overall structure (used with the permission of Canada Health Infoway, 2018).
FIG. 2.
FIG. 2.
PrescribeIT future features (used with the permission of Canada Health Infoway, 2018).
FIG. 3.
FIG. 3.
Key features of the Surescripts system (used with the permission of Surescripts, 2019).
FIG. 4.
FIG. 4.
Traditional PA (used with the permission of Surescripts, 2019). PA, prior authorization.
FIG. 5.
FIG. 5.
Electronic PA in Surescripts (used with the permission of Surescripts, 2019).
FIG. 6.
FIG. 6.
Australia eRx Architecture (adapted from eRx, 2018a). eRx, electronic medical prescription.
FIG. 7.
FIG. 7.
UK e-Prescription service architecture (adapted from NHS, 2019).
FIG. 8.
FIG. 8.
Spain e-Prescription system architecture (adapted from Ministry of Health, Social Services, and Equality, 2014).
FIG. 9.
FIG. 9.
Japan current prescription process steps translated from Ministry of Health, Labor, and Welfare (2019).
FIG. 10.
FIG. 10.
Japan e-Prescription system in the 2016 guidelines (translated) (Ministry of Health, Labor, and Welfare, 2016).
FIG. 11.
FIG. 11.
Japan new e-Prescription system expected in 2020 (translated) (Ministry of Health, Labor, and Welfare, 2019).
FIG. 12.
FIG. 12.
Sweden e-Prescription system components (adapted from Hassel (2019).
See this image and copyright information in PMC

References

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