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Vol 271 No 7268 p393
27 September 2003

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Related websites
DoH: Electronic transmission of prescriptions ()
DOH: "ETP evaluation of pilots" summary report ( 50K)

ETP is viable but consent is a problem

Requirements for handwritten signatures will need to be removed if ETP is to work nationally

Electronic transmission of prescriptions (ETP) is viable, an independent review of the three pilot schemes in England has concluded, but the need to gain written consent from each patient was a time-consuming exercise that contributed to the pilots' slow starts.

A summary report on the pilots, published by the Department of Health last week, says that although each of the pilots achieved its aim of sending prescriptions electronically, a single common model of ETP is needed for national implementation. Changes to legislation will be needed to remove the current requirements for handwritten signatures from both prescribers and patients or their representatives. Electronic ways of identifying patients’ exemption status will also be needed for a national scheme to be successful.

Reviewers from the Sowerby Centre for Health Informatics at Newcastle, the Manchester school of pharmacy, the Industrial Statistics Research Unit at the University of Newcastle and scientific research company QinetiQ examined the first six months’ work of the pilots, coinciding mainly with the second half of 2002. The pilots continued for another six months after this and most of the significant volume of prescription transfer occurred after the review period.

The biggest initial problems were technical difficulties and patient recruitment. Although the pilots were, in their own terms, successful, they did not demonstrate any of the potential benefits expected of ETP. These could have included convenience and choice for patients, greater time for pharmacists to spend discussing medication with patients and reduced workloads for general practitioners and the Prescription Pricing Authority.

The report says no major fraud and security concerns were seen. Some types of fraud might be eliminated but others may become easier, it concludes, without giving details of what these might be.

Both the Pharmacy2u and TransScript consortia told The Journal that while the review was fair it would have been better if it had been delayed to take account of the pilots’ initial problems. ETP is now to form part of the national integrated care records system (ICRS) for the NHS. The consortia said that they hope to take part in further ETP work if they are invited to do so by companies involved in developing the ICRS.

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