We had already learned to know and use it in a difficult moment such as the pandemic emergency, which had accelerated a change already underway. Now however, as a measure of necessity, the e-prescription will become final. The confirmation came from the Minister of Health, Orazio Schillaci.
Electronic version of that papery red (mainly used for the prescription of drugs, diagnostic tests or specialist visits) and that bianca (for paid, non-loanable medicines), the electronic prescription or digital prescription it is a document that allows access to the pharmaceutical and outpatient services provided by the National Health Service (SSN). But how is it made and what are the advantages of this evolution? Let’s try to find out together.
What is the electronic prescription
The virtual version or “dematerialized” of the recipe was introduced in the health sector during the computerization process which aims to complete it elimination of the paper support, in favor of real-time interconnection between the Central Reception System, the Health Card and prescribers, pharmacies and facilities that provide specialist outpatient services. Besides having the same characteristics of the red prescription in terms of prescription capacity by the doctor and temporal validity, the dematerialized prescription presents some advantagessuch as the possibility of collecting medicines even outside one’s own region.
It was introduced in Italy in 2016 for prescription-only medications Class A (i.e. essential medicines and for chronic diseases whose cost is borne by the State), while from May 2020 it has also been extended to based medicines of narcotic and psychotropic substances (included in sections B, C, D, E) and medicines with strong analgesic activity. The last update dates back to December 2020, when the Ministry of Economy and Finance extended the possibility, starting from 30 January of the 2021to prescribe through the electronic prescription too all paid medicines which usually were included in the white recipe.
It must be said that the path towards the dematerialisation of many health services certainly contributes to making the whole National Health System more efficient, but it has proved to be an extremely effective measure above all in limiting travel as much as possible and reducing the spread of the COVID during the pandemic, ensuring the availability of medicines to the most fragile subjects and, in general, reducing the influx of patients into medical offices. An ordinance of the Civil Protection then allowed the citizen not to collect the reminder, but to receive the electronic prescription number directly at home via a telephone message (text message, verbal telephone communication) or e-mail.
Dematerialization: what it consists of
The dematerialized recipe it is governed by an inter-ministerial decree of 2011. The information contained in this prescription (such as co-payment exemptions, drugs or specialist outpatient services) are forwarded digitally, in real time, to pharmacies and specialist doctors, as well as to the Ministry of Economy and Finance , and can be recalled from the system at the time of delivery of the prescribed service.
In addition to making accurate and timely i check of appropriateness both in the prescription and dispensing phases, this type of recipe aims to simplify the paper documentation management activities by the ASL; moreover, the system carries out checks in real time which allow for the correct identification of the patient in the prescription phase, the existence of the patient’s right to income exemptions, the existence of the drug to be dispensed (thanks to the interconnection with the Bank Data from the Handbook of the Italian Medicines Agency), as well as the verification that the same package has not already been sold previously, and also the existence of the specialist service on the basis of the tariff nomenclators and catalogs provided by each individual Region.
How the new recipe works
Made one positive evaluation of the request for medicines presented by the patient, or after having visited him to establish what type of tests he should undergo, the doctor connects to a identification computer system and proceeds with the compilation of the medical prescription, entering the type of medicine or service, and the pathology that determine the request. Using a specific IT application, made available by the Health Card System (TS) and called Central Reception System (SAC or, in the case of a regional system, SAR), records the same information required by the red paper prescription: the patient’s data, his/her identification number, the medicine or necessary tests, the diagnostic query (i.e. the health problem which determines the request for the service), any exemptions (due to income or pathology), the priority code for specialist outpatient services which are carried out for the first time.
The doctor refers to regional cookbook for medicines paid by the NHS, while for specialist services it is based on tariff nomenclators and on the catalogs supplied by each single Region. For drugs, no more than can be prescribed 2 packs.
Once generated, the dematerialized recipe is stored in the system and identified by a Unique National Code generated by the Central Reception System, i.e. the Electronic Recipe Number (NRE for Red Recipe or NRBE for White Recipe), also called recipe code. It is an alphanumeric code, which replaces the traditional recipe barcode, divided into two blocks, made up of 15 digits in total, located at the top right of the prescription. The doctor then delivers a memorandum of the prescription (still on paper) and subsequently transmits it in electronic form to the patient by e-mail, text message or other means of communication.
The patient will only have to go to the pharmacy, equipped with health insurance card, to collect the drug. Here, by connecting to the same telematic system, the pharmacist (or the Cup) will be able to directly access the digital prescription and the holder’s data, using the electronic prescription number (NRE) and the tax code, then he will deliver the drug (or, in case of the Cup, the performance will be booked).
Warning: its validity is 30 days and once expired it will no longer be considered valid. Even the reminder, like the red prescription, can be spent only once, always within a month, beyond which the electronic prescription is blocked by the system and the drug can no longer be dispensed.
Memorandum
Although the prescription is electronic, the doctor can still issue a paper memo of the prescription, printed on a white sheet in A5 format, to guarantee that the service is provided even in the event of unavailability of computer systems. Where required by the Regional System, the reminder is also available online and the citizen can collect the drug, subject to consent from the pharmacies for access to electronic prescriptions, by presenting the health card. In case of computer connection problems, using the reminder it will still be possible to collect the prescribed medicines. Even if you miss the reminder, you will still be able to pick up your medicine, as the prescription is registered in a database accessible to all pharmacies.
As well as for the red recipethis paper copy of the e-prescription is also meant to be eliminated over time: in fact, a process has been undertaken to arrive at the digitization of the memo, and make the prescription completely digital.
Differences and advantages
In terms of prescription ability by the doctor and by temporal validity (30 days), there is none between the electronic prescription and the red paper one difference. Just like the paper version, the virtual one is used to prescribe Level A medicines, diagnostic tests and specialist visits. Unlike the paper one, however, the dematerialized recipe:
1) can be used throughout Italy (the use of the electronic prescription ensures the circularity of pharmaceutical prescriptions in the conventional regime throughout the national territory). It is thus possible to collect the medicine with the reminder from your doctor in any pharmacy without paying the full price, as was the case with the red prescription used outside the Region; you are entitled to the same exemption or to pay the same ticket;
2) It saves the cost from the special card used for the red prescription (that is, the paper with the colored border of the fields that the doctor fills in with the necessary data);
3) is more precise and completethanks to the use of the computer program.
Prescribing medicines and healthcare services by electronic prescription has resulted in several advantagesas a major check on the appropriateness of the medical prescriptions prescribed with respect to the patient’s clinical history, a reduction in the paper used, a limited exposure to the risk of infections;
For i chronic patientsthe dematerialized recipe will be valid for one year and will allow you to stock up on medicines for 30 days of therapyalways according to the doctor’s instructions. Many patients in this condition are elderly people, often suffering from more than one chronic disease, not self-sufficient or unable to move. In addition to easing these people, the measure will help ease the burden administrative load for family doctors, for the benefit of patient care.