E-prescribing in the Czech Republic: 1450 pharmacies, but no doctors, register for central prescriptions database

27 October 2009

Andrea Jarolímková, Vojtech Chloupek

Electronic prescribing of medicines, also known as "e-prescribing", is a key part of the eHealth concept currently being adopted in the Czech Republic. Although the relevant legal regulation concerning e-prescribing was put in place at the end of 2007, due to data protection issues and current lack of take-up by doctors the project is unlikely to be finished until 2010.

On 31 December 2008, the Czech Health Authority established the Central Database of Electronic Prescriptions (CDEP) so as to fulfil its obligation imposed by the Czech Pharmaceuticals Act. CDEP makes it possible for all doctors and pharmacies to be connected in one e-prescribing system and therefore allows for electronic delivery of a prescription from the doctor to the pharmacy. Data concerning patients and medications will be stored in CDEP for five years and, subject to the patient's consent, will be accessible by all doctors registered in the system. That being said, patients will be able to verify which doctor inspected or made any entry in their files.

Pharmacies have a statutory duty to register in CDEP and must use it to perform other obligations, for example to collect information about the sale of restricted medicines and provide them to the Czech Health Authority.

The establishment of CDEP had a crucial role in the initiation of the e-prescribing process. During the first phase, starting in January 2009, pharmacies gradually registered onto the CDEP, depending on their technical equipment and the capacity of software suppliers. Although the first phase of pharmacy registration should have been completed, to date approximately 1450 pharmacies from the 2600 that should have been registered, have been registered in CDEP.

Doctors could be registered in CDEP from January. However, they have no legal obligation to do so and whether doctors choose to be registered depends on the circumstances of the individual doctor, who may be influenced by their patients' interests, the technical capacity of computer equipment in their practices and the cost of special software. Embarrassingly for the proponents of e-prescribing, not a single doctor in the Czech Republic has become registered in CDEP yet.

Therefore, the Czech Health Authority plans to run a second registration phase in the autumn of 2009.  This could primarily be aimed at increasing the doctors' knowledge about the advantages of e-prescribing and testing of special software.

The doctors appear to be concerned about potential misuse of their patients' sensitive personal data and recent developments may reinforce these concerns. The Czech Data Protection Authority delivered a protocol on the review of CDEP to the Czech Health Authority at the beginning of August 2009. The review was focused primarily on data protection issues concerning the collection of patients' personal data and their security in CDEP. The Czech Data Protection Authority concluded that the Czech Health Authority is acting outside the scope of its competence and contrary to data protection law. The Czech Health Authority has been invited to present its objections against this protocol (which is unfortunately not publicly available) until the end of August 2009.

Consequently, it appears that the whole concept of e-prescribing in the Czech Republic is fully dependant on the resolution of the data protection issue (which may not be easy to overcome) and also the success of the Czech Health Authority in persuading doctors to register and make use of the e-prescribing system. However, it is clear that in light of the hurdles to successful implementation of the e-prescribing system, this project is unlikely to be finished earlier than 2010.

Authors

Chloupek-Vojtech

Vojtech Chloupek

Partner
Czech Republic & Slovakia

Call me on: +420 226 030 500