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Cross-border e-prescriptions improve continuity of care

Publication date 2.3.2022 9.01
Press release

In 2011, an EU Directive was adopted on the application of patients' rights in cross-border healthcare. The mobility of EU citizens between Member States is increasing. It is therefore important to ensure that citizens continue to receive care and safe medical treatment also when travelling within the EU (Directive 2011/24/EU of the European Parliament and of the Council). In order to evaluate the experience of using cross-border prescriptions, THL has launched a customer survey together with the School of Pharmacy of the University of Eastern Finland. The results will be published in spring 2022.

​​​​​​​Cross-border e-health services ensure that patients can move freely between EU countries and have access to high quality healthcare in another country. When citizens use cross-border e-prescriptions, information about the provided medicine is also forwarded to the prescription centre of the customer's country of residence. This does not happen if the person handles the matter abroad with a paper prescription. Securing information flows and continuity of care between countries thus improves medication safety for EU citizens.

If, for example, the medicines prescribed in Finland run out during a trip abroad, the customer can use their Finnish prescription to pick up more medicines from a local pharmacy in their country of stay.  Similarly, during a longer trip abroad, the customer can buy their medications from a local pharmacy instead of buying all the medicines in advance in Finland. Citizens travelling abroad should note that not all medicines can be obtained with a cross-border prescription. 

Finland and Estonia pioneering the use of cross-border prescriptions

The above Directive established the basis for promotion of cross-border e-health services in the EU. Currently, the development work is focused on the preparation and gradual introduction of cross-border e-prescriptions and electronic patient data summaries.

Finland and Estonia were the first countries to introduce an European e-prescription, which is a type of cross-border prescription. It has been possible to buy prescription medicines from Estonian pharmacies using a Finnish e-prescription since January 2019 and in Finland using an Estonian e-prescription since June 2020. On average, 25 prescriptions are dispensed in Estonia per month and 7 are dispensed in Finland.

At present, Croatia and Portugal have introduced a cross-border prescription service. Other countries are also gradually introducing corresponding services.

More information is needed on cross-border prescription experiences

There is only limited research data on cross-border prescription experiences. In particular, there is no previous published research data on customer experiences.

In order to evaluate customer experiences, THL partnered with the School of Pharmacy of the University of Eastern Finland to carry out in autumn 2021 a customer satisfaction survey among customers using cross-border e-prescriptions while visiting Estonia. The aim is to study Finns' experiences of using cross-border e-prescriptions in an Estonian pharmacy and the effects of cross-border prescriptions on the accessibility and safety of medicines. In addition, the aim is to identify potential areas for development of cross-border e-prescriptions and to utilise these in the development and extension of cross-border prescriptions to other EU countries. The results will be published in spring 2022.

Further information on European prescriptions

Finnish Institute for Health and Welfare (THL), Senior Specialist Annika Koivisto, [email protected]

Past experience of the benefits of the cross-border prescription service

Previous studies have highlighted the state of development of the cross-border prescription service, and it is now time to evaluate the post-implementation experiences. A study published in 2015 interviewed pharmaceutical professionals about their experiences of the European Patient Smart Open Services (epSOS) project (2008-2014). The aim of the project was to develop, pilot and evaluate cross-border e-health services. The project laid the foundations for the current cross-border e-health services. Pharmaceutical professionals selected for the study had been involved in piloting the cross-border prescriptions.

These professionals were of the opinion that cross-border prescriptions would reduce dispensing errors and improve medication safety when customers obtain medicines abroad. The interviewees highlighted the option of reading the prescription in the mother tongue of the pharmaceutical professional as the main advantage of cross-border prescriptions. This was seen to reduce the language barrier and facilitate communication. The pharmacists estimated that the translation of the prescription would help ensure that the right medication is given.

Reelika Jõgi's thesis, published in 2021, examined the experiences of Finnish and Estonian pharmaceutical professionals with cross-border prescriptions. The study was carried out through cooperation between the School of Pharmacy of the University of Eastern Finland, Kela, the Institute of Pharmacy of the University of Tartu and the Estonian State Agency of Medicines. The main advantage of cross-border prescriptions mentioned by pharmaceutical professionals was improved medicine availability. The respondents preferred European e-prescriptions to paper prescriptions. The main challenges identified for cross-border prescriptions were the rigidity of the cross-border prescription delivery service, differences in prescription and delivery practices between countries, a lack of knowledge among customers about the rules for cross-border prescriptions, and the language barrier.

A part of the project “World’s smoothest cross-border mobility and daily life through digitalisation”

Finland was the President of the Nordic Council of Ministers in 2021. At the beginning of the year 2021, the Presidency project “World’s smoothest cross-border mobility and daily life through digitalisation” was launched. Its aim is to streamline the everyday life and mobility of people and companies across borders by promoting the exchange of data between authorities in the Nordic countries. The project will create an operating model and good practices to strengthen and enhance cross-border exchange of data. The project will last three years and will run from 2021 to 2023.

The Digital and Population Data Services Agency plays a key role in the implementation of the project. The Agency will lead the implementation of the Presidency project and co-ordinate the work of the project’s working groups. At the beginning of the project, a report on the current state of people’s everyday life across borders will be prepared. The main output of the project will be a joint operating model and good practices to strengthen and enhance cross-border exchange of data.

The Ministry of Finance owns the project and guides its implementation. The administrative branches of the Ministry of Social Affairs and Health, the Ministry of Education and Culture, and the Ministry of Justice are also involved in the implementation.