E-Prescription Digitalizing Law Firm in Serbia

The Government of the Republic of Serbia recognized early on the importance of digitalisation and the development of e-administration in general, including in the health care system. One of the results was that e-prescriptions replaced the paper version in 2017.

Key-features of the Serbian E-Prescription 

E-prescription in Serbia was designed for the public healthcare system, doctors working in the public healthcare institutions, and prescription drugs and medical devices that are fully or partially reimbursed by the Republic Fund of Healthcare Insurance. Private healthcare institutions and doctors do not have access to it and continue to use the paper prescriptions. 

The e-prescription system is linked to each citizen’s health card as issued by the Republic Fund of Healthcare Insurance and is accessible through information system by doctors and pharmacies. Once the e-prescription is issued and uploaded by the doctor, the patient can collect the medicine or medical device in pharmacy within a certain period depending on the category of the product (15 days for most of the drugs, but e.g. three days for antibiotics, seven days for narcotics, even 30 days for some specific medicines). Renewable e-prescriptions for chronic therapy can cover the period from two to six months. 

Legal basis of the E-prescription

The legal basis for introducing e-prescriptions was the Ordinance on the form and content of the medical prescription, the method of issuing and prescribing medicines. It was passed in conformity with Healthcare Law and Law on Personal Data Protection.

Risks related to E-prescriptions

Leakage of personal data contained in patients’ health cards has been identified as one of the main risks of the e-prescription. The Ministry of Health published online the Notice on the processing of personal data specifying the data being collected and processed. The Notice claims that the administrators of the information system use appropriate technical and organizational measures to protect the personal data that they collect and process and that the measures they use are designed to ensure the highest level of security that corresponds to the risk of processing patients’ personal data. There is currently no published information on the effectiveness of the data protection system in practice.

Status Review

The project to introduce electronic prescriptions was initiated on 30 October 2017, with an implementation test in 10 city municipalities of the city of Belgrade in health care institutions of the primary health care. In December 2017, every Belgrade municipality was covered, as well as certain parts of Vojvodina, central and southern Serbia, which amounted to a total of 62 Primary health care institutions. In the first quarter of 2018, the implementation in the territory of Vojvodina was completed and the expansion towards Central and Southern Serbia continued. The implementation process was completed in July 2018. 
E-prescriptions can be redeemed in any of the 3,600 pharmacies throughout Serbia that have a contract with the Republic Health Insurance Fund on the issuance of medicines at the expense of mandatory health insurance funds. Around 40 million e-prescriptions have been issued so far, out of which almost 3 million are for renewable prescriptions. Also, 5.5 thousand pharmacists and 9.5 thousand doctors are registered on the system. 
In conjunction with allowing prescriptions to be issued for regular therapy for chronic patients for two to six months instead of one, e-prescription produced savings of up to 2 million euros annually, as the number of patient visits to general practitioners just for the prescription of regular therapy has been reduced by 20 to 40 percent.