The e-prescription: between regulatory ambition and practical benefit
The electronic prescription is regarded as an important building block in the digitalisation of Swiss health care. It is meant to reduce media breaks, increase medication safety and simplify processes for patients, physicians and pharmacies. But while countries such as Denmark, Estonia and Sweden have been prescribing digitally on an almost universal basis for years, Switzerland remains in a transition phase. What legal foundations apply today? What opportunities and challenges arise for pharmacies? And what must pharmacists pay particular attention to when handling electronic prescriptions?
Key points
- Electronic prescriptions are legally permissible in Switzerland provided authenticity, integrity and traceability are guaranteed.
- The revised Data Protection Act sets high requirements for handling electronic health data.
- Cantonal differences remain a relevant factor for pharmacies despite digitalisation.
- The e-prescription can reduce medication errors and improve medication safety.
The e-prescription: more than digitised paper
Legally speaking, an electronic prescription is not simply a scanned paper prescription. It is a digital medical prescription that can be created, signed, transmitted and redeemed electronically.
In Switzerland, E-Rezept Schweiz was developed as a joint industry project by medical, pharmacy and health organisations. The aim is to create a uniform standard that works independently of individual software providers.
According to federal estimates, around 150 to 180 million medicines are dispensed in Switzerland each year. A considerable part of the associated processes still takes place on paper or via media breaks such as fax, e-mail or printouts. Digitalising the prescription is intended to simplify these workflows while improving patient safety.
The legal basis: what applies today?
The foundation is the Swiss Therapeutic Products Act (TPA). It does not prescribe whether a prescription must be issued on paper or electronically. What is decisive is that the prescription meets the legal requirements.
Under Art. 26 TPA, prescription-only medicines may be dispensed only against a valid medical prescription. Electronic prescriptions are permissible provided authenticity, integrity and traceability are guaranteed.
The following legal bases also play an important role:
- Therapeutic Products Act (TPA)
- Ordinance on Medicinal Products (OMP)
- Data Protection Act (DPA)
- Ordinance on the Electronic Patient Record (EPRO)
- cantonal health legislation
Since the revised Data Protection Act came into force in September 2023 in particular, health data must be classified as personal data requiring special protection. Pharmacies must therefore ensure that electronic prescriptions are processed, stored and archived in compliance with data protection law.
Data protection: the underestimated challenge
While the discussion frequently focuses on technical aspects, data protection is the greater challenge for many pharmacies.
Health data is among the most sensitive personal data there is. Several requirements must therefore be met for electronic prescriptions:
- secure data transmission
- access controls
- logging of access
- protection against manipulation
- archiving that complies with data protection law
This becomes particularly relevant for prescriptions transmitted by e-mail or messenger services. Such channels do not automatically meet the requirements for data protection and data security.
For pharmacies this means that internal processes must be reviewed regularly and staff trained accordingly.
Cantonal differences remain
A frequently underestimated aspect is the federalist structure of the Swiss health system.
While the therapeutic products legislation is regulated nationally, cantonal requirements sometimes differ considerably. This concerns, for example:
- documentation obligations
- retention periods
- implementation of data protection requirements
- the inspection and supervisory practice of cantonal pharmacists
For pharmacies with several locations, or for mail-order pharmacies, this can cause additional administrative work.
The introduction of the e-prescription does not automatically eliminate these differences. Digital processes must continue to be compatible with the respective cantonal requirements.
What does the e-prescription bring for medication safety?
International experience shows clear advantages.
A study by the European Commission was able to demonstrate that electronic prescriptions can reduce medication errors, particularly in dosage instructions, legibility and transmission errors. At the same time, digital systems improve the traceability of prescriptions and make prescription forgery more difficult.
Several advantages arise for pharmacies from this:
- better legibility of prescriptions
- fewer queries to medical practices
- lower risk of transmission errors
- improved documentation
- more efficient processes for repeat prescriptions
Given the growing skills shortage in particular, every simplification of a process can make an important contribution to relieving the burden.
The reality in pharmacies
Despite the advantages, introduction has so far been slower than originally expected.
The most frequent challenges include:
- differing practice software systems
- lack of interoperability
- investment costs
- training needs
- adapting existing processes
Many pharmacies therefore currently find themselves in a hybrid world in which paper prescriptions, PDF prescriptions and genuine electronic prescriptions are processed in parallel.
This transition phase is likely to last several more years.
What pharmacists should do now
For pharmacists, understanding regulatory requirements is increasingly becoming a core competence.
Particularly recommended are:
- regular review of internal data protection processes
- training the team on digital prescriptions
- checking the compatibility of the pharmacy software
- monitoring cantonal developments
- active engagement with e-prescription standards
Those who prepare early can not only reduce regulatory risks but also benefit from more efficient workflows.
In brief
The electronic prescription is no longer a vision of the future but a central element in the digitalisation of Swiss health care. The legal foundations are largely in place, but practical implementation remains demanding. For pharmacies this means keeping technological developments, data protection requirements and cantonal particularities in view at the same time. In the long run, however, the e-prescription is likely to establish itself as an important lever for more efficiency, safety and patient focus.
References
- Bundesgesetz über Arzneimittel und Medizinprodukte (Heilmittelgesetz, HMG), SR 812.21, insbesondere Art. 26. Bundesrecht der Schweizerischen Eidgenossenschaft.
- Verordnung über die Arzneimittel (VAM), SR 812.212.21. Bundesrecht der Schweizerischen Eidgenossenschaft.
- Bundesgesetz über den Datenschutz (DSG), SR 235.1, revidierte Fassung, in Kraft seit 1. September 2023.
- E-Rezept Schweiz. Grundlagen und technische Spezifikationen. Herausgegeben von den Trägerorganisationen des Schweizer E-Rezept-Standards.
- Bundesamt für Gesundheit (BAG): Digitalisierung im Gesundheitswesen und Elektronisches Patientendossier (EPD), aktuelle Publikationen und Hintergrundberichte.
- European Commission. Electronic Prescriptions and Patient Summaries for Cross-Border Healthcare: Benefits and Implementation Experiences in Europe. Luxemburg: Publications Office of the European Union.
- OECD/European Observatory on Health Systems and Policies. Digital Health Systems in Europe: Evidence and Best Practices. Paris: OECD Publishing.