Background: As part of the eSTI2 Consortium, an online clinical consultation has been developed enabling people undertaking a chlamydia test to access their results online, undergo an automated medical consultation and collect treatment at a community pharmacy without contact with a healthcare professional. However, mechanisms for electronic prescribing across the specialist-primary care interface do not currently exist in the UK. The development of a novel method of electronically prescribing oral Azithromycin is described, which bridges this interface and complies with current UK legislation and regulations.
Methods: A wide-ranging literature search was conducted, with diverse outputs classified and synthesised to derive a list of possible prescribing mechanisms. Each mechanism was assessed according to: compliance with existing legislation; regulations; organisational and feasibility constraints.
Results: Eight possible mechanisms of conveying the information required in a prescription from the online clinical consultation to a community pharmacy were identified. Seven were found to be unfeasible because of: existing legislation; requirements for identifiable patient data to be transferred to a central server; regulations surrounding the use of private prescriptions within state provided health care; requirement for faxing a prescription. A compromise was reached with the sending of an automated email authorising a pre-selected community pharmacy to provide patients with pre-packed Azithromycin.
Conclusions: The marked differences in regulations, content guidance, implementation and uptake of electronic prescribing systems in specialist and primary care within the UK have created two mutually exclusive systems. This is hindering development of patient-centred prescribing within eHealth. Although a workable solution has been found, more flexible solutions are required to enable eSexual health to realise its full potential.