A Snapshot of the Electronic Transmission and Processing of Prescriptions project in the Iranian Social Security Organization

Abstract

Iranian Social Security Organization(ISSO) is going to enable the sharing of health related information in a secure environment by means of reliable data in the right time to improve health of insured people throughout the country. There are around 7000 pharmacy throughout the country that ISSO contracted with them in order to deliver seamless services to 30 million insured people. The management of the huge amount of prescriptions based on a scientific basis with considering the financial issues of rising the cost of medicaments certainley needs a sophisticated business process reeingineering using ICT ; the work that is going to be completed in the ISSO in next few months.

Electronic Transmission & Processing of Prescriptions (ETPP) Project in the ISSO

Iranian Social Security Organization ( ISSO) is responsible for delivering direct and indirect medical services to 30 million insured people through the ISSO’s health care network in the country. In the ISSO healthcare network, there are more than 350 owned medical centers in addition to 40000 ( including 7000 pharmacies ) contracted healthcare institutions. ISSO is going to enable the sharing of health information using a secure electronic environment to improve health of insured people based on scientific approach alongside the facilitation of tracking the financial loads & risks. This electronic environment brings facilities for different stakeholders in the ISSO by means of reducing chances of abuse and redundant inspections, simplification of outpatient procedures, increasing the accuracy of medical expenses report information, holding the reimbursement information, medical records, etc. We assigned the following five main working groups in order to manage this nationwide project (ETPP): Functionality, Technical, Standards, Legal ( and ethical) aspects and Implementation. The key to the success of this project relied on seamless systems integration supported by a highly flexible and secure platform.

ISSO has launched the ETPP project since five years ago and through these years, the above mentioned multidiscpline teams brought significant changes for the ISSO from the organizational and technical points of view. A national updated drugs code database, a national XML based prescriptions data exchange format, a distributed web based system for transmission of the prescriptions data form all of the 7000 contracted pharmacies to the ISSO 's subsidiaries and then headquarters, a comprehensive application for processing of the prescriptions data are recent milestones of this project. By the way, we have achieved the essential goals such as : to control scientifically the items in prescriptions, to monitor the behaviour patterns of medicaments consuming and prescribing throughout the country in the ISSO 's healthcare network, to control the cost of medicaments and subsidiary payments auditing, to track of reimbursement budget.