Residents of Lithuania who travel, work or study and have an electronic prescription (e-prescription) issued in this country, can now purchase the necessary medicines in other European Union (EU) countries. Patients of these European countries can also buy them in Lithuanian pharmacies. The information system providing these possibilities was developed and installed by the programming company Novian Systems on behalf of the Lithuanian Register Centre.
The growing list of EU countries where Lithuanian residents can use e-prescriptions is given here (in Lithuanian).
Situation
Nowadays, travelling among Lithuanians and other countries inhabitants is becoming increasingly commonplace. According to the Lithuanian State Data Agency, in 2022–2023, more than one million tourists visited Lithuania during the year, and the average number of people who travelled from Lithuania exceeded 700 thousand, part of them travelled to and came from European countries. On top of that are also the Lithuanian and other countries residents who work and study in foreign countries.
Following the digitalisation of healthcare services, e-prescription have been used in Lithuania since 2015. In 2023, as many as 20 million e-prescriptions were issued. However, up until 2024, Lithuanian residents in foreign countries could only use a written prescription. Residents of other countries were also unable to use e-prescriptions when visiting Lithuania.
Problem
In order to enable Lithuanian residents to use e-prescriptions in other EU countries, the existing Lithuanian e-prescription system needed to be integrated into the EU’s unified eHealth Digital Service Infrastructure (eHDSI).
This infrastructure, also known as MyHealth@EU, includes the implementation of new electronic cross-border healthcare services in 25 EU countries. It provides safe and simple online access to medical data for healthcare and pharmaceutical professionals at any time, and anywhere in the EU.
In order to achieve this goal, Lithuania had to create the Lithuanian National e-Health Contact Centre Information System (LNHCC IS) and integrate it into the EU eHealth Digital Service Infrastructure.
Solution
As part of the implementation of this project, the LNHCC IS was created as a subsystem of the Electronic Health Services and Cooperation Infrastructure Information System (ESPBI IS), which was integrated into the unified EU eHealth service infrastructure.
The purpose of the LNHCC IS is to carry out the international exchange of e-prescriptions and documents concerning dispensed medicines and patient summary data with the other EU countries that have similar contact points and are integrated into the unified EU e-services infrastructure.
The project of creating, implementing and integrating the new system into the unified EU eHealth services infrastructure was executed by the programming company Novian Systems on behalf of the Registry Centre of Lithuania. The implementation of the project also involved cooperating with the Ministry of Health of the Republic of Lithuania.
During this project, specialists from Novian Systems were guided by the functional and technical requirements and legal acts applicable to the EU’s health data exchange infrastructure.
In order to integrate new functionality into the existing modular system architecture while maintaining system compatibility and ensuring the highest security standards, it was given autonomy and was separated from the main system. This allowed it to be easily managed and updated without affecting the performance of the entire system, as well as ensuring optimal performance.
It is important that the new system is easy to expand and prepared for high loads, so it works smoothly even when the number of users grows. System security is ensured at various levels, from authentication and authorisation to data encryption and auditing.
The health data exchange protocols HL7 FHIR and CDA combined in the project allow efficient and reliable data exchange between different systems, ensuring wide-scale compatibility and future development opportunities.
Result
The created system allows Lithuania to exchange e-prescription data and other relevant information throughout the EU.
With this system, residents of Lithuania with an e-prescription, upon presentation of a document confirming personal identity, can purchase the necessary medicines in other EU countries with which Lithuania has already implemented the cross-border e-prescription service.
Similarly, patients arriving from other EU countries with which Lithuania exchanges e-prescription data can purchase medications using e-prescriptions in Lithuanian pharmacies.
For this purpose, a resident of another EU country must provide the pharmacy specialist with an identity document and/or any another document or mandatory information required by the other EU country where the electronic prescription was issued, in accordance with the requirements of that country (the relevant list of countries where Lithuania has implemented the cross-border e-prescription service is available here (in Lithuanian)).
At the end of 2024, residents of Lithuania were able to use cross-border e-prescription services in Latvia, Poland, Spain, Greece, Portugal and Estonia. Residents of these countries who came to Lithuania also had this opportunity. The list of participating countries is growing.
