Maintaining the pharmacy model: The Catalan Electronic Prescription Infrastructure

This chapter presents the genesis and evolution of the public e-prescription information infrastructure (EPI) of Catalonia, Spain from 2000 to 2013. The implementation of the EPI required a transition from a mainly paper-based and asynchronous prescription model to a digital and synchronous one. This transition involved doing changes into the practices, systems and roles of the CatSalut (the Catalan Health Service), doctors and health providers, pharmacists and Colleges of Pharmacists, and ultimately patients. Our narrative extols those changes and how the pre-existing technological and institutional resources of professionals shaped the design, and evolution of the infrastructure. Our narrative traces those events from the perspective of pharmacists and shows how the installed base of pharmacists was used and extended in a way that maintained and strengthened the pharmacy model. The reminder of the chapter is structured as follows. In the next section, we present the Catalan model of community pharmacies (see the Chap. 11 for a description of the overall Catalan health system). This section is followed by our narrative of the case. Next we analyze and discuss the implications of our results.