Interoperability Challenges and Critical Success Factors in the Deployment of Cross-border Digital Medical Prescriptions in Finland and Estonia

This case study explores the challenges in the interoperability of cross-border digital medical prescriptions between Finland and Estonia as pioneer countries in cross-border ePrescription which means Finnish patients' prescriptions can be dispensed with medicines in Estonian pharmacies and vice versa. This delves into the critical factors that contributed to the success of this government e-service as well as the different deployment constraints that happened at every stage of the six levels of the refined eHealth European Interoperability Framework. The reported challenges and implemented solutions are further mapped out at which environments they typically occur whether in micro, meso, and macro levels. The data collection was done in multi-method by which semi-structured interviews were conducted to eight (8) key government experts from Finland and Estonia. Results revealed that common challenges include different health care systems, different national legislations on the policy of consent, constraints in the semantic level as new prescriptions emerge in the pharmaceutical markets and the need for assessment to measure actual benefits and impact. On one side, the drivers of successful implementation consist of organizational and country resources, long-standing cross-border cooperation, trust, and political commitment, and pan-European support.