Social & Administrative Sciences, School of Pharmacy, University of Wisconsin, Madison, Wisconsin, USA.
J Am Med Inform Assoc. 2012 Nov-Dec;19(6):1059-65. doi: 10.1136/amiajnl-2011-000779. Epub 2012 Jun 29.
This paper explored pharmacy staff perceptions of the strengths and weaknesses of electronic prescribing (e-prescribing) design in retail pharmacies using the sociotechnical systems framework. This study examined how adoption of e-prescribing technology is affecting clinical practice and patient care.
Direct observations and think aloud protocols were used to collect data from seven retail pharmacies.
Pharmacists and pharmacy technicians reported strengths of e-prescribing design that facilitated pharmacy work which included: legibility, ease of archiving, quick access to prescriptions and consistency in the format of electronic prescriptions (e-prescriptions). Design weaknesses and potential hazards to patient care associated with e-prescribing systems were due to differences between pharmacy and prescriber computer systems which resulted in the selection of wrong patient or drug (name, directions, dose, strength, formulation, package sizes). There were unique strengths and weaknesses in the design of e-prescriptions peculiar to the three pharmacy computer systems examined in this study.
Findings from this study can help inform policy on creating e-prescribing design standards for pharmacy. e-Prescribing system developers can use the results of this study to identify and apply the most usable features of the three main pharmacy computer systems to design systems that support dispensing efficiency and safety.
This is the first study to highlight design flaws with e-prescribing in retail pharmacies. The sociotechnical systems framework was useful in providing an indepth understanding of the pharmacist and pharmacy technician's interface with e-prescribing technology. This information can be used by policy makers to create e-prescribing standards for pharmacies.
本研究采用社会技术系统框架探讨了零售药店药剂师对电子处方(e-prescribing)设计优缺点的看法。本研究考察了 e 处方技术的采用如何影响临床实践和患者护理。
采用直接观察和出声思维记录法从七家零售药店收集数据。
药剂师和药剂技术员报告了电子处方设计的优势,这些优势有助于药房工作,包括:易读性、便于归档、快速获取处方和电子处方格式的一致性。与电子处方系统相关的设计弱点和对患者护理的潜在危害是由于药房和处方医生计算机系统之间的差异造成的,这导致选择了错误的患者或药物(名称、用法、剂量、强度、剂型、包装尺寸)。在所研究的三种药店计算机系统中,电子处方的设计具有独特的优缺点。
本研究的结果可以为制定药店电子处方设计标准的政策提供信息。电子处方系统开发人员可以利用本研究的结果来识别和应用三种主要药店计算机系统的最可用功能,以设计支持配药效率和安全的系统。
这是首次强调零售药店电子处方设计缺陷的研究。社会技术系统框架有助于深入了解药剂师和药剂技术员与电子处方技术的接口。这些信息可用于政策制定者制定药店电子处方标准。