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运用设计科学研究实施在线药品服务。

Implementing an online pharmaceutical service using design science research.

作者信息

Lapão Luís Velez, da Silva Miguel Mira, Gregório João

机构信息

Global Health and Tropical Medicine (GHTM), WHO Collaborating Center for Health Workforce Policy and Planning, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n° 100, Lisboa, 1349-008, Portugal.

Instituto Superior Técnico, Universidade de Lisboa, Avenida Rovisco Pais, 1, Lisboa, 1049-001, Portugal.

出版信息

BMC Med Inform Decis Mak. 2017 Mar 27;17(1):31. doi: 10.1186/s12911-017-0428-2.

Abstract

BACKGROUND

The rising prevalence of chronic diseases is pressing health systems to introduce reforms. Primary healthcare and multidisciplinary models have been suggested as approaches to deal with this challenge, with new roles for nurses and pharmacists being advocated. More recently, implementing healthcare based on information systems and technologies (e.g. eHealth) has been proposed as a way to improve health services. However, implementing online pharmaceutical services, including their adoption by pharmacists and patients, is still an open research question. In this paper we present ePharmacare, a new online pharmaceutical service implemented using Design Science Research.

METHODS

The Design Science Research Methodology (DSRM) was chosen to implement this online service for chronic diseases management. In the paper, DSRM's different activities are explained, from the definition of the problem to the evaluation of the artifact. During the design and development activities, surveys, observations, focus groups, and eye-tracking glasses were used to validate pharmacists' and patients' requirements. During the demonstration and evaluation activities the new service was used with real-world pharmacists and patients.

RESULTS

The results show the contribution of DSRM in the implementation of online services for pharmacies. We found that pharmacists spend only 50% of their time interacting with patients, uncovering a clear opportunity to implement online pharmaceutical care services. On the other hand, patients that regularly visit the same pharmacy recognize the value in patient follow-up demanding to use channels such as the Internet for their pharmacy interactions. Limitations were identified regarding the high workload of pharmacists, but particularly their lack of know-how and experience in dealing with information systems (IST) for the provision of pharmaceutical services.

CONCLUSIONS

This paper summarizes a research project in which an online pharmaceutical service was proposed, designed, developed, demonstrated and evaluated using DSRM. The main barriers for pharmacists' adoption of online pharmaceutical services provision were the lack of time, time management and information systems usage skills, as well as a precise role definition within pharmacies. These problems can be addressed with proper training and services reorganization, two proposals to be investigated in future works.

摘要

背景

慢性病患病率的不断上升促使卫生系统进行改革。初级卫生保健和多学科模式被认为是应对这一挑战的方法,同时倡导护士和药剂师发挥新的作用。最近,有人提出基于信息系统和技术(如电子健康)实施医疗保健,作为改善卫生服务的一种方式。然而,实施在线药学服务,包括药剂师和患者对其的采用,仍然是一个有待研究的问题。在本文中,我们介绍了ePharmacare,这是一种使用设计科学研究方法实施的新型在线药学服务。

方法

选择设计科学研究方法(DSRM)来实施这项用于慢性病管理的在线服务。本文解释了DSRM的不同活动,从问题的定义到工件的评估。在设计和开发活动中,通过调查、观察、焦点小组和眼动追踪眼镜来验证药剂师和患者的需求。在演示和评估活动中,新服务与现实中的药剂师和患者一起使用。

结果

结果显示了DSRM在药房在线服务实施中的作用。我们发现药剂师仅花费50%的时间与患者互动,这表明实施在线药学护理服务存在明显的机会。另一方面,经常光顾同一家药房的患者认识到患者随访的价值,要求使用互联网等渠道进行药房互动。研究发现了一些局限性,包括药剂师工作量大,但特别是他们在处理用于提供药学服务的信息系统方面缺乏专业知识和经验。

结论

本文总结了一个研究项目,其中使用DSRM提出、设计、开发、演示和评估了一种在线药学服务。药剂师采用在线药学服务的主要障碍包括时间不足、时间管理和信息系统使用技能欠缺,以及药房内缺乏明确的角色定义。这些问题可以通过适当的培训和服务重组来解决,这是未来工作中有待研究的两项建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ee2/5369181/c4aa88fcff81/12911_2017_428_Fig1_HTML.jpg

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