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医生对药物安全性及电子处方可用性的认知——芬兰初级医疗保健医生的半结构化访谈

Medication safety and the usability of electronic prescribing as perceived by physicians-A semistructured interview among primary health care physicians in Finland.

作者信息

Kauppinen Hanna, Ahonen Riitta, Mäntyselkä Pekka, Timonen Johanna

机构信息

School of Pharmacy/Social Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.

Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.

出版信息

J Eval Clin Pract. 2017 Dec;23(6):1187-1194. doi: 10.1111/jep.12759. Epub 2017 May 4.

Abstract

RATIONALE, AIMS AND OBJECTIVES: In Finland, a fully operational and nationwide electronic prescription (ePrescription) system was implemented by law in 2012 to 2015. From 2017, all prescriptions have to be electronic. ePrescriptions are intended to facilitate prescribing and to improve medication safety in Finnish health care. In this study, the aim was to explore physicians' experiences with the impacts of ePrescriptions on prescribing and medication safety in Finland.

METHOD

Data were collected by conducting 42 interviews among primary health care physicians in spring 2015. The data obtained were analyzed by means of qualitative content analysis.

RESULTS

Most of the physicians considered ePrescriptions to be convenient to issue because of the paperless procedure. Additionally, physicians stated that information concerning patients' prescriptions was better available through the Prescription Centre since physicians were able to check patients' prescriptions, including those issued elsewhere. In particular, ePrescriptions have improved the control of narcotics and medicines classified as primarily affecting the central nervous system. However, establishing a patient's overall medication through the Prescription Centre was regarded as difficult because prescription information was sometimes incoherent and had not been updated. The ePrescribing system was also described as inflexible, especially the correcting, cancelling, or renewing of ePrescriptions. For example, the system required too many "mouse clicks" and PIN entries to justify the actions taken in prescriptions. The system's slowness and the poor connection between physicians' electronic patient records and the Prescription Centre were also underlined.

CONCLUSIONS

According to the Finnish physicians interviewed, ePrescriptions have facilitated prescribing in some respects. However, the ePrescribing system still has problems and the Prescription Centre cannot be fully used for the management of a patient's overall medication.

摘要

原理、目的和目标:在芬兰,2012年至2015年依法实施了全面运行的全国性电子处方系统。从2017年起,所有处方都必须电子化。电子处方旨在便利开处方并提高芬兰医疗保健中的用药安全性。本研究的目的是探讨医生对电子处方对芬兰开处方和用药安全性影响的体验。

方法

2015年春季对基层医疗医生进行了42次访谈以收集数据。通过定性内容分析法对获得的数据进行分析。

结果

大多数医生认为由于无纸化程序,电子处方开具起来很方便。此外,医生表示通过处方中心可以更好地获取患者的处方信息,因为医生能够查看患者的处方,包括在其他地方开具的处方。特别是,电子处方改善了对麻醉药品和主要影响中枢神经系统药物的管控。然而,通过处方中心确定患者的总体用药情况被认为很困难,因为处方信息有时不连贯且未更新。电子处方系统也被描述为缺乏灵活性,尤其是在电子处方的更正、取消或续签方面。例如,该系统需要太多的“鼠标点击”和个人识别码输入来证明在处方中采取的操作是合理的。该系统的缓慢以及医生电子病历与处方中心之间的连接不畅也被强调。

结论

根据接受访谈的芬兰医生的说法,电子处方在某些方面便利了开处方。然而,电子处方系统仍然存在问题,处方中心不能完全用于管理患者的总体用药情况。

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