Strumann Christoph, Möller Birger, Steinhäuser Jost
Institute of Family Medicine, Universitätsklinikum Schleswig-Holstein - Campus Lübeck, Lübeck, Deutschland.
Gesundheitswesen. 2022 Oct;84(10):961-967. doi: 10.1055/a-1498-1816. Epub 2021 Jun 23.
The GERDA ("Protected e-prescription service for pharmacies") project of the Chamber of Pharmacists (LAK) and Pharmacists Association (LAV) of the federal state of Baden-Wuerttemberg provided the opportunity to prescribe medications within the telemedical portal "docdirekt" that is operated by the Association of Statutory Health Insurance Physicians of Baden-Wuerttemberg. Against this background, the aim of the study was to explore and prioritize barriers and enablers among pharmacists to participate in a medical supply system that includes electronic prescriptions (e-prescriptions). Based on these determinants, recommendations for optimizing the successful implementation of similar care offers were derived.
A mixed methods design was chosen to explore and prioritize the determinants. In the first step, determinants for participation in an electronic prescribing system were explored by means of individual interviews of docdirekt tele-physicians, primary care physicians and pharmacists. In a second step, these determinants were prioritized through a quantitative survey of pharmacists.
Out of the 523 pharmacists that answered the questionnaire, more than half were willing to participate in an e-prescription system, while 8.5% excluded future participation. A total of 18 determinants for the e-prescription system participation could be explored. The protection of the free pharmacy choice for the patients was identified as the most important determinant, followed by the option of a correction function for e-prescriptions (e. g. to avoid retaxing or medication errors), the integration of the e-prescription into the existing pharmacy IT system and the statutory exclusion of direct contracts with online pharmacies. Time savings and possibly higher remunerations were rated as less relevant.
More than half of the pharmacies surveyed stated that they wanted to participate in an e-prescription system. Widespread introduction of e-prescriptions in planned for January 2022. Successful implementation of this move will be facilitated if the identified determinants are taken into consideration by politics, software developers and associations.
德国巴登 - 符腾堡州药剂师协会（LAK）和药剂师联合会（LAV）的GERDA项目（“面向药房的受保护电子处方服务”）提供了在由巴登 - 符腾堡州法定医疗保险医师协会运营的远程医疗门户“docdirekt”内开具药物处方的机会。在此背景下，本研究的目的是探索药剂师参与包括电子处方（e - 处方）在内的医疗供应系统的障碍和促进因素，并对其进行优先级排序。基于这些决定因素，得出了优化类似医疗服务成功实施的建议。
选择混合方法设计来探索决定因素并对其进行优先级排序。第一步，通过对docdirekt远程医生、初级保健医生和药剂师进行个人访谈，探索参与电子处方系统的决定因素。第二步，通过对药剂师的定量调查对这些决定因素进行优先级排序。
在523名回答问卷的药剂师中，超过一半愿意参与电子处方系统，而8.5%排除未来参与的可能性。总共可以探索出18个参与电子处方系统的决定因素。患者自由选择药房的保护被确定为最重要的决定因素，其次是电子处方的校正功能选项（例如避免重复征税或用药错误）、电子处方与现有药房信息技术系统的集成以及与在线药房直接签约的法定排除。节省时间和可能更高的报酬被认为相关性较低。
超过一半接受调查的药房表示他们希望参与电子处方系统。计划于2022年1月广泛引入电子处方。如果政治、软件开发人员和协会考虑到已确定的决定因素，这一举措的成功实施将得到促进。
