O'Connor Hannah, Melanophy Gail, Martin Carlos Medina, Flattery Martin, O'Dea Edel
Pharmacy Department, St James's Hospital, Dublin, Ireland.
School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Ireland.
J Oncol Pharm Pract. 2023 Sep;29(6):1404-1417. doi: 10.1177/10781552221126102. Epub 2022 Nov 6.
A National Cancer Information System is planned for phased implementation in Irish cancer centres to enable electronic prescribing (ePrescribing) of systemic anti-cancer therapy. This study aimed to capture the opinions of healthcare professionals in a hospital setting relating to the current paper-based workflow for systemic anti-cancer therapy prescribing and their attitudes and expectations of the new ePrescribing system to develop recommendations, which assist in the planning and implementation of future ePrescribing systems.
A mixed methods study of concurrent design was conducted. Interviews with healthcare professionals primarily aimed to evaluate processes and identify areas requiring improvement within the current paper-based workflow for systemic anti-cancer therapy prescribing. An online questionnaire adapted from the Information Systems Expectations and Experiences tool primarily aimed to capture expectations of the new ePrescribing system and attitudes towards the transition.
Twelve healthcare professionals were interviewed, and 50 healthcare professionals responded to the online questionnaire (response rate: 33.3%). Eight major themes emerged from interview transcripts relating to opinions on the paper-based workflow. Questionnaire respondents reported positive attitudes towards ePrescribing implementation and had high expectations for workflow improvements and functionalities of the new system. Seven recommendations for ePrescribing implementation were developed: (1) prioritise specific processes; (2) plan for changes in communication; (3) repeat research in the post-implementation setting; (4) ensure good information technology infrastructure and system support; (5) ensure optimum training; (6) outline limitations of clinical decision support; (7) provide clear instructions on local configurability.
This study identifies potential challenges in transitioning to ePrescribing and provides recommendations, which assist stakeholders in ensuring safe and effective transitions, thus informing future ePrescribing systems' implementation in haematology/oncology settings.
计划在爱尔兰癌症中心分阶段实施国家癌症信息系统,以实现全身抗癌治疗的电子处方(ePrescribing)。本研究旨在了解医院环境中医护人员对当前全身抗癌治疗纸质处方工作流程的看法,以及他们对新电子处方系统的态度和期望,从而制定相关建议,以协助未来电子处方系统的规划和实施。
采用混合方法进行同步设计研究。与医护人员进行访谈,主要目的是评估流程,并确定当前全身抗癌治疗纸质处方工作流程中需要改进的领域。根据信息系统期望与体验工具改编的在线问卷,主要目的是了解对新电子处方系统的期望以及对过渡的态度。
对12名医护人员进行了访谈,50名医护人员回复了在线问卷(回复率:33.3%)。访谈记录中出现了八个主要主题,涉及对纸质工作流程的看法。问卷受访者对电子处方实施持积极态度,对工作流程改进和新系统功能有很高期望。制定了七条电子处方实施建议:(1)优先考虑特定流程;(2)规划沟通方式的变化;(3)在实施后环境中重复研究;(4)确保良好的信息技术基础设施和系统支持;(5)确保提供最佳培训;(6)概述临床决策支持的局限性;(7)提供关于本地可配置性的明确说明。
本研究确定了向电子处方过渡中的潜在挑战,并提供了相关建议,有助于利益相关者确保安全有效的过渡,从而为未来血液学/肿瘤学环境中电子处方系统的实施提供参考。