Results of the Arizona Medicaid health information technology pharmacy focus groups

Benefits and barriers associated with e-prescribing in community pharmacy - A systematic review

Background

The utilization of electronic prescribing is growing, prompted by lockdown measures during the COVID-19 pandemic. However, despite this increasing adoption, there is a notable dearth of consolidated evidence regarding the challenges and opportunities associated with the integration of electronic prescribing systems within the daily clinical practices of community pharmacists.

Objective

This paper aims to systematically review the community pharmacists' perspectives on barriers and facilitators to electronic prescribing, addressing the significant need for understanding how electronic prescribing impacts the workflow and decision-making processes of pharmacists, ultimately influencing the quality of patient care.

Methods

PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched from January 1, 2000, to October 25, 2022, using search terms related to electronic prescribing, computerised physician order entry, community/retail pharmacies, and pharmacists.

Results

A total of 28 studies were included in the systematic review. In these studies, community pharmacists perceived that design, interoperability, attitude towards e-prescribing technology, information quality, workflow, productivity, and accessible resources facilitated e-prescribing. In addition, the included studies emphasized the importance of technological support for the successful implementation of electronic prescribing systems. The system's design characteristics significantly improve e-prescribing technology's favourable effects. According to our review, it has been proposed that a poorly designed e-prescribing system can have a negative impact on the quality of care, implementation, and user satisfaction. In contrast, a well-designed system can significantly contribute to improvements.

Conclusions

The review highlighted that e-prescribing has both barriers and facilitators, with the quality of the system and its implementation influencing these factors. Technical issues and user acceptance (patient/prescribers/pharmacists) can act as barriers or enablers, highlighting the need for comprehensive consideration and monitoring of e-prescribing to identify and address potential issues.

Pharmacists' Perceptions of the Barriers and Facilitators to the Implementation of Clinical Pharmacy Key Performance Indicators

Background

In hospitals around the world, there has been no consensus regarding which clinical activities a pharmacist should focus on until recently. In 2011, a Canadian clinical pharmacy key performance indicator (cpKPI) collaborative was formed. The goal of the collaborative was to advance pharmacy practice in order to improve patient outcomes and enhance the quality of care provided to patients by hospital pharmacists. Following a literature review, which indicated that pharmacists can improve patient outcomes by carrying out specific activities, and an evidence-informed consensus process, a final set of eight cpKPIs were established. Canadian hospitals leading the cpKPI initiative are currently in the early stages of implementing these indicators.

Objective

To explore pharmacists' perceptions of the barriers and facilitators to the implementation of cpKPIs.

Methods

Clinical pharmacists employed by the Nova Scotia Health Authority were invited to participate in focus groups. Focus group discussions were audio-recorded and transcribed, and data was analyzed using thematic analysis.

Findings

Three focus groups, including 26 pharmacists, were conducted in February 2015. Three major themes were identified. Resisting the change was comprised of documentation challenges, increased workload, practice environment constraints, and competing priorities. Embracing cpKPIs was composed of seeing the benefit, demonstrating value, and existing supports. Navigating the unknown was made up of quality versus quantity battle, and insights into the future.

Conclusions

Although pharmacists were challenged by documentation and other changes associated with the implementation of cpKPIs, they demonstrated significant support for cpKPIs and were able to see benefits of the implementation. Pharmacists came up with suggestions for overcoming resistance associated with the implementation of cpKPIs and provided insights into the future of pharmacy practice. The identification of barriers and facilitators to cpKPI implementation will be used to inform the implementation process on a local and national level.

Crucial factors for the acceptance of a computerized national medication list: insights into findings from the evaluation of the Austrian e-Medikation pilot

OBJECTIVE

The objective of this paper is to present crucial factors among registered doctors and pharmacists for acceptance of the Austrian 'e-Medikation' system which is aimed at providing, on a national level, complete and recent information on all the medication that were prescribed or dispensed to a patient.

METHODS

As the accompanying formative evaluation study of the pilot project showed different overall acceptance rates among participating physicians and pharmacists, a decision tree analysis of 30 standardized survey items was performed to identify crucial acceptance factors.

RESULTS

For the physicians' group, only two items (fear of improper data use and satisfaction with software support) were crucial for overall e-Medikation acceptance. The analysis of the pharmacists' data resulted in five crucial factors primarily focusing on functional aspects and the perceived benefits of e-Medikation.

CONCLUSION

The results indicate that the acceptance among physicians and pharmacists depends on quite different factors. This must be taken into account during the planned rollout of e-Medikation or of comparable products.

Reflections on the role of the pharmacy regulatory authority in enhancing quality related event reporting in community pharmacies

BACKGROUND

Given the demanding nature of providing pharmacy services, coupled with the expanded scope of practice of the professions in jurisdictions around the world, greater commitment to continuous quality improvement through adoption of quality-related event (QRE) reporting is necessary to ensure patient safety. Pharmacy regulatory authorities (PRAs) are in a unique position to enhance QRE reporting and learning through the standardization of expected practice.

OBJECTIVE

This study was aimed to gain a better understanding of the perceived roles of PRAs in enhancing QRE reporting and learning in community pharmacies, and identifying regulatory best practices to execute such roles.

METHODS

A purposive case sampling approach was used to identify PRA staff members from two groups (Deputy registrars and pharmacy inspectors) in 10 Canadian jurisdictions to participate in focus groups in the fall of 2011. Focus groups were used to explore perceptions of the role of PRAs in enhancing and promoting QRE reporting and learning, and perceived barriers to effective implementation in practice. Thematic analysis was used to analyze the qualitative data.

RESULTS

Two focus groups were conducted, one with seven Deputy registrars/Practice managers, and one with nine pharmacy inspectors. Five themes were identified, including (1) defining QRE reporting and compliance, (2) navigating role conflict, (3) educating for enhanced QRE reporting and learning, (4) promoting the positive/removing the fear of QREs, and (5) tailoring QRE reporting and learning consistency.

CONCLUSIONS

Overall, participants perceived a strong role for PRAs in enhancing QRE reporting and learning and providing education for pharmacies to support their compliance with reporting standards. However, PRAs must navigate the conflict inherent in both educating and promoting a process for achieving a standard while simultaneously inspecting compliance to that standard. Ensuring pharmacies have autonomy in operationalizing standards may help to mitigate this conflict. Finally, greater education for PRAs themselves to better inspect compliance and in order to better communicate the benefits of QRE reporting and learning to pharmacies would be beneficial.

Assessment of pharmacy information system performance in selected hospitals in isfahan city during 2011

BACKGROUND

In supporting a therapeutic approach and medication therapy management, pharmacy information system acts as one of the central pillars of information system. This ensures that medication therapy is being supported and evaluated with an optimal level of safety and quality similar to other treatments and services.

OBJECTIVES

This research aims to evaluate the performance of pharmacy information system in three types of teaching, private and social affiliated hospitals.

PATIENTS AND METHODS

The present study is an applied, descriptive and analytical study which was conducted on the pharmacy information system in use in the selected hospitals. The research population included all the users of pharmacy information systems in the selected hospitals. The research sample is the same as the research population. Researchers collected data using a self-designed checklist developed following the guidelines of the American Society of Health-System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and pharmacy information system pharmacists and users. To collect data besides observation, the questionnaires were distributed among pharmacy information system pharmacists and users. Finally, the analysis of the data was performed using the SPSS software.

RESULTS

Pharmacy information system was found to be semi-automated in 16 hospitals and automated in 3 ones. Regarding the standards in the guidelines issued by the Society of Pharmacists, the highest rank in observing the input standards belonged to the Social Services associated hospitals with a mean score of 32.75. While teaching hospitals gained the highest score both in processing standards with a mean score of 29.15 and output standards with a mean score of 43.95, and the private hospitals had the lowest mean scores of 23.32, 17.78, 24.25 in input, process and output standards respectively.

CONCLUSIONS

Based on the findings, the studied hospitals had minimal compliance with the input, output and processing standards related to the pharmacy information system. It is suggested that the establishment of a team composed of operational managers, computer fields experts, health information managers, pharmacists as well as physicians may contribute to the promotion of the capabilities of pharmacy information system to be able to focus on health care practitioners' and users' requirements.

Adoption of and experience with e-prescribing by primary care physicians

BACKGROUND

The impetus of electronic prescribing (e-prescribing) is the reduction of preventable medication errors by generating a legible prescription checked via e-prescribing software for drug-drug and other interactions. Although the adoption of e-prescribing among physicians is growing, the Institute of Medicine's recommendations that all prescriptions be routed electronically by 2010 certainly has not been met.

OBJECTIVES

To provide an update on e-prescribing use among primary care physicians (PCPs), describe their experience with e-prescribing, and provide insight into prescribers' decisions to implement e-prescribing in their practices.

METHODS

An Internet-based survey was administered to a national convenience sample of physicians. The respondents were categorized into e-prescribers or non-e-prescribers. Data to describe demographic characteristics, respondents' experiences with e-prescribing, and respondents' decision to implement e-prescribing were collected. Nonparametric tests were used to test differences in the factors influencing e-prescribers' and traditional prescribers' decisions about electronic prescription implementation.

RESULTS

Four hundred forty-three PCPs participated in the study. There were no significant differences in the demographic characteristics of e-prescribers and non-e-prescribers. Most e-prescribers (83%) reported satisfaction with their e-prescribing system and a preference for e-prescribing over traditional prescribing. Although 22% of respondents indicated that they have started and stopped e-prescribing, most have resumed or intended to resume e-prescribing in the near future. More than half of the respondents reported that they are experiencing problems with their e-prescribing software.

CONCLUSIONS

E-prescribing appears to be present in many types of primary care practices and geographic areas of the country. Despite their satisfaction with and preference for e-prescribing, PCPs still appear to be experiencing problems with e-prescribing software. Implications of these study results for the pharmacy profession are discussed.