Appl Clin Inform - Design challenges for electronic medication administration record systems in residential aged care facilities: a formative evaluation.

Tópicos

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Resumo

TRODUCTION: Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements.METHODS: A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system.RESULTS: The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues. We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows.DISCUSSION: Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.

Resumo Limpo

troduct electron medic administr record emar system promot potenti intervent enhanc medic safeti residenti age care facil racf purpos studi conduct inpractic evalu emar pilot one australian racf roll provid recommend system improvementsmethod multidisciplinari team conduct direct observ workflow n hour racf site communiti pharmaci semistructur interview n racf staff communiti pharmacist conduct investig view emar system data analys use ground theori approach identifi challeng associ design emar systemresult current emar system offer endtoend solut medic manag mani step includ prescrib doctor communic communiti pharmacist still perform manual use paper chart fax machin five major challeng associ design emar system identifi limit interact inadequ flexibl problem relat inform layout semant lack relev decis support system mainten issu suggest recommend improv design emar system optim exist workflowsdiscuss immedi valu can achiev improv system interact reduc inconsist data entri design offer dedic organis support minimis connect issu longerterm benefit can achiev ad decis support featur establish system interoper requir stakehold group eg communiti pharmaci prior system roll inpractic evalu technolog like emar system great valu identifi design weak inhibit optim system use

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