BMC Med Inform Decis Mak - Meeting user needs in national healthcare systems: lessons from early adopter community pharmacists using the electronic prescriptions service.

Tópicos

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Resumo

CKGROUND: The Electronic Prescription Service release Two (EPS2) is a new national healthcare information and communication technology in England that aims to deliver effective prescription writing, dispensing and reimbursement service to benefit patients. The aim of the study was to explore initial user experiences of Community Pharmacists (CPs) using EPS2.METHODS: We conducted nonparticipant observations and interviews in eight EPS2 early adopter community pharmacies classified as 'first-of-type' in midlands and northern regions in England. We interviewed eight pharmacists and two dispensers in addition to 56 hours recorded nonparticipant observations as field notes. Line-by-line coding and thematic analysis was conducted on the interview transcripts and field notes.RESULTS: CPs faced two types of challenge. The first was to do with missing electronic prescriptions. This was sometimes very disrupting to work practice, but pharmacists considered it a temporary issue resolvable with minor modifications to the system and user familiarity. The second was to do with long term design-specific issues. Pharmacists could only overcome these by using the system in ways not intended by the developers. Some felt that these issues would not exist had 'real' users been involved in the initial development. The issues were: 1) printing out electronic prescriptions (tokens) to dispense from for safe dispensing practices and to free up monitors for other uses, 2) logging all dispensing activities with one user's Smartcard for convenience and use all human resources in the pharmacy, and, 3) problematic interface causing issues with endorsing prescriptions and claiming reimbursements.CONCLUSIONS: We question if these unintended uses and barriers would have occurred had a more rigorous user-centric principles been applied at the earlier stages of design and implementation of EPS. We conclude that, since modification can occur at the evaluation stage, there is still scope for some of these barriers to be corrected to address the needs, and enhance the experiences, of CPs using the service, and make recommendations on how current challenges could be resolved.

Resumo Limpo

ckground electron prescript servic releas two ep new nation healthcar inform communic technolog england aim deliv effect prescript write dispens reimburs servic benefit patient aim studi explor initi user experi communiti pharmacist cps use epsmethod conduct nonparticip observ interview eight ep earli adopt communiti pharmaci classifi firstoftyp midland northern region england interview eight pharmacist two dispens addit hour record nonparticip observ field note linebylin code themat analysi conduct interview transcript field notesresult cps face two type challeng first miss electron prescript sometim disrupt work practic pharmacist consid temporari issu resolv minor modif system user familiar second long term designspecif issu pharmacist overcom use system way intend develop felt issu exist real user involv initi develop issu print electron prescript token dispens safe dispens practic free monitor use log dispens activ one user smartcard conveni use human resourc pharmaci problemat interfac caus issu endors prescript claim reimbursementsconclus question unintend use barrier occur rigor usercentr principl appli earlier stage design implement ep conclud sinc modif can occur evalu stage still scope barrier correct address need enhanc experi cps use servic make recommend current challeng resolv

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