Abstract
ObjectiveConsiderable international investment in hospital electronic prescribing (ePrescribing) systems has been made, but despite this, it is proving difficult for most organizations to realize safety, quality, and efficiency gains in prescribing. The objective of this work was to develop policy-relevant insights into the optimization of hospital ePrescribing systems to maximize the benefits and minimize the risks of these expensive digital health infrastructures.MethodsWe undertook a systematic scoping review of the literature by searching MEDLINE, Embase, and CINAHL databases. We searched for primary studies reporting on ePrescribing optimization strategies and independently screened and abstracted data until saturation was achieved. Findings were theoretically and thematically synthesized taking a medicine life-cycle perspective, incorporating consultative phases with domain experts.ResultsWe identified 23,609 potentially eligible studies from which 1367 satisfied our inclusion criteria. Thematic synthesis was conducted on a data set of 76 studies, of which 48 were based in the United States. Key approaches to optimization included the following: stakeholder engagement, system or process redesign, technological innovations, and education and training packages. Single-component interventions (n = 26) described technological optimization strategies focusing on a single, specific step in the prescribing process. Multicomponent interventions (n = 50) used a combination of optimization strategies, typically targeting multiple steps in the medicines management process.DiscussionWe identified numerous optimization strategies for enhancing the performance of ePrescribing systems. Key considerations for ePrescribing optimization include meaningful stakeholder engagement to reconceptualize the service delivery model and implementing technological innovations with supporting training packages to simultaneously impact on different facets of the medicines management process.
Highlights
MethodsWe used the 6-stage framework proposed by Arksey and O’Malley[7] and further refined by Levac et al[8] to undertake a systematic scoping review of the international literature
Take down policy The University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorer content complies with UK legislation
The concept of saturation still seems to be evolving, we identify with the 2016 definition by Given,[13] who considered saturation as the point at which “additional data do not lead to any new emergent themes.”
Summary
We used the 6-stage framework proposed by Arksey and O’Malley[7] and further refined by Levac et al[8] to undertake a systematic scoping review of the international literature. Our methods are detailed in full in the published protocol and summarized hereinafter.[9] Embracing the iterative nature of conducting a scoping protocol, a feature strongly endorsed by Levac et al,[8] the inclusion and exclusion criteria from the initial protocol have been refined (Table 1). An essential requirement for included studies was the implementation of an optimization strategy within an ePrescribing system. Inclusion criteria Primary studies or systematic reviews with a clearly defined methodology that describe an approach/approaches that are implemented to optimize an ePrescribing system. The study should be set in a high-income country, as defined by the OECD
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
