Abstract
ObjectivesThere is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making.Materials and MethodsWe organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9.ResultsWe drew on data from 17 participants (approximately eight per roundtable), six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing “wants” and aspirations from organizational “needs”.Discussion and conclusionsDevelopment of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management.
Highlights
Hospital electronic prescribing systems are being implemented by healthcare organizations in an attempt to improve the safety, quality, and efficiency of the medication use process [1,2,3,4]
We drew on data from 17 participants, six hours of discussion, and 15 pages of field notes
Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing ‘‘wants’’ and aspirations from organizational ‘‘needs’’
Summary
Hospital electronic prescribing ( referred to as ePrescribing) systems are being implemented by healthcare organizations in an attempt to improve the safety, quality, and efficiency of the medication use process [1,2,3,4]. As with any large organizational change initiative involving a major financial outlay, business cases are utilized to outline the underlying reasoning for ePrescribing implementations, including expected investments, benefits and timeframes [8]. This typically includes the justification for desired changes tailored to individual organizational factors and is sometimes presented as an argument to obtain management commitment for the desired change [9]. Variations in organizational contexts and needs complicate work in this area [9], this being compounded by a lack of robust empirical efforts systematically addressing key concepts and processes [9], and limited experience of adapting business cases over longer periods of time [10]
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