Abstract
ObjectivesWe studied vendor perspectives about potentially transferable lessons for implementing organisations and national strategies surrounding the procurement of Computerised Physician Order Entry (CPOE)/Clinical Decision Support (CDS) systems in English hospitals.SettingData were collected from digitally audio-recorded discussions from a series of CPOE/CDS vendor round-table discussions held in September 2014 in the UK.ParticipantsNine participants, representing 6 key vendors operating in the UK, attended. The discussions were transcribed verbatim and thematically analysed.ResultsVendors reported a range of challenges surrounding the procurement and contracting processes of CPOE/CDS systems, including hospitals’ inability to adequately assess their own needs and then select a suitable product, rushed procurement and implementation processes that resulted in difficulties in meaningfully engaging with vendors, as well as challenges relating to contracting leading to ambiguities in implementation roles. Consequently, relationships between system vendors and hospitals were often strained, the vendors attributing this to a lack of hospital management's appreciation of the complexities associated with implementation efforts. Future anticipated challenges included issues surrounding the standardisation of data to enable their aggregation across systems for effective secondary uses, and implementation of data exchange with providers outside the hospital.ConclusionsOur results indicate that there are significant issues surrounding capacity to procure and optimise CPOE/CDS systems among UK hospitals. There is an urgent need to encourage more synergistic and collaborative working between providers and vendors and for a more centralised support for National Health Service hospitals, which draws on a wider body of experience, including a formalised procurement framework with value-based product specifications.
Highlights
Vendors reported a range of challenges surrounding the procurement and contracting processes of Computerised Physician Order Entry (CPOE)/Clinical Decision Support (CDS) systems, including hospitals’ inability to adequately assess their own needs and select a suitable product, rushed procurement and implementation processes that resulted in difficulties in meaningfully engaging with vendors, as well as challenges relating to contracting leading to ambiguities in implementation roles
There is an urgent need to encourage more synergistic and collaborative working between providers and vendors and for a more centralised support for National Health Service hospitals, which draws on a wider body of experience, including a formalised procurement framework with value-based product specifications
Stimulated by monetary incentives, such as the US Health Information Technology for Economic and Clinical Health (HITECH) Act and the English Integrated Digital Care Technology Fund, the implementation of medication-related Health Information Technologies (HIT) in hospitals has resulted in a recent surge of activity.[1,2,3,4]
Summary
Stimulated by monetary incentives, such as the US Health Information Technology for Economic and Clinical Health (HITECH) Act and the English Integrated Digital Care Technology Fund, the implementation of medication-related Health Information Technologies (HIT) in hospitals has resulted in a recent surge of activity.[1,2,3,4] The underlying hope is that such systems will contribute to enhancing the efficiency, safety and quality of healthcare.[5,6,7,8]In the UK, such systems are commonly referred to as electronic prescribing (or ePrescribing) systems and are associated with functionality surrounding prescribing, decision support at the point of care, transmission of prescribing-related information (eg, when ordering or monitoring), medicines administration, and use of data for secondary uses (eg, quality improvement).[9]. Stimulated by monetary incentives, such as the US Health Information Technology for Economic and Clinical Health (HITECH) Act and the English Integrated Digital Care Technology Fund, the implementation of medication-related Health Information Technologies (HIT) in hospitals has resulted in a recent surge of activity.[1,2,3,4] The underlying hope is that such systems will contribute to enhancing the efficiency, safety and quality of healthcare.[5,6,7,8]. There are increasing concerns surrounding the governance structures of this approach including the lack of formal evaluation and flexibility, as well as usability and interoperability issues of technologies.[14]
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