E-prescribing System Research Articles

Transition to ePrescribing for systemic anti-cancer therapy - Perceptions of a multidisciplinary haematology/oncology team in a large teaching hospital.

A National Cancer Information System is planned for phased implementation in Irish cancer centres to enable electronic prescribing (ePrescribing) of systemic anti-cancer therapy. This study aimed to capture the opinions of healthcare professionals in a hospital setting relating to the current paper-based workflow for systemic anti-cancer therapy prescribing and their attitudes and expectations of the new ePrescribing system to develop recommendations, which assist in the planning and implementation of future ePrescribing systems. A mixed methods study of concurrent design was conducted. Interviews with healthcare professionals primarily aimed to evaluate processes and identify areas requiring improvement within the current paper-based workflow for systemic anti-cancer therapy prescribing. An online questionnaire adapted from the Information Systems Expectations and Experiences tool primarily aimed to capture expectations of the new ePrescribing system and attitudes towards the transition. Twelve healthcare professionals were interviewed, and 50 healthcare professionals responded to the online questionnaire (response rate: 33.3%). Eight major themes emerged from interview transcripts relating to opinions on the paper-based workflow. Questionnaire respondents reported positive attitudes towards ePrescribing implementation and had high expectations for workflow improvements and functionalities of the new system. Seven recommendations for ePrescribing implementation were developed: (1) prioritise specific processes; (2) plan for changes in communication; (3) repeat research in the post-implementation setting; (4) ensure good information technology infrastructure and system support; (5) ensure optimum training; (6) outline limitations of clinical decision support; (7) provide clear instructions on local configurability. This study identifies potential challenges in transitioning to ePrescribing and provides recommendations, which assist stakeholders in ensuring safe and effective transitions, thus informing future ePrescribing systems' implementation in haematology/oncology settings.

Electronic prescribing systems in hospitals to improve medication safety: a multimethods research programme

Electronic prescribing systems in hospitals to improve medication safety: a multimethods research programme

Users’ Views Regarding Electronic Prescribing Implementation: A Qualitative Case Study in A Private Hospital of Magelang City, Indonesia

The use of the Internet and digital system in a hospital named the Hospital Information System (HIS) has grown rapidly and remarkably, including in Indonesia. One of the HIS components is electronic prescribing (e-prescribing). Although the Indonesian government has mandated HIS in hospitals since 2011, successful implementation is not without challenges. Therefore, this study aimed to explore users' views regarding e-prescribing implementation through a case study in a private hospital in Magelang City, Indonesia. This study applied a qualitative approach. Participants were e-prescribing users who were selected purposively. Data were gathered using interviews. The Capability, Opportunity, Motivation, and Behavior (COM-B) model was used to structure the interview guideline. Data were transcribed verbatim and analyzed using a thematic approach. Twenty participants were interviewed. Five themes emerged through the interviews: selfreflection, perceived advantages, policy, capacity building, and quality assurance. The themes express optimism in implementing eprescribing. Users are central to e-prescribing system acceptance, as is explained in the self-reflection and perceived advantages themes. Furthermore, top management plays a pivotal role in improving the capacity and ensuring system implementation quality. This study’s findings imply that the user, system, and organization play crucial roles in enhancing health care service quality through e-prescribing.

A retrospective observational study of the use of gastroprotection for patients on dual antiplatelet therapy in an acute trust in England

Abstract Introduction Dual antiplatelet therapy (DAPT), a combination of aspirin and either clopidogrel, prasugrel or ticagrelor, is recommended for secondary prevention of ischaemic events (heart attack and stroke) in people with coronary artery disease. Patients taking DAPT may be at high gastrointestinal (GI) bleed risk if other factors (including advanced age, or concomitant use of medicines that are known to increase the risk of GI bleeds) are present. Such patients should be considered for gastroprotection e.g. a proton pump inhibitor (PPI) or H2 receptor antagonist. Aim To assess whether gastroprotection was prescribed for inpatients taking DAPT in a 750-bed acute hospital in England. Methods This was a retrospective analysis of existing data. Patient episodes involving prescription of DAPT upon discharge between April 2020 and April 2021 were extracted from the e-prescribing system (WellSky). Electronic records of the identified patient episodes were searched for co-prescription of either PPI or H2 antagonist. We also ascertained if patients on DAPT should have received gastro-protection using age 71 and over, and concomitant drugs as separate risk factors. Results Over this 13-month period there were 1693 patient episodes (mean age 72 years, 63% male) when DAPT was prescribed at discharge, of which gastroprotection was also prescribed in 1210 (71%). Of the 483 episodes when gastroprotection was not prescribed, 223 (46%) met the criterion of age as a risk factor for gastroprotection. There were a further 20 episodes of patients aged under 71 years not on gastroprotection but receiving an SSRI, NSAID, prednisolone, nicorandil or an anticoagulant. Conclusion We identified that gastroprotection was potentially missing in 243 (14%) of the total DAPT patient episodes. Though there is evidence for the use of PPIs reducing the risk of GI bleeding in patients treated with DAPT after percutaneous coronary intervention or acute coronary syndrome (1), studies have reported that gastroprotection has been missed in the at risk group (2). When considering newly initiated gastroprotection, various factors are considered e.g. any possible interaction with a PPI if one of the antiplatelets is clopidogrel. In addition, PPIs have adverse effects such as low sodium / magnesium, and this may be a reason for consideration of a H2 antagonist. Further work is required to make our prescribers and pharmacy team aware of the importance of considering gastroprotection for this patient cohort. The strength of this study is the extraction of data from our electronic prescribing system for a large cohort of patients prescribed specified antiplatelet medication. Our study has some potential limitations. First, it was conducted in a single centre in England; this might restrict the generalisability of our findings. Second, the retrospective nature of this study may introduce bias or other uncertainties. Third, we did not ascertain the indication for DAPT nor if patients came in on these drugs as opposed to being started during their admission. Fourth, we did not check risk factors for gastroprotection other than age and selected concomitantly prescribed drugs. Finally, we did not check if those not prescribed gastroprotection had significant contraindications other than electrolyte abnormalities. References (1) Guo H, Ye Z, Huang R. Clinical outcomes of concomitant use of proton pump inhibitors and dual antiplatelet therapy: a systematic review and meta-analysis. Front Pharmacol. 2021 Aug 2;12:694698. (2) Sehested TSG, Carlson N, Hansen PW, Gerds TA, Charlot MG, Torp-Pedersen C, et al. Reduced risk of gastrointestinal bleeding associated with proton pump inhibitor therapy in patients treated with dual antiplatelet therapy after myocardial infarction. Eur Heart J. 2019;40(24):1963–70.

Perception of physicians towards electronic prescription system and associated factors at resource limited setting 2021: Cross sectional study.

The healthcare industry is increasingly concerned about medical errors, which are the leading cause of death worldwide and also compromise patient safety. This medical error is even more serious in developing countries where healthcare is not supported by technology. Because of the traditional paper-based prescription system, Ethiopia has an overall medication prescribing error rate of 58.07% that could be avoided if an electronic prescription system was in place. Therefore, this study aims to assess physicians' perceptions towards electronic prescription implementation. From February 1 to April 5, 2021, an institution-based cross-sectional study was conducted among physicians working in public hospitals in the Amhara region. 384 physicians were selected using a simple random sampling method. The data was collected using a self-administered questionnaire and analysed using SPSS, version 21. To assess factors associated with perception among physicians, a binary and multivariable logistic regression analysis were performed. A P.05 value, at a 95% confidence interval, was considered statistically significant. The validity of the questionnaire was determined based on expert opinion, as well as its reliability was determined by calculating the value of Cronbach alpha (α = .78). In this study, 231 (76.5%) of study participants had a positive perception of electronic prescription. Around 70.8% had more than 5 years of computer usage experience. Nearly 90% of participants claimed that their prescriptions were legible; however, 89% believe that paper-based prescriptions are prone to error. According to multivariable logistic regression analysis, technical skill [AOR] 4.7, 95% confidence interval [CI] (1.27-17.41), good internet access (AOR 2.82, % CI 1.75-4.54), and perceived usefulness of e-prescription system (AOR 3.31, 95% CI 1.01-12.12) were significantly associated with perception. The majority of respondents have a positive perception of electronic prescription. The most notable factors associated with physician perception were organizational factors, internet access, perceived usefulness of the system, and technical skill.

An e-Delphi study to obtain expert consensus on the level of risk associated with preventable e-prescribing events.

AimsWe aim to seek expert opinion and gain consensus on the risks associated with a range of prescribing scenarios, preventable using e‐prescribing systems, to inform the development of a simulation tool to evaluate the risk and safety of e‐prescribing systems (ePRaSE).MethodsWe conducted a two‐round e‐Delphi survey where expert participants were asked to score pre‐designed prescribing scenarios using a five‐point Likert scale to ascertain the likelihood of occurrence of the prescribing event, likelihood of occurrence of harm and the severity of the harm.ResultsTwenty‐four experts consented to participate with 15 pand 13 participants completing rounds 1 and 2, respectively. Experts agreed on the level of risk associated with 136 out of 178 clinical scenarios with 131 scenarios categorised as high or extreme risk.ConclusionWe identified 131 extreme or high‐risk prescribing scenarios that may be prevented using e‐prescribing clinical decision support. The prescribing scenarios represent a variety of categories, with drug–disease contraindications being the most frequent, representing 37 (27%) scenarios, and antimicrobial agents being the most common drug class, representing 28 (21%) of the scenarios. Our e‐Delphi study has achieved expert consensus on the risk associated with a range of clinical scenarios with most of the scenarios categorised as extreme or high risk. These prescribing scenarios represent the breadth of preventable prescribing error categories involving both basic and advanced clinical decision support. We will use the findings of this study to inform the development of the e‐prescribing risk and safety evaluation tool.

Patients with Cardiovascular Implantable Electronic Devices in the Era of COVID-19 and Their Response to Telemedical Solutions.

Background and objectives: The COVID-19 pandemic has transformed the healthcare system, leading to the rapid implementation of telemedical solutions, especially in cardiology. The aim of this survey was to evaluate the patients (pts) with cardiac implantable electronic devices (CIED) perspectives on the telemedicine elements such as teleconsultation, telemonitoring, and e-prescription. Materials and methods: An anonymous questionnaire was created and delivered to CIED pts who came to the ambulatory outpatient clinic. In this survey, we evaluated teleconsultation, home monitoring systems, and e-prescription in the 17 single-choice and multiple-choice questions and a rating on a scale of 0 to 10. Results: During the four-month period, 226 pts (58% male) completed the questionnaire. Regular visits were most frequent in pts living in the urban area where the clinic was located, and least frequent in those living in rural areas (p = 0.0158). Moreover, 89 pts (39%) had teleconsultation before CIED interrogation, and satisfaction was 99%; 24 pts (11%) had home-monitoring control and 135 pts (60%) would have liked to have this opportunity; 88 pts (34.5%) would be able to pay additional costs for home-monitoring, with a mean amount of 65 PLN (±68.24). The e-prescription system was used by 203 pts (90%), and it was evaluated with 8.6 points (±2) on a scale from 0 to 10 points. Conclusions: The COVID-19 pandemic disrupted the previous functioning of the health system, and telemedicine became an alternative to traditional ambulatory visits and proved to be essential in the continuity of patient care. There is a substantial need for further development of telemedicine solutions in the healthcare system.

Patients', pharmacists', and prescribers' attitude toward using blockchain and machine learning in a proposed ePrescription system: online survey.

ObjectiveTo evaluate the attitudes of the parties involved in the system toward the new features and measure the potential benefits of introducing the use of blockchain and machine learning (ML) to strengthen the in-place methods for safely prescribing medication. The proposed blockchain will strengthen the security and privacy of the patient’s prescription information shared in the network. Once the ePrescription is submitted, it is only available in read-only mode. This will ensure there is no alteration to the ePrescription information after submission. In addition, the blockchain will provide an improved tracking mechanism to ensure the originality of the ePrescription and that a prescriber can only submit an ePrescription with the patient’s authorization. Lastly, before submitting an ePrescription, an ML algorithm will be used to detect any anomalies (eg, missing fields, misplaced information, or wrong dosage) in the ePrescription to ensure the safety of the prescribed medication for the patient.MethodsThe survey contains questions about the features introduced in the proposed ePrescription system to evaluate the security, privacy, reliability, and availability of the ePrescription information in the system. The study population is comprised of 284 respondents in the patient group, 39 respondents in the pharmacist group, and 27 respondents in the prescriber group, all of whom met the inclusion criteria. The response rate was 80% (226/284) in the patient group, 87% (34/39) in the pharmacist group, and 96% (26/27) in the prescriber group.Key FindingsThe vast majority of the respondents in all groups had a positive attitude toward the proposed ePrescription system’s security and privacy using blockchain technology, with 72% (163/226) in the patient group, 70.5% (24/34) in the pharmacist group, and 73% (19/26) in the prescriber group. Moreover, the majority of the respondents in the pharmacist (70%, 24/34) and prescriber (85%, 22/26) groups had a positive attitude toward using ML algorithms to generate alerts regarding prescribed medication to enhance the safety of medication prescribing and prevent medication errors.ConclusionOur survey showed that a vast majority of respondents in all groups had positive attitudes toward using blockchain and ML algorithms to safely prescribe medications. However, a need for minor improvements regarding the proposed features was identified, and a post-implementation user study is needed to evaluate the proposed ePrescription system in depth.

Issues with the Swedish e-prescribing system - An analysis of health information technology-related incident reports using an existing classification system.

ObjectiveTo identify issues with the Swedish e-prescribing system and devise a set of recommendations to overcome the identified challenges.MethodsA number of health information technology-related incidents were collected retrospectively from various sources using purposive and snowball sampling. A search term containing five keywords was used to identify the electronic prescription-related incidents. The identified incidents (n = 24) were subjected to an existing framework, i.e., the Health Information Technology Classification System. Special attention was paid to the software-related issues, which were analysed using thematic analysis.ResultsSeveral types of software-related issues (n = 22) were identified: system configuration, interface with other software systems or components, software functionality, data storage and backup, record migration, software not accessible, and network/server down or slow. Both human and technical factors contributed to these incidents, including prescriptions not cancelled actively, drug handling errors, software programming errors, and system updates/upgrades. These software problems led to various consequences, such as incidents affecting multiple patients’ care management, delays in patient care, and risks of serious deterioration of health. Several temporary initiatives or administrative adjustments, for instance, cover letters to patients and local strategies, were used to overcome some of these challenges.ConclusionsThis study provides insights into the challenges related to the e-prescribing system, contributing factors, consequences, and actions taken to mitigate those risks. Therefore, healthcare organisations using the e-prescribing system should adopt the provided recommendations to minimise the risks of design and developmental challenges, implementation and use-related issues, and the problems related to monitoring, evaluation, and optimisation.

Policy parameters for optimising hospital ePrescribing: An exploratory literature review of selected countries of the Organisation for Economic Co-operation and Development

ObjectiveElectronic prescribing systems offer considerable opportunities to enhance the safety, effectiveness and efficiency of prescribing and medicines management decisions but, despite considerable investments in health IT infrastructure and healthcare professional training, realising these benefits continues to prove challenging. How systems are customised and configured to achieve optimal functionality is an increasing focus for policymakers. We sought to develop an overview of the policy landscape currently supporting optimisation of hospital ePrescribing systems in economically developed countries with a view to deriving lessons for the United Kingdom (UK).MethodsWe conducted a review of research literature and policy documents pertaining to optimisation of ePrescribing within hospitals across Organisation for Economic Co-operation and Development (OECD) countries on Embase, Medline, National Institute for Health (NIH), Google Scholar databases from 2010 to 2020 and the websites of organisations with international and national health policy interests in digital health and ePrescribing. We designed a typology of policies targeting optimisation of ePrescribing systems that provides an overview of evidence relating to the level at which policy is set, the aims and the barriers encountered in enacting these policies.ResultsOur database searches retrieved 11 relevant articles and other web resources mainly from North America and Western Europe. We identified very few countries with a national level strategy for optimisation of ePrescribing in hospitals. There were hotspots of digital maturity in relation to ePrescribing at institutional, specialisation, regional and national levels in the US and Europe. We noted that such countries with digital maturity fostered innovations such as patient involvement.ConclusionsWe found that, whilst helpful to achieve certain aims, coordinated strategies within and across countries for optimisation of ePrescribing systems are rare, even in countries with well-established ePrescribing and digital health infrastructures. There is at present little policy focus on maximising the utility of ePrescribing systems.

E-solutions in Estonian community pharmacies: A literature review.

ObjectiveEstonian innovative electronic solutions have long been leading the way in the healthcare sector. This article aims to give an overview of all e-solutions and their usability in community pharmacies in Estonia and how they compare and operate with the wider e-health system.MethodsA comprehensive literature review was conducted on publicly accessible information regarding Estonian e-health and electronic community pharmacy solutions.FindingsWhile Estonian e-health system, including the e-prescription system is developed and maintained by the nationally funded Health and Wellbeing Infosystem Center, community pharmacy owners have established many noteworthy systems such as the e-pharmacist decision-support system, commodities info systems, online pharmacies, a telehealth prescription reminder service, and an automated dosage dispense system. Some pharmacies are collaborating with private healthcare service providers to allow quick and easy prescription renewal through an electronic channel.ConclusionDifferent electronic systems have overall greatly improved Estonian pharmacy services, accuracy and flow of consultations, and accessibility of medicines. In some cases, more support and active involvement is still needed from government agencies for full implementation.

Pharmacist’s perception of the impact of electronic prescribing on medication errors and productivity in community pharmacies

Paper-based prescriptions have been used for several decades by many healthcare practitioners. The literature suggests that several challenges are associated with handwritten prescriptions that might impact patients’ safety and medication errors. Electronic prescribing (e-prescribing) has been developed to phase out handwritten and computer-generated prescriptions that are printed on paper or faxed directly to a dispensing pharmacy. This research aimed to examine pharmacists’ thoughts about the e-prescribing impact on their practice. We also evaluated the adoption rate of e-prescribing by assessing the proportion of electronic prescriptions (e-Rx) received in community pharmacies across the Canadian provinces. This research was conducted as a secondary analysis of the 2016 National Survey of Community-Based Pharmacists: Use of Digital Health Technology in Practice by Nielson. The survey was conducted in collaboration between Canada Health Infoway and the Canadian Pharmacy Association. The target population of the survey was Canadian pharmacists who were in community practice. The provinces included in this research were Ontario, Quebec, Saskatchewan, Alberta, and British Columbia (n = 450). The findings of this study suggest that community pharmacists in Canada were willing to embrace e-prescribing to support their practice. Most of pharmacists thought that e-prescribing was a useful tool to reduce medication errors and improve efficiency in pharmacies. However, the largest proportion of prescriptions issued by prescribers continue to be in paper form, whether handwritten or computer-generated. Further research is needed to investigate the barriers to the adoption of e-prescribing systems among primary care practitioners in Canada.

30-Day Mortality Following Systemic Anti-Cancer Treatment (SACT) Review in Driving Quality of Care in Hematologic Malignancies in a Tertiary Care Hospital

IntroductionThere is growing evidence to support SACT 30-day mortality rate as a key metric for assessing quality of cancer care and a key indicator of avoidable harm to patients from SACT due therapy-related or poor patient selection factors. This has been established for solid organ malignancy. However, data in patients with hematologic malignancy is limited. At the Gloucestershire Hospitals NHS Foundation Trust, a large district general hospital providing specialist care to over 600,000 people, we collated data from our in-house SACT dataset to assess factors that impact the 30-day SACT mortality and establish a benchmark for multidisciplinary, educational mortality meeting discussions on mortality in patients receiving SACT. We aimed to review cases characterizing patients, causes of death and the role of SACT in deaths.MethodsThis retrospective study included all patients aged 18 years or older with a hematologic malignancy who received SACT between Jan 1, 2016, and Mar 31, 2021, irrespective of the number of previous treatment cycles or regimens and irrespective of their response within the disease trajectory. SACT was defined as any cytotoxic chemotherapy, immunotherapies such as monoclonal antibodies, and targeted biological treatments. We calculated 30-day mortality after the most recent cycle of SACT for these patients. We analyzed whether patient, tumor type, and therapy-related factors were associated with the risk of 30-day mortality.ResultsA total of 1903 patients with hematologic malignancy received SACT. The 30-day mortality rate for our center was 3.89% for patients receiving SACT and 4.9% of all-cause mortality. In the 30-day mortality cohort the median patient age at death was 71 years (interquartile range (IQR) 52-86); ratio of men to women, 1.18. 30-day mortality increased with age for patients treated with palliative intent or intent to remission (OR 4.9, 95% CI .985-26.255; p=0.0171). Median duration of 30-mortality post SACT was 17 days (IQR 8-22). The commonest malignancy was plasma cell dyscrasias (54%) and 68% receiving treatments with intent to remission. ECOG performance status was 0-2 at final SACT cycle in 65%, 3 in 27% and 4 in 8%. 47% of patients were receiving their first cycle (median number of cycles received 2; IQR 1-3) and 43% receiving first line therapy (median lines of therapy 2; IQR 1-3). Therapy naïve patients had significantly higher 30-day mortality than those who received previous SACT (OR 3.435, 95% CI 2.06-5.66; p<0·0001). 42% of deaths occurred in hospital and 54% were attributed to primary refractory and/or aggressive disease. Other causes of death included infection (19% neutropenic, 15% non-neutropenic) including COVID-19 (3%), major bleed (5%), thromboembolism (1%) and cardiac event (1%).ConclusionsSACT data provides “real world” assessment of treatment patterns and outcomes in routine malignant hematology practice. It highlights the importance of systematic data collection and analyses to better inform factors associated with higher risk of 30-day mortality in patients with hematologic malignancy, which ultimately promotes review of clinical decision making and offers an opportunity for service improvements. Our findings shed light into some of the factors that affect the risk of early mortality of patients with hematologic malignancy and provides a way to measure if the health service is improving. The insights into risk factors for 30-day mortality will aid in better understanding for treating clinicians and their patients on predictors of potential harms and benefits of SACT thereby carefully balancing patients' personalized expectations with representative outcomes and treatment risks and should be the focus of discussions about SACT, particularly in pretreated or older patient groups. Neutropenic sepsis remains a significant cause of SACT related mortality warranting further improvements in care. Prospective case discussions together with this retrospective review have generated service improvements at our center including standardizing chemotherapy helpline pathways, systematizing SACT mandatory data recording on e-prescribing system and mandatory response assessments as part of SACT protocols' review. Future research work to examine outcomes based on subtypes of hematologic malignancy and on larger datasets is critical for improving our understanding at delivering the right drugs to the right patients. DisclosuresNo relevant conflicts of interest to declare.

Assessing Electronic Prescription: A Cross-sectional Study of Pharmacists in Germany

ZusammenfassungHintergrund Mit dem Modellprojekt GERDA („Geschützter e-Rezept-Dienst der Apotheken“) wurde von der Landesapothekerkammer (LAK) und dem Landesapothekerverband (LAV) in Baden-Württemberg die Möglichkeit geschaffen, Rezepte im Rahmen von Online-Sprechstunden über das von der Kassenärztlichen Vereinigung Baden-Württemberg betriebene telemedizinische Portal „docdirekt“, zu verordnen. Vor diesem Hintergrund war das Ziel der Studie, Barrieren und fördernde Faktoren aufseiten der Apotheken für die Beteiligung an einer Versorgung, die eine elektronische Verordnung von Rezepten beinhaltet, zu explorieren und zu priorisieren. Auf Basis dieser Determinanten wurden Empfehlungen zur Optimierung einer erfolgreichen Implementierung ähnlicher Versorgungsangebote abgeleitet. Methode Es wurde ein Mixed-Methods-Design gewählt, um die Determinanten zu explorieren und zu priorisieren. Im ersten Schritt wurden Determinanten für die Beteiligung an einem System, welches die elektronische Verordnung von Rezepten ermöglicht mithilfe von Einzelinterviews mit an docdirekt beteiligten Teleärzten, niedergelassenen Hausärzten und Apothekern exploriert. Anschließend wurden diese Determinanten in einem zweiten Schritt durch eine quantitative Befragung von Apothekern priorisiert. Ergebnisse Von den 523 an der Umfrage teilgenommenen Apothekern war mehr als die Hälfte bereit sich an einem E-Rezept-System zu beteiligen, 8,5% schließen eine zukünftige Beteiligung aus. Insgesamt konnten 18 Determinanten für die Beteiligung an einem System, welches die elektronische Verordnung von Rezepten ermöglicht, exploriert werden. Der Schutz der freien Apothekenwahl wurde als wichtigster Aspekt für eine Beteiligung identifiziert. Gefolgt von der Möglichkeit einer Korrekturfunktion bei E-Rezepten (um z. B. Retaxierungen oder Medikationsfehlern zu vermeiden), der Integration des E-Rezepts in die bestehende Apotheken-EDV sowie dem gesetzlichen Ausschluss von direkten Verträgen mit Versandapotheken. Zeitersparnisse und eine ggf. höhere Vergütung wurden dagegen als weniger relevant bewertet. Schlussfolgerung Insgesamt gab über die Hälfte der befragten Apotheken an, sich an einem E-Rezept-System beteiligen zu wollen. Für die ab Januar 2022 geplante flächendeckende Einführung von E-Rezepte kann der Einbezug der identifizierten fördernden Faktoren vonseiten der Politik, Softwareentwickler und Verbände eine wichtige Rolle bei der Implementierung spielen.

Providing Security for Patient’s E-Prescription using Cryptography Technique

The benefits of electronic medical prescriptions and the information and communication technologies that benefit those areas have led to significant improvements in healthcare over the years. In the overall context of health care information protection, the confidentiality of data reported by doctors requires special treatment. This paper introduces an e-prescription system that addresses some of the challenges associated with prescription privacy protection in the process of prescribing drugs. The main purpose is to provide security and protect prescription from being stolen. The benefit of project is that it provides the different results in short time. Our goal is to provide online user with the appropriate tools to secure their medical prescription from being misuse by intruder. Our solution is not only straight forward but also easy to grasp by those who will join us to make a global difference. .The biggest advantage we have is that we can encrypt and decrypt by using proper algorithm so that only intended user can decrypt it.

Self-Monitoring of Blood Glucose for Patients With Type 2 Diabetes in Primary Care: A Single-Centre, 10-Year Retrospective Analysis.

BackgroundWhile type 1 diabetics often require self-monitoring of blood glucose (SMBG), the evidence for tight blood glucose monitoring in non-insulin treated type 2 diabetes mellitus (T2DM) patients is limited. In addition to its lack of cost-effectiveness, unnecessary blood glucose monitoring may also result in anxiety and decreased quality of life. In this retrospective audit, we assessed SMBG prescribing practice at one general practice against guidelines from the National Institute for Health and Care Excellence (NICE).MethodsA systematic search of T2DM patients diagnosed at a general practice in London, United Kingdom, in the last 10 years was undertaken. A total of 146 patients fulfilled these criteria, of which 100 patients were randomly selected for inclusion in this audit. Medical notes were reviewed and collated for analysis.ResultsOnly 85% of patients with T2DM were being managed in accordance with the NICE guidelines on SMBG, while 15% were not. It was more common for patients who did not need monitoring to be inappropriately prescribed SMBG (10%) than it was for patients who needed monitoring to be under-prescribed SMBG (5%). The reasons for prescribing SMBG were often left undocumented.ConclusionAdherence to the NICE guidelines is subpar. Recommended solutions include educating healthcare professionals involved in the prescribing of SMBGs, regular reviews of the continued necessity of SMBG, and digital alerts on e-prescribing systems.

Optimizing Hospital Electronic Prescribing Systems: A Systematic Scoping Review.

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.

Protocol for a qualitative study to identify strategies to optimise hospital ePrescribing systems

IntroductionElectronic prescribing (ePrescribing) is a key area of development and investment in the UK and across the developed world. ePrescribing is widely understood as a vehicle for tackling medication-related safety...

Evaluation of electronic prescriptions in Turkey: A community pharmacy perspective

ObjectiveThe purpose of this study was to determine the opinions of pharmacists, who are important users of e-prescribing practices in Turkey, on the function of a prescription application. MethodA questionnaire was developed to determine the opinions of pharmacists on Turkish e-prescribing practices, using a stratified and systematic random sampling method. A total of 378 pharmacists responded to the questionnaire. ResultsThe average level of satisfaction of e-prescription reported by pharmacists was 4.4 ± 0.8. Although 52.4% of the participating pharmacists reported no problems using the e-prescription application, 47.6% reported encountering problems. The majority of the problems associated with e-prescription practices were caused by the physicians who entered the e-prescription into the system. The most common problem (17.4%) reported was the inability to read the e-prescription code as written by physicians. The primary contribution of the e-prescribing practice reported by pharmacists was the acceleration of prescription procedures. ConclusionE-prescription practice is advantageous to pharmacies across many aspects, improving drug delivery to patients, and most pharmacists reported thatthe e-prescription practice washighly satisfying. The development of electronic and information technologies increases access toinformation resources and diversity, resulting inchanges in the expectations and utilisation levels of users; therefore, continuous improvements are required to improve the performance of the e-prescribing system.

E-Prescribing: Benefit, Barrier, and Adopting Challenge in Electronic Prescribing

E-Prescribing system provides prescribing drugs electronically that can be a stand-alone system or be integrated with Electronic Health Records (EHRs) system. When implementing an E-Prescribing system, we need to consider it’s benefits and barriers, also adopting factors that can affect the success of the implementation. The main advantage of using an E-Prescribing system is to increase patient safety, meanwhile, the biggest barriers and challenges are it’s cost-related and adaptation by health facilities and related health workers. This article review provides information about E-prescribing and it’s elements to help for a better understanding of the system and to give some insights before adopting the e-prescribing system.&#x0D; J MEDICINE JUL 2020; 21 (2) : 98-101