E-prescribing System Research Articles

Nationwide implementation of electronic prescriptions: Lessons learned in Finland

Medication adherence can be divided into primary and secondary adherence. Primary medication non-adherence (PMN) occurs when a patient does not obtain medicine with their initial prescription. Secondary non-adherence measures prescription refills among patients who previously filled their first prescription. While secondary non-adherence has been studied thoroughly, PMN has been assessed less extensively, due to lack of available data. Estonian ePrescription system might prove a valuable tool for this.The aim of this study was to evaluate PMN and the interval between prescribing and dispensing of medicines using the Estonian ePrescriptions database to establish its potential use for this purpose and for other qualitative drug utilization research measures. Osteoporosis medicines were used as an example.The Estonian Prescription Centre was used to evaluate if patients purchase medicines after initial prescription of osteoporosis medicine. Prescriptions from 2012 to 2015 of all patients over 18 were included. PMN was defined as the first prescription not being dispensed before it expired (60 days). The rate of PMN was calculated.Estonian ePrescription System enabled fast evaluation of PMN of osteoporosis patients based on data about prescribing, dispensing and time intervals in-between. Of patients who started osteoporosis treatment 13.1% were primary non-adherent. Of primary non-adherent patients 42% still started treatment at some point during the study. Of patients who did purchase their first prescription 80.4% did so within a week and 95% within 25 days.The Estonian ePrescription system is a useful tool for monitoring PMN. The PMN of osteoporosis medicines was identified as lower than previously reported. More similar type of studies about other groups of medicines would be needed to understand the pattern of PMN and give valuable information to healthcare specialists about how to increase initiation of treatment.

The Effect of Cognitive Load and Task Complexity on Automation Bias in Electronic Prescribing.

Determine the relationship between cognitive load (CL) and automation bias (AB). Clinical decision support (CDS) for electronic prescribing can improve safety but introduces the risk of AB, where reliance on CDS replaces vigilance in information seeking and processing. We hypothesized high CL generated by high task complexity would increase AB errors. One hundred twenty medical students prescribed medicines for clinical scenarios using a simulated e-prescribing system in a randomized controlled experiment. Quality of CDS (correct, incorrect, and no CDS) and task complexity (low and high) were varied. CL, omission errors (failure to detect prescribing errors), and commission errors (acceptance of false positive alerts) were measured. Increasing complexity from low to high significantly increased CL, F(1, 118) = 71.6, p < .001. CDS reduced CL in high-complexity conditions compared to no CDS, F(2, 117) = 4.72, p = .015. Participants who made omission errors in incorrect and no CDS conditions exhibited lower CL compared to those who did not, F(1, 636.49) = 3.79, p = .023. Results challenge the notion that AB is triggered by increasing task complexity and associated increases in CL. Omission errors were associated with lower CL, suggesting errors may stem from an insufficient allocation of cognitive resources. This is the first research to examine the relationship between CL and AB. Findings suggest designers and users of CDS systems need to be aware of the risks of AB. Interventions that increase user vigilance and engagement may be beneficial and deserve further investigation.

The effect of topical pain creams: A solution to oral opioids

Medication adherence can be divided into primary and secondary adherence. Primary medication non-adherence (PMN) occurs when a patient does not obtain medicine with their initial prescription. Secondary non-adherence measures prescription refills among patients who previously filled their first prescription. While secondary non-adherence has been studied thoroughly, PMN has been assessed less extensively, due to lack of available data. Estonian ePrescription system might prove a valuable tool for this.The aim of this study was to evaluate PMN and the interval between prescribing and dispensing of medicines using the Estonian ePrescriptions database to establish its potential use for this purpose and for other qualitative drug utilization research measures. Osteoporosis medicines were used as an example.The Estonian Prescription Centre was used to evaluate if patients purchase medicines after initial prescription of osteoporosis medicine. Prescriptions from 2012 to 2015 of all patients over 18 were included. PMN was defined as the first prescription not being dispensed before it expired (60 days). The rate of PMN was calculated.Estonian ePrescription System enabled fast evaluation of PMN of osteoporosis patients based on data about prescribing, dispensing and time intervals in-between. Of patients who started osteoporosis treatment 13.1% were primary non-adherent. Of primary non-adherent patients 42% still started treatment at some point during the study. Of patients who did purchase their first prescription 80.4% did so within a week and 95% within 25 days.The Estonian ePrescription system is a useful tool for monitoring PMN. The PMN of osteoporosis medicines was identified as lower than previously reported. More similar type of studies about other groups of medicines would be needed to understand the pattern of PMN and give valuable information to healthcare specialists about how to increase initiation of treatment.

Payer and manufacturer perspectives on the role of quality measures in outcomes-based contracts

Medication adherence can be divided into primary and secondary adherence. Primary medication non-adherence (PMN) occurs when a patient does not obtain medicine with their initial prescription. Secondary non-adherence measures prescription refills among patients who previously filled their first prescription. While secondary non-adherence has been studied thoroughly, PMN has been assessed less extensively, due to lack of available data. Estonian ePrescription system might prove a valuable tool for this.The aim of this study was to evaluate PMN and the interval between prescribing and dispensing of medicines using the Estonian ePrescriptions database to establish its potential use for this purpose and for other qualitative drug utilization research measures. Osteoporosis medicines were used as an example.The Estonian Prescription Centre was used to evaluate if patients purchase medicines after initial prescription of osteoporosis medicine. Prescriptions from 2012 to 2015 of all patients over 18 were included. PMN was defined as the first prescription not being dispensed before it expired (60 days). The rate of PMN was calculated.Estonian ePrescription System enabled fast evaluation of PMN of osteoporosis patients based on data about prescribing, dispensing and time intervals in-between. Of patients who started osteoporosis treatment 13.1% were primary non-adherent. Of primary non-adherent patients 42% still started treatment at some point during the study. Of patients who did purchase their first prescription 80.4% did so within a week and 95% within 25 days.The Estonian ePrescription system is a useful tool for monitoring PMN. The PMN of osteoporosis medicines was identified as lower than previously reported. More similar type of studies about other groups of medicines would be needed to understand the pattern of PMN and give valuable information to healthcare specialists about how to increase initiation of treatment.

Combatting the opioid epidemic – The power of naloxone intervention in community pharmacy

Medication adherence can be divided into primary and secondary adherence. Primary medication non-adherence (PMN) occurs when a patient does not obtain medicine with their initial prescription. Secondary non-adherence measures prescription refills among patients who previously filled their first prescription. While secondary non-adherence has been studied thoroughly, PMN has been assessed less extensively, due to lack of available data. Estonian ePrescription system might prove a valuable tool for this.The aim of this study was to evaluate PMN and the interval between prescribing and dispensing of medicines using the Estonian ePrescriptions database to establish its potential use for this purpose and for other qualitative drug utilization research measures. Osteoporosis medicines were used as an example.The Estonian Prescription Centre was used to evaluate if patients purchase medicines after initial prescription of osteoporosis medicine. Prescriptions from 2012 to 2015 of all patients over 18 were included. PMN was defined as the first prescription not being dispensed before it expired (60 days). The rate of PMN was calculated.Estonian ePrescription System enabled fast evaluation of PMN of osteoporosis patients based on data about prescribing, dispensing and time intervals in-between. Of patients who started osteoporosis treatment 13.1% were primary non-adherent. Of primary non-adherent patients 42% still started treatment at some point during the study. Of patients who did purchase their first prescription 80.4% did so within a week and 95% within 25 days.The Estonian ePrescription system is a useful tool for monitoring PMN. The PMN of osteoporosis medicines was identified as lower than previously reported. More similar type of studies about other groups of medicines would be needed to understand the pattern of PMN and give valuable information to healthcare specialists about how to increase initiation of treatment.

Factors that influence the intent of pharmacists in the provision of medication therapy management services

Medication adherence can be divided into primary and secondary adherence. Primary medication non-adherence (PMN) occurs when a patient does not obtain medicine with their initial prescription. Secondary non-adherence measures prescription refills among patients who previously filled their first prescription. While secondary non-adherence has been studied thoroughly, PMN has been assessed less extensively, due to lack of available data. Estonian ePrescription system might prove a valuable tool for this.The aim of this study was to evaluate PMN and the interval between prescribing and dispensing of medicines using the Estonian ePrescriptions database to establish its potential use for this purpose and for other qualitative drug utilization research measures. Osteoporosis medicines were used as an example.The Estonian Prescription Centre was used to evaluate if patients purchase medicines after initial prescription of osteoporosis medicine. Prescriptions from 2012 to 2015 of all patients over 18 were included. PMN was defined as the first prescription not being dispensed before it expired (60 days). The rate of PMN was calculated.Estonian ePrescription System enabled fast evaluation of PMN of osteoporosis patients based on data about prescribing, dispensing and time intervals in-between. Of patients who started osteoporosis treatment 13.1% were primary non-adherent. Of primary non-adherent patients 42% still started treatment at some point during the study. Of patients who did purchase their first prescription 80.4% did so within a week and 95% within 25 days.The Estonian ePrescription system is a useful tool for monitoring PMN. The PMN of osteoporosis medicines was identified as lower than previously reported. More similar type of studies about other groups of medicines would be needed to understand the pattern of PMN and give valuable information to healthcare specialists about how to increase initiation of treatment.

An audit of the accuracy of medication information in electronic medical discharge summaries linked to an electronic prescribing system.

Poor communication of medication information to general practitioners when patients are discharged from hospital is a widely recognised problem. There has been little research exploring the accuracy of medication information in electronic discharge summaries (EDS) linked to hospital e-prescribing systems. To evaluate the accuracy of medication lists and medication change information in EDS produced using an integrated e-prescribing and EDS system (where EDS discharge medication lists were imported from discharge e-prescription records, medication change information was manually entered, and medications were dispensed from paper copies of the patients' e-prescriptions). Retrospective audit of EDSs for a random sample, representative of adult patients ( n = 87) discharged from a major teaching hospital. EDS medication lists were compared to pharmacist-verified paper discharge prescriptions (considered to be the most accurate discharge medication list) to identify discrepancies. EDS medication change information was compared to medication changes identified by comparing pharmacist-verified "Medication History on Admission" forms with pharmacist-verified paper discharge prescriptions. There were 85/87 (98%) EDSs that included a discharge medication list. Of these, 50/85 (59%) contained one or more medication list discrepancies (median 1, range 0-15). The most common discrepancy was omission of medication (58%); 84/131 (64%) discrepancies were considered clinically significant (risk of adverse outcome); 162/351 (46%) clinically significant medication changes were stated in the EDS; and 153/351 (44%) changes were both stated and included a reason. EDS discrepancies were common despite integration with e-prescribing. Eliminating paper prescriptions, enhancing e-prescribing/EDS functionality and involving pharmacists in EDS preparation may reduce discrepancies.

Pharmacy Customers' Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland.

BackgroundOne of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers.ObjectiveThe aim of this study was to investigate Finnish pharmacy customers’ (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions.MethodsQuestionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers’ experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests.ResultsCompleted questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when acting on behalf of another person (25/418, 6.0%) at the pharmacy. The most common way of keeping up to date with ePrescriptions was to ask at the pharmacy (631/1278, 49.37%). The vast majority of the respondents were satisfied with ePrescriptions as a whole (1221/1274, 95.84%).ConclusionsFinnish pharmacy customers are satisfied with the recently implemented nationwide ePrescription system. They seldom have any difficulties purchasing medicines, renewing their ePrescriptions, or acting on behalf of someone else at the pharmacy. Customers usually keep up to date with their ePrescriptions by asking at the pharmacy. However, some customers are unaware of the practices or have difficulty keeping up to date with the status of their ePrescriptions. The provision of relevant information and assistance by health care professionals is therefore required to promote customers’ adoption of the ePrescription system.

Physicians' Estimates of Electronic Prescribing's Impact on Patient Safety and Quality of Care

Background Electronic prescribing (e-prescribing) is a potentially important intervention that can be used to reduce errors. It provides many potential benefits over handwritten medication prescriptions, including standardization, legibility, audit trails, and decision support. Electronic health record (EHR) and e-prescribing systems may greatly enhance communication and improve the quality and safety of care. Objectives Our aim is to investigate physician's opinions about the influence of electronic prescriptions on patient safety and quality of care. Methods This study extends the technology acceptance model to analyze the acceptance of e-prescribing and adds an understanding of what kind of impact the external variables (patient identification and the interoperability of applications) have on physicians' individual work performance (i.e., patient safety and quality of care). The empirical analysis uses data from surveys conducted in 2012 and 2014 in Finland. The participants were physicians, and e-prescribing was the only method that could be used for prescribing medication when these studies were conducted. Results Physicians' perceived usefulness of e-prescribing was significantly associated with patient safety and quality of care. The interoperability of an EHR had a significant effect on both the perceived ease of use and perceived usefulness of e-prescribing. The findings show that experience with an e-prescribing system has a positive effect on participants' perceived ease of use and perceived usefulness of e-prescribing. Conclusion This study highlights potential safety and efficiency benefits associated with integrated health information technology in health care. The perceived usefulness of e-prescribing affected physicians' opinions on patient safety and quality of care.

From E-Prescribing to Drug Management System

This study focuses on user reactions to the replacement of an information system they had been using. More specifically, a survey of physicians involved in the transition from an e-prescribing system to a new integrated drug management system was conducted. Data about physicians' level of stress induced by the system transition, satisfaction with the new system, and intention to continue to use the system, were collected as well as system usage logs before, during, and after the transition. Results indicate that physicians experiencing higher level of stress used the new system less during the transition as well as during the two months post-transition than their counterparts who reported lower level of stress. Although satisfaction with the new system was positively related to physicians' intention to use, it was not significantly related to actual usage. A discussion of the results and their implications for research and practice concludes the paper.

Realizing E-Prescribing's Potential to Reduce Outpatient Psychiatric Medication Errors.

Preliminary evidence from observational and cohort studies suggests that replacement of paper- and phone-based medication prescriptions with electronic prescribing systems in ambulatory settings is associated with decreased medication errors. However, problems from traditional prescribing also occur with e-prescribing (such as incorrect medication dose and instructions or wrong patient), as do some new problems (a confusing user interface leading to prescribing the wrong medication). The authors present four steps for reducing medication errors in outpatient psychiatric settings: continuing to implement e-prescribing, streamlining user interfaces, improving interoperability among various e-prescribing and retail pharmacy systems, and using education and advocacy to achieve these goals.

Use of a national database as a tool to identify primary medication non-adherence: The Estonian ePrescription system.

Medication adherence can be divided into primary and secondary adherence. Primary medication non-adherence (PMN) occurs when a patient does not obtain medicine with their initial prescription. Secondary non-adherence measures prescription refills among patients who previously filled their first prescription. While secondary non-adherence has been studied thoroughly, PMN has been assessed less extensively, due to lack of available data. Estonian ePrescription system might prove a valuable tool for this. The aim of this study was to evaluate PMN and the interval between prescribing and dispensing of medicines using the Estonian ePrescriptions database to establish its potential use for this purpose and for other qualitative drug utilization research measures. Osteoporosis medicines were used as an example. The Estonian Prescription Centre was used to evaluate if patients purchase medicines after initial prescription of osteoporosis medicine. Prescriptions from 2012 to 2015 of all patients over 18 were included. PMN was defined as the first prescription not being dispensed before it expired (60 days). The rate of PMN was calculated. Estonian ePrescription System enabled fast evaluation of PMN of osteoporosis patients based on data about prescribing, dispensing and time intervals in-between. Of patients who started osteoporosis treatment 13.1% were primary non-adherent. Of primary non-adherent patients 42% still started treatment at some point during the study. Of patients who did purchase their first prescription 80.4% did so within a week and 95% within 25 days. The Estonian ePrescription system is a useful tool for monitoring PMN. The PMN of osteoporosis medicines was identified as lower than previously reported. More similar type of studies about other groups of medicines would be needed to understand the pattern of PMN and give valuable information to healthcare specialists about how to increase initiation of treatment.

Cryptanalysis and improvement of certificateless proxy signcryption scheme for e-prescription system in mobile cloud computing

Certificateless proxy signcryption (CLPSc) is one of the most efficient security primitives for secure data transmission. The entrustment of signing rights to a proxy signcrypter at the behest of an original signcrypter imparts its utility in various fields such as an online proxy auction, healthcare industry, cloud computing, mobile-agents, ubiquitous computing, etc. Unlike the traditional sign-then-encrypt approach, signcryption primitive saves computational costs and bandwidth load. Recently, a pairing-free CLPSc scheme has been proposed which claims to be secure against forgery under adaptive chosen-message attacks. This paper unveils that the aforementioned scheme has failed to provide unforgeability. As an improvement of their scheme, a novel pairing-free certificateless proxy signcryption scheme using elliptic curve cryptography (ECC) has been proposed for e-prescription system in mobile cloud computing. The proposed scheme is proven to be secure against indistinguishability under adaptive chosen-ciphertext attack and existential forgery under adaptive chosen-message attack in the random oracle model against Type 1 and Type 2 adversaries through formal analysis. The proposed scheme outperforms the existing schemes in terms of computational efficiency making it suitable for futuristic mobile cloud computing applications.

PP.05.15] THE IMPACT OF SWITCHING FROM PROTOTYPE TO GENERIC ATORVASTATIN ON PERSISTENCE AND COMPLIANCE IN GREECE

Objective: To investigate the effect of switching from prototype to generic atorvastatin on adherence in hypercholesterolemic patients newly treated with atorvastatin under real life clinical conditions. Design and method: We conducted a non-interventional, ambispective, single-center, cohort study in Greece between May 2015 and October 2016. All adult hypercholesterolemic patients from the largest hypertension clinic in Greece with a documented first prescription with a prototype atorvastatin during a 6-month index period were screened retrospectively. Patients that either received a second prescription of prototype atorvastatin or switched to a generic version of atorvastatin were identified as the potential study pool. A random sample of 190 patients equally split in two cohorts comprised the study population, and were followed up prospectively. Persistence to treatment was assessed by time to discontinuation. Compliance was assessed by both the proportion of days covered (PDC) through the official Governmental e-prescribing system and the self-administered Morisky Medication Adherence Scale (MMAS-4). Finally, treatment satisfaction was measured with the self-administered Treatment Satisfaction Questionnaire for Medication (TSQM). Results: As per protocol 190 patients were enrolled in the study, 95 in each cohort. There were no statistically significant differences between cohorts regarding baseline characteristics, while all patients were hypertensive. The 18-month survival probability estimates were 90.2% and 76.4% for the non-switch and switch cohort respectively (HR = 0.574, p = 0.1627). Non-switchers were more compliant than switchers as measured by both PDC (79.1% vs. 73.0%, p < 0.001) and MMAS-4 scale (percent reporting high adherence: 73.7% vs. 26.3%, p < 0.001) and presented better results in TSQM dimensions (convenience: 65.9 vs. 62.3, p < 0.001, effectiveness: 68.2 vs. 62.9, p < 0.001, side effects: 98.7 vs. 98.4, p = 0.945, global satisfaction: 67.5 vs. 57.5, p < 0.001). Conclusions: Switching from a prototype to generic atorvastatin was associated with impaired persistence, compliance and treatment satisfaction in newly treated hypercholesterolemic patients. This new data provide a basis for further research to better understand adherence behavior.

Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department.

IntroductionMedication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%–38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions.MethodsWe conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period.ResultsOverall, E-prescriptions included fewer prescription errors as compared to HW-prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p <0.0001), missing frequency (3.5% to 2.2%, p=0.04), missing strength errors (32.4% to 10.2%, p <0.0001) and legibility (0.7% to 0.2%, p=0.005). E-prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02).ConclusionA basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive.

Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian hospital network

While clinician attitudes towards electronic prescribing (e-prescribing) systems have been widely studied, little is known about the perspectives of patients, despite being the primary beneficiaries of these systems. The objective of this study is to explore and compare patient and clinician attitudes towards an integrated e-prescribing and dispensing system, in order to guide improvements in system implementation, service delivery and enhancements to system functionality. A cross-sectional survey was developed and administered to patients and multidisciplinary clinicians at a multisite Australian metropolitan teaching hospital network in all areas where e-prescribing was fully implemented. Participants' views on perceived impact and valued features of the e-prescribing system were elucidated. Overall, 783 participants (400 patients and 383 clinicians) completed the survey. Although 98% of clinicians were aware of the transition to e-prescriptions, only 36% of patients were aware prior to the study. Over 80% of patients and clinicians perceived improvements in prescribing and dispensing safety and clinician workflow; 90% of patients were comfortable with information privacy associated with e-prescriptions; and 86% of patients preferred e-prescriptions to handwritten prescriptions. Although over 80% of patients valued features that improved access to information and medication safety, clinicians were more discerning about valued system features. The majority of patients and clinicians reported a positive impact of e-prescribing on safety and efficiency. Both groups valued safe and effective use of medicines, although differences existed in the importance placed on key system features. A greater focus on patient engagement and communication is needed to optimise the delivery of patient-centred care.

The impact of electronic prescriptions on the medicine dispensing process in Finnish community pharmacies - a survey of pharmacists

Objective To explore the impact of electronic prescriptions (ePrescriptions) on the dispensing process in Finnish community pharmacies. Methods A survey of a random sample of dispensers (B.Sc. in Pharmacy) (n = 1004) and pharmacists (M.Sc. in Pharmacy) (n = 228) was conducted in 2014. Key findings Altogether, 778 questionnaires were analysed, giving response rates of 64% (n = 635) for dispensers and 65% (n = 143) for pharmacists. According to the respondents, prescription renewal (75%), transferring prescription data into the pharmacy data system (75%), receiving a prescription (73%), checking prescription information (62%) and making dispensing entries concerning the prescription (58%) have become easier with ePrescriptions. However, correcting dispensing entries afterwards (78%), correcting one's own processing errors made during dispensing (77%), correcting errors on the prescription caused by the physician (73%) and cancellation of medicine dispensing (64%) have been hindered. Technical problems in using ePrescriptions were most often experienced less than once a month. Conclusions Some parts of the dispensing process have become easier, whereas making corrections to the prescription has been hindered with ePrescriptions. Thus, the ePrescription system needs further development to ensure the easy and efficient use of ePrescriptions in the future.

A survey exploring National Health Service ePrescribing Toolkit use and perceived usefulness amongst English hospitals

BackgroundThere is currently limited guidance for hospitals to implement ePrescribing systems and we have developed an ePrescribing Toolkit designed to support ongoing implementation, adoption and optimisation of efforts. This work...

Evidenced Based Drug-Drug Interaction Alerts in an E-Prescribing System

Evidenced Based Drug-Drug Interaction Alerts in an E-Prescribing System

Medication safety and the usability of electronic prescribing as perceived by physicians-A semistructured interview among primary health care physicians in Finland.

In Finland, a fully operational and nationwide electronic prescription (ePrescription) system was implemented by law in 2012 to 2015. From 2017, all prescriptions have to be electronic. ePrescriptions are intended to facilitate prescribing and to improve medication safety in Finnish health care. In this study, the aim was to explore physicians' experiences with the impacts of ePrescriptions on prescribing and medication safety in Finland. Data were collected by conducting 42 interviews among primary health care physicians in spring 2015. The data obtained were analyzed by means of qualitative content analysis. Most of the physicians considered ePrescriptions to be convenient to issue because of the paperless procedure. Additionally, physicians stated that information concerning patients' prescriptions was better available through the Prescription Centre since physicians were able to check patients' prescriptions, including those issued elsewhere. In particular, ePrescriptions have improved the control of narcotics and medicines classified as primarily affecting the central nervous system. However, establishing a patient's overall medication through the Prescription Centre was regarded as difficult because prescription information was sometimes incoherent and had not been updated. The ePrescribing system was also described as inflexible, especially the correcting, cancelling, or renewing of ePrescriptions. For example, the system required too many "mouse clicks" and PIN entries to justify the actions taken in prescriptions. The system's slowness and the poor connection between physicians' electronic patient records and the Prescription Centre were also underlined. According to the Finnish physicians interviewed, ePrescriptions have facilitated prescribing in some respects. However, the ePrescribing system still has problems and the Prescription Centre cannot be fully used for the management of a patient's overall medication.