Lisa Lee1, Robin Williams2, Aziz Sheikh3. 1. eHealth Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Medical School. lisa.lee@ed.ac.uk. 2. Institute for the Study of Science, Technology and Innovation, School of Social and Political Sciences, The University of Edinburgh. Robin.Williams@ed.ac.uk. 3. eHealth Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Medical School. aziz.sheikh@ed.ac.uk.
Abstract
BACKGROUND: Hospital ePrescribing systems are expected to improve quality of care for patients, yet the perspectives of patients themselves have seldom been explored in the context of ePrescribing deployments. OBJECTIVE: We sought to understand the significance of ePrescribing for patients through a case study of renal in-patients on a hospital ward, before and after the introduction of an ePrescribing system. METHODS: Three data sources were drawn on as part of the case study: interviews with representatives from national patient groups (n = 10), in-patients on a renal ward (n = 11 pre-implementation; n = 12 post-implementation) and fieldnotes (n = 25) of observations made on the case study ward. Data were analysed thematically focusing on: (1) perceived benefits of ePrescribing; (2) patient awareness and understanding of the medications prescribed and (3) patient views on medicines reconciliation at admission and discharge. RESULTS: While ePrescribing was viewed positively overall, its implementation in the case study site failed to address the lack of patient involvement in the prescribing process and poor medication counselling upon discharge. Importantly, the limited impact of the ePrescribing system in these particular areas appeared to be the result of institutional and cultural practices rather than solely technological factors. CONCLUSIONS: The introduction of ePrescribing systems offers new opportunities to improve sharing of knowledge and communication with all those involved in the patient's care pathways, including patients, carers and healthcare professionals across diverse care settings. Achieving this will, first and foremost, require significant cultural and policy shifts in how the patient's role is perceived by clinicians in relation to medicines management.
BACKGROUND: Hospital ePrescribing systems are expected to improve quality of care for patients, yet the perspectives of patients themselves have seldom been explored in the context of ePrescribing deployments. OBJECTIVE: We sought to understand the significance of ePrescribing for patients through a case study of renal in-patients on a hospital ward, before and after the introduction of an ePrescribing system. METHODS: Three data sources were drawn on as part of the case study: interviews with representatives from national patient groups (n = 10), in-patients on a renal ward (n = 11 pre-implementation; n = 12 post-implementation) and fieldnotes (n = 25) of observations made on the case study ward. Data were analysed thematically focusing on: (1) perceived benefits of ePrescribing; (2) patient awareness and understanding of the medications prescribed and (3) patient views on medicines reconciliation at admission and discharge. RESULTS: While ePrescribing was viewed positively overall, its implementation in the case study site failed to address the lack of patient involvement in the prescribing process and poor medication counselling upon discharge. Importantly, the limited impact of the ePrescribing system in these particular areas appeared to be the result of institutional and cultural practices rather than solely technological factors. CONCLUSIONS: The introduction of ePrescribing systems offers new opportunities to improve sharing of knowledge and communication with all those involved in the patient's care pathways, including patients, carers and healthcare professionals across diverse care settings. Achieving this will, first and foremost, require significant cultural and policy shifts in how the patient's role is perceived by clinicians in relation to medicines management.
Authors: Sara Garfield; Seetal Jheeta; Fran Husson; Jill Lloyd; Alex Taylor; Charles Boucher; Ann Jacklin; Anna Bischler; Christine Norton; Rob Hayles; Bryony Dean Franklin Journal: PLoS One Date: 2016-04-19 Impact factor: 3.240