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Evaluating physicians’ perspectives on the efficiency and effectiveness of the electronic prescribing system

Published online by Cambridge University Press:  24 February 2021

Ahmad Raeesi Open the ORCID record for Ahmad Raeesi [Opens in a new window] ,
Reza Abbasi Open the ORCID record for Reza Abbasi [Opens in a new window]  and
Reza Khajouei Open the ORCID record for Reza Khajouei [Opens in a new window]
Ahmad Raeesi
Affiliation:
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
Reza Abbasi
Affiliation:
Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
Reza Khajouei*
Affiliation:
Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
*
Author for correspondence: Reza Khajouei, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, P.O. Box: 7616911320, Haft-bagh Highway, Kerman, Iran. E-mail: r.khajouei@kmu.ac.ir; r.khajouei@yahoo.com
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Abstract

Background

The implementation of the electronic prescribing system follows certain objectives, and users’ perspectives can contribute to understanding the efficiency and effectiveness of this system. This study aimed to evaluate physicians’ perspectives on the efficiency and effectiveness of the electronic prescribing system.

Methods

This study was conducted on all physicians using the electronic prescribing system in clinics and hospitals affiliated with the treatment deputy of the Social Security Organization (SSO) in Sistan and Baluchistan Province in Iran. Data were collected using a self-administered questionnaire containing three sections: (i) Six items related to demographic data and clinical experience, (ii) Specific questions based on a five-point Likert scale-related physicians’ perspectives about efficiency (19 questions) and effectiveness (13 questions), and (iii) Open-ended questions about the positive and negative aspects of using the electronic prescribing system.

Results

The mean and standard deviation of the efficiency and effectiveness of the electronic prescribing system were 3.68 ± 0.67 and 3.84 ± 0.65, respectively. Patient safety had the highest mean score among all dimensions (4.0 ± 0.64). Most participants (n = 55, 79%) considered the efficiency and effectiveness of this system high. More than 90 percent of the physicians (n = 63) believed that the electronic prescribing system enables a better medication prescription by providing alerts and access to patients’ medication history.

Conclusion

The findings showed that most physicians believed that the electronic prescribing system of Iran's SSO has high efficiency and effectiveness. In particular, physicians believed that using this system improves patient safety and reduces costs.

Keywords

EvaluationElectronic prescriptionElectronic prescribing systemEfficiencyEffectiveness
Type
Article Commentary
Information
International Journal of Technology Assessment in Health Care , Volume 37 , Issue 1 , 2021 , e42
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Electronic Prescribing - MeSH - NCBI [Internet]. [cited 2018 May 22]. Available from: https://www.ncbi.nlm.nih.gov/mesh/68055695Google Scholar
Palappallil, DS, Pinheiro, C. Perceptions of prescribers towards electronic prescription: A pre-implementation evaluation. J Young Pharm. 2018;10:313–17.CrossRefGoogle Scholar
Dhavle, AA, Rupp, MT. Towards creating the perfect electronic prescription. J Am Med Inform Assoc. 2014;22:e7–12.CrossRefGoogle ScholarPubMed
Lapane, KL, Rosen, RK, Dubé, C. Perceptions of e-prescribing efficiencies and inefficiencies in ambulatory care. Int J Med Inform. 2011;80:39–46.CrossRefGoogle ScholarPubMed
Kruse, CS, Beane, A. Health information technology continues to show positive effect on medical outcomes: Systematic review. J Med Internet Res. 2018;20:e41.CrossRefGoogle ScholarPubMed
Warholak, TL, Rupp, MT. Analysis of community chain pharmacists’ interventions on electronic prescriptions. J Am Pharm Assoc. 2009;49:59–64.CrossRefGoogle ScholarPubMed
Her, QL, Amato, MG, Seger, DL, Beeler, PE, Slight, SP, Dalleur, O, et al. The frequency of inappropriate nonformulary medication alert overrides in the inpatient setting. J Am Med Inform Assoc. 2016;23:924–33.CrossRefGoogle ScholarPubMed
Porterfield, A, Engelbert, K, Coustasse, A. Electronic prescribing: Improving the efficiency and accuracy of prescribing in the ambulatory care setting. Perspect Health Inf Manag. 2014;11:1g.Google ScholarPubMed
Dreischulte, T, Donnan, P, Grant, A, Hapca, A, McCowan, C, Guthrie, B. Safer prescribing — A trial of education, informatics, and financial incentives. N Engl J Med. 2016;374:1053–64.CrossRefGoogle ScholarPubMed
Amini Rarani, M, Rafiye, H, Khedmati Morasae, E. Social health status in Iran: An empirical study. Iran J Public Health. 2013;42:206–14.Google ScholarPubMed
Devine, EB, Hollingworth, W, Hansen, RN, Lawless, NM, Wilson-Norton, JL, Martin, DP, et al. Electronic prescribing at the point of care: A time-motion study in the primary care setting. Health Serv Res. 2010;45:152–71.CrossRefGoogle ScholarPubMed
Hollingworth, W, Devine, EB, Hansen, RN, Lawless, NM, Comstock, BA, Wilson-Norton, JL, et al. The impact of e-prescribing on prescriber and staff time in ambulatory care clinics: A time-motion study. J Am Med Inform Assoc. 2007;14:722–30.CrossRefGoogle ScholarPubMed
Lim, WY, HSS, AS, Ng, LM, John Jasudass, SR, Sararaks, S, Vengadasalam, P, et al. The impact of a prescription review and rrescriber feedback system on prescribing practices in primary care clinics: A cluster randomised trial. BMC Fam Pract. 2018;19:120.CrossRefGoogle ScholarPubMed
Sinsky, C, Colligan, L, Li, L, Prgomet, M, Reynolds, S, Goeders, L, et al. Allocation of physician time in ambulatory practice: A time and motion study in 4 specialties. Ann Intern Med. 2016;165:753.CrossRefGoogle ScholarPubMed
ISO 9241-11. Ergonomic requirements for office work with visual display terminals (VDTs): Part 11: Guidance on usability. Int. Organ Stand. 1998;45:9.Google Scholar
Georgsson, M, Staggers, N. Quantifying usability: An evaluation of a diabetes mhealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics. J Am Med Inform Assoc. 2016;23:5–11.CrossRefGoogle ScholarPubMed
Khajouei, R, Abbasi, R. Evaluating nurses’ satisfaction with two nursing information systems. Comput Inform Nurs. 2017;35:307–14.CrossRefGoogle ScholarPubMed
Khajouei, R, Peek, N, Wierenga, PC, Kersten, MJ, Jaspers, MWM. Effect of predefined order sets and usability problems on efficiency of computerized medication ordering. Int J Med Inform. 2010;79:690–8.CrossRefGoogle ScholarPubMed
Samadbeik, M, Ahmadi, M, Sadoughi, F, Garavand, A. A copmarative review of electronic prescription systems: Lessons learned from developed countries. J Res Pharm Pract. 2017;6:3–11.Google ScholarPubMed
Kannry, J. Effect of E-prescribing systems on patient safety. Mt Sinai J Med. 2011;78:827–33.CrossRefGoogle ScholarPubMed
Russ, AL, Chen, S, Melton, BL, Johnson, EG, Spina, JR, Weiner, M, et al. A novel design for drug-drug interaction alerts improves prescribing efficiency. Jt Comm J Qual Patient Saf. 2015;41:396–405.Google ScholarPubMed
Kaushal, R, Barron, Y, Abramson, EL. The comparative effectiveness of 2 electronic prescribing systems. Am J Manag Care. 2011;17:SP88–94.Google ScholarPubMed
Statistics of the Health centers of Social Security Organization in Iran [Internet]. [cited 2018 Aug 31]. Available from: https://www.tamin.ir/News/Item/33085/73/33085.htmlGoogle Scholar
National formulary pharmacopoeia of Iran [Internet]. Iranian Ministry of Health. 2020 [cited 2020 Dec 13]. Available from: https://www.fda.gov.ir/getattachment/395593b4-3bc8-4bd1-ab7d-6147984abe30/%D9%81%D9%87%D8%B1%D8%B3%D8%AA-%D8%B1%D8%B3%D9%85%DB%8C-%D8%AF%D8%A7%D8%B1%D9%88%D9%87%D8%A7%DB%8C-%D8%A7%DB%8C%D8%B1%D8%A7%D9%86-(%D9%85%D9%87%D8%B1-%D9%85%D8%A7%D9%87-99)Google Scholar
Devine, EB, Williams, EC, Martin, DP, Sittig, DF, Tarczy-Hornoch, P, Payne, TH, et al. Prescriber and staff perceptions of an electronic prescribing system in primary care: A qualitative assessment. BMC Med Inform Decis Mak. 2010;10:72.CrossRefGoogle ScholarPubMed
Kaushal, R, Kern, LM, Barrón, Y, Quaresimo, J, Abramson, EL. Electronic prescribing improves medication safety in community-based office practices. J Gen Intern Med. 2010;25:530–6.CrossRefGoogle ScholarPubMed
Weingart, SN. An empirical model to estimate the potential impact of medication safety alerts on patient safety, health care utilization, and cost in ambulatory care. Arch Intern Med. 2009;169:1465.CrossRefGoogle Scholar
Stenner, SP, Chakravarthy, R, Johnson, KB, Miller, WL, Olson, J, Wickizer, M, et al. Eprescribing: Reducing costs through in-class therapeutic interchange. Appl Clin Inform. 2016;7:1168–81.CrossRefGoogle ScholarPubMed
McMullin, ST, Lonergan, TP, Rynearson, CS. Twelve-month drug cost savings related to use of an electronic prescribing system with integrated decision support in primary care. J Manag Care Pharm. 2005;11:322–32.CrossRefGoogle ScholarPubMed
Lee, T-T, Lee, T-Y, Lin, K-C, Chang, P-C. Factors affecting the use of nursing information systems in Taiwan. J Adv Nurs. 2005;50:170–8.CrossRefGoogle ScholarPubMed
Sittig, DF, Kuperman, GJ, Fiskio, J. Evaluating physician satisfaction regarding user interactions with an electronic medical record system. Proc AMIA Symp. 1999: 400–4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2232602/Google ScholarPubMed
Marasovic, C, Kenney, C, Elliott, D, Sindhusake, D. Attitudes of Australian nurses toward the implementation of a clinical information system. Comput Nurs. 1997;15:91–8.Google ScholarPubMed
Abbasi, F, Khajouei, R, Mirzaee, M. The efficiency and effectiveness of surgery information systems in Iran. BMC Med Inform Decis Mak. 2020;20:229.CrossRefGoogle ScholarPubMed
Khajouei, R, Wierenga, PC, Hasman, A, Jaspers, MWM. Clinicians satisfaction with CPOE ease of use and effect on clinicians’ workflow, efficiency and medication safety. Int J Med Inform. 2011;80:297–309.CrossRefGoogle ScholarPubMed
Kim, S-Y. Factors affecting the degree of satisfaction for nursing information system. Stud Health Technol Inform. 2006;122:523–6.Google ScholarPubMed
Frøkjær, E, Hertzum, M, Hornbæk, K. Measuring usability: Are effectiveness, efficiency, and satisfaction really correlated? Proceedings of the SIGCHI Conference on human factors in computing systems, vol. 2; 2000. p. 345–52.CrossRefGoogle Scholar