Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry

BMC Medical Informatics and Decision Making

Jonathan Penm¹  Kevin K. Y. Kuan²  Eui Dong Kim²  Neysa Petrina²  Yiren Liu²  Milan Rasikbhai Vaghasiya³  Simon Poon³  Naren Gunja⁴ 

[1] Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, 2006, Camperdown, NSW, Australia;Department of Pharmacy, Prince of Wales Hospital, 2031, Randwick, NSW, Australia;School of Computer Science, The University of Sydney, 2006, Camperdown, NSW, Australia;School of Computer Science, The University of Sydney, 2006, Camperdown, NSW, Australia;Western Sydney Local Health District, 2145, Westmead, NSW, Australia;Western Sydney Local Health District, 2145, Westmead, NSW, Australia;Faculty of Medicine and Health, The University of Sydney, 2006, Camperdown, NSW, Australia;

关键词: Electronic health records;    Implementation science;    Electronic prescribing;    Medical informatics;    Technology assessment;   

DOI  :  10.1186/s12911-021-01584-w

来源: Springer

【 摘 要 】

BackgroundHospitals across Australia are implementing Clinical Information Systems, e.g. Electronic Medication Management Systems (EMMS) at a rapid pace to moderate health services. The benefits of the EMMS depend on the acceptance of the system by the clinicians. The study hospital used a unique patient-centric implementation strategy that was based on the guiding principle of “one patient, one chart” to avoid a patient being on a hybrid medication chart. This paper aims to study the factors facilitating or hindering the adoption of the EMMS as viewed by clinicians and the implementation team.MethodsFour focus groups (FG), one each for (1) doctors, (2) nurses, (3) pharmacists, and (4) implementation team, were conducted. A guide for the FG was based on the Unified Theory of Acceptance and Use of Technology (UTAUT).ResultsA total of 23 unique subthemes were identified and were grouped into five main themes (1) implementation strategy, (2) organisational outcome of EMMS, (3) individual impact of EMMS, (4) IT product, and (5) organisational culture. Clinicians reported improvement in their workflow efficiency post-EMMS implementation. They also reported some challenges in using the EMMS that centered around the area of infrastructure, technical and design issues. Additionally, the implementation team highlighted two crucial factors influencing the success of EMMS implementation, namely: (1) the patient-centric implementation strategy, and (2) the organisation readiness.ConclusionOverall, this study outlines the implementation process of the EMMS in a large healthcare facility from the clinicians’ and the implementation team’s perspectives using UTAUT model. The result suggests that clinicians’ acceptance of the EMMS was highly influenced by the unique implementation strategy (namely, patient-centric approach and clinical leadership in the implementation team). Whereas the level of adoption of EMMS by clinicians was determined by their level of perceived and realised benefits. On the other hand, a number of barriers to the adoption of EMMS were discovered, namely, general training instead of customised training based on local needs, technical and design issues and lack of availability of computer systems. It is suggested that promptly resolving these issues can improve the adoption of the EMMS.

【 授权许可】

CC BY