Document Type : Original Article
Authors
- neda borhani moghani 1
- Marziyhe Meraji 2
- Elaheh Houshmand 3
- Somayeh Fazaeli 2
- Marjan Vedjani 4
- Zahra Ebnehosseni 5
1 Msc student, Health Information Technology, Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
2 Assistant Professor , Health Information Management, Department of Health Information Technology, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
3 Associate Professor, Research Center for Social Factors Affecting Health, Department of Health Economics and Management, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
4 PhD, Health Care Management, Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran,
5 PhD, Medical Informatics, Psychiatric and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
Introduction: Considering the beginning of the implementation of electronic prescribing in the country, the present study was conducted with the aim of explaining the challenges during the implementation of electronic prescribing.
Research method: This study was conducted using a qualitative method through interviews with physicians working in Mashhad University of Medical Sciences in 1401. The participants were selected by purposive sampling, after conducting three in-depth interviews, interview questions were extracted. After the semi-structured interviews were conducted, they were recorded and implemented, in order to analyze them, content analysis method and MAXQDA version 10 software were used.
Finding: In this study, the challenges were categorized into two main categories, including the organizational category and the infrastructure category. organizational challenges; Challenges related to insurance, referral of patients, education and information to beneficiaries, monitoring and infrastructure challenges; infrastructure, user interface and database. The main challenges of implementing electronic prescribing were related to the outage and slowness of systems and the Internet and the existence of multiple systems for insurances.
Conclusion: the infrastructure challenges which are among the important obstacles in the path of the full implementation of the electronic prescribing plan should be resolved, in order to improve the implementation problems, the continuous monitoring of the prescribing systems should be considered and the results should be applied immediately, as It is recommended to reform infrastructures, integrate insurance systems, use electronic signatures and electronic version standards, and provide practical training.
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Main Subjects
- Oktarlina RZ. E-prescribing: benefit, barrier, and adopting challenge in electronic prescribing. Journal of Medicine. 2020;21(2):98.
- Kierkegaard P. E-prescription across Europe. Health and Technology. 2013;3:205-19.
- Pangalos G, Sfyroeras V, Pagkalos I. E–prescription as a tool for improving services and the financial viability of healthcare systems: the case of the Greek national e–prescription system. International journal of electronic healthcare. 2014;7(4):301-14.
- Electronic prescription project of Social Security Organization. Available at: https//ihio.gov.ir.2021.
- Al-Kahtani NK, Ramzi OI, Subbarayalu AV, Almulhim JA, Almulhim B. Physicians perception toward an electronic prescribing system at an academic medical center (Amc) In Saudi Arabia: an exploratory study. Int J Sci Technol Res. 2019;8(10):358-63.
- Gіder Ö, Ocak S, Top M. Evaluation of electronic prescription implications in Turkey: An investigation of the perceptions of physicians. Worldviews on Evidence‐Based Nursing. 2015;12(2):88-97.
- Abramson EL, Patel V, Pfoh ER, Kaushal R. How physician perspectives on e-prescribing evolve over time. Applied Clinical Informatics. 2016;7(04):994-1006.
- Hellström L, Waern K, Montelius E, Åstrand B, Rydberg T, Petersson G. Physicians' attitudes towards ePrescribing–evaluation of a Swedish full-scale implementation. BMC medical informatics and decision making. 2009;9(1):1-10.
- Grossman JM, Gerland A, Reed MC, Fahlman C. Physicians' experiences using commercial e-prescribing systems. Health Aff (Millwood). 2007;26(3):w393-404.
- Eltajoury W, M. Maatuk A, Denna I, K. Elberkawi E, editors. Physicians' Attitudes towards Electronic Prescribing Software: Perceived Benefits and Barriers. International Conference on Data Science, E-learning and Information Systems 2021; 2021.
- Sweidan M, Williamson M, Reeve JF, Harvey K, O'Neill JA, Schattner P, et al. Identification of features of electronic prescribing systems to support quality and safety in primary care using a modified Delphi process. BMC medical informatics and decision making. 2010;10:1-9.
- Ahmadi M, Samadbeik M, Sadoughi F. Modeling of outpatient prescribing process in iran: a gateway toward electronic prescribing system. Iranian journal of pharmaceutical research: IJPR. 2014;13(2):725.
- Cohen JF, Bancilhon J-M, Jones M. South African physicians' acceptance of e-prescribing technology: an empirical test of a modified UTAUT model. South African Computer Journal. 2013;50(1):43-54.
- Bulut S, Yıldız A, Kaya S. Evaluation of transition to electronic prescriptions in Turkey: perspective of family physicians. International journal of health policy and management. 2019;8(1):40.
- Kivekäs E, Enlund H, Borycki E, Saranto K. General practitioners' attitudes towards electronic prescribing and the use of the national prescription centre. Journal of evaluation in clinical practice. 2016;22(5):816-25.
- Pizzi LT, Suh D-C, Barone J, Nash DB. Factors related to physicians’ adoption of electronic prescribing: results from a national survey. American Journal of Medical Quality. 2005;20(1):22-32.
- Craxford S, Taylor L, Duguid A, Shivji F, Pickering S. The learning curve of electronic prescribing. British Journal of Hospital Medicine. 2015;76(9):538-40.
- Bates DW, Gawande AA. Improving safety with information technology. New England journal of medicine. 2003;348(25):2526-34.
- Josendal AV, Bergmo TS. From paper to E-prescribing of multidose drug dispensing: a qualitative study of workflow in a community care setting. Pharmacy. 2021;9(1):41.
- Rupp MT, Warholak TL. Evaluation of e-prescribing in chain community pharmacy: best-practice recommendations. Journal of the American Pharmacists Association. 2008;48(3):364-91a.
- Joia LA, Magalhães C. Implementation of an electronic prescription system in a Brazilian general hospital: Understanding sources of resistance. The Electronic Journal of Information Systems in Developing Countries. 2009;39(1):1-18.
- Almutairi BA, Potts HW, Al-Azmi SF. Physicians’ perceptions of electronic prescribing with electronic medical records in Kuwaiti primary healthcare centres. Sultan Qaboos University Medical Journal. 2018;18(4):e476.
- Maatuk AM, Elghriani AM, Denna I, Werfalli AA, editors. Barriers and Opportunities to Implementing Electronic Prescription Software in Public Libyan Hospitals. 2022 International Conference on Engineering & MIS (ICEMIS); 2022: IEEE.
- Miller RA, Waitman LR, Chen S, Rosenbloom ST. The anatomy of decision support during inpatient care provider order entry (CPOE): empirical observations from a decade of CPOE experience at Vanderbilt. Journal of biomedical informatics. 2005;38(6):469-85.
- Tamblyn R, Huang A, Kawasumi Y, Bartlett G, Grad R, Jacques A, et al. The development and evaluation of an integrated electronic prescribing and drug management system for primary care. Journal of the American Medical Informatics Association. 2006;13(2):148-59.
- Bell DS, Cretin S, Marken RS, Landman AB. A conceptual framework for evaluating outpatient electronic prescribing systems based on their functional capabilities. Journal of the American Medical Informatics Association. 2004;11(1):60-70.
- Schadow G, Fleck C, Nalkande M, Sangawar A, Rosenthal C, Carlson M, et al. Value of New Drug Knowledge for e-Prescribing. United state: Agency for Healthcare Research and Quality 7p Report. (R01HS15377).
- Merlin B, Chazard E, Pereira S, Serrot E, Sakji S, Beuscart R, et al. Can F-MTI semantic-mined drug codes be used for Adverse Drug Events detection when no CPOE is available? MEDINFO 2010: IOS Press; 2010. p. 1025-9.
- Zadeh PE, Tremblay MC. A review of the literature and proposed classification on e-prescribing: Functions, assimilation stages, benefits, concerns, and risks. Research in Social and Administrative Pharmacy. 2016;12(1):1-19.
- Hor CP, O'Donnell JM, Murphy AW, O'Brien T, Kropmans TJ. General practitioners' attitudes and preparedness towards Clinical Decision Support in e-Prescribing (CDS-eP) adoption in the West of Ireland: a cross sectional study. BMC medical informatics and decision making. 2010;10(1):1-8.
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