Patient perspectives of an integrated electronic ...

Patient perspectives of an

integrated electronic medication

prescribing and dispensing system

Grace Lau, Jayde Ho, Susan Lin, Karen Yeoh, Tiffany Wan, Marisa Hodgkinson

Monash Health Pharmacy Department, Victoria

Introduction

Gagnon et al. Barriers and facilitators to implementing electronic prescription:

A systematic review of user groups’ perceptions. JAMIA. 2014

Perceptions of e-prescribing

Physicians &

clinical staff

(e.g. nurses)

Pharmacists &

pharmacy staff

Managers, IT staff,

combination of groups

IntroductionMonash Health

~ 15,000 staff

Monash Health Fast Facts 2014-15. www.monashhealth.org

Introduction

~ 1.4 million residents each year have accessto our services in the greater community

Monash Health Fast Facts 2014-15. www.monashhealth.org

Monash Health

~ 15,000 staff

Introduction

Aim

To explore patient attitudes

towards an e-prescribing system

Objectives

Evaluate patient experience with electronic prescriptions and service delivery

Identify valued features of e-prescribing systems to guide further developments in system functionality

Identify areas for improvement in patient-centred care

Setting

& Study

Design

Method

Metropolitan hospital network– 2170+ beds, 5+ sites, 2312 km2 catchment

– e-prescribing implemented Jun’13 – Jan’16

Cross-sectional survey– all areas with e-prescribing fully implemented

– 5 weeks (25/01/16 – 26/02/16)

Patients who had received an e-prescriptionSubjects

Technology BriefPrescribing

Technology Brief

PA

TIE

NT

OR

PA

HR

MA

CIS

T

Printed

E-prescription

Technology BriefDispensing

Technology Brief

Integrated prescribing and dispensing

Method

Data

Collection

Results

Sample (n=400)

76.3% (400/524) survey response rate

Population

19,242 original e-prescriptions

13,648 unique patients

Results

Awareness

of change64%

36%

Aware (143/400)

Unaware (257/400)

Outpatients (143/400)Aware (60) Unaware (83)

Inpatients (257/400)Aware (83) Unaware (174)

Results

Perceptions

&

Experiences

Results: Perceptions & Experiences

92.5% agree overall (370/400)

Prescriptions are

easier to read

Provides a complete

electronic record

of your medicines 95.0% agree overall (380/400)

Access to Information

Results: Perceptions & Experiences

89.8% agree overall (359/400)

I am comfortable about the

privacy of information

about my medicines that

is on the computer system

Privacy

Results: Perceptions & Experiences

Dispensing of

medicines is safer

88.3% agree overall(353/400)

90.8% agree overall(363/400)

Prescribing of

medicines is safer

Medication safety

Results: Perceptions & Experiences

Communication between my treating team

and Monash Health pharmacists about my

medicines is better77.0% agree overall

(308/400)

Filling prescriptions at

Monash Health Pharmacy

is faster

(262/400)

65.5% agree overall

Interactions in healthcare system

Results: Perceptions & Experiences

I prefer computer-

generated prescriptions85.8% agree overall

(343/400)

Results

0 20 40 60 80 100

% of Respondents

Valued

Features

Results: Valued Features

0 20 40 60 80 100

% of Respondents

1. Correct patient details 92.5% (370/400)

2. Prescribing history 90.0% (360/400)

3. Prescription legibility 87.5% (350/400)

4. Dispensing history 84.3% (337/400)

Access to Information

Results: Valued Features

0 20 40 60 80 100

% of Respondents

5. Medicine interaction alerts 85.0% (340/400)

6. Allergy/ADR alerts 84.3% (337/400)

7. Central allergy/ADR record 83.5% (334/400)

8. Appropriate doses displayed 77.8% (311/400)

Medication Safety

0 20 40 60 80 100

% of Respondents

Results: Valued Features

9. Improved communication

between health professionals77.5% (310/400)

10. Time saved waiting for

prescription to be written57.3% (229/400)

11. Time saved at pharmacy 56.5% (226/400)

Interactions in healthcare system

Results: Valued Features

0 20 40 60 80 100

% of Respondents

Access to Information

Medication Safety

Interactions in healthcare system

Discussion: Key Findings

High patient satisfaction with electronic prescriptions

Greater value placed on system features that improve

effective access to information and medication safety

Most patients unaware of change, prior to study

Relevance to other systems/hospitals

Discussion: Moving Forward

patients during eMM implementation

patient perceptions, experiences and values

knowledge to improve patient experience:

guide enhancements in service delivery &

system functionality

tailor education & communication to patients

Image credits (in order of use): ‘Crowded waiting room’ [modified: grayscale] by Kenneth Feucht | ‘Sea of People’ [modified: grayscale] by

Garry Knight. CC BY 2.0 | ‘A Face in the Crowd’ [modified: grayscale] by Michael Pardo. CC BY 2.0 | ‘A different perspective’ by Anna Tesar.

CC BY 2.0 | MerlinMAP ePrescribing, printed prescription and Merlin images used with permission from Pharmhos Software. | Clipart images

used with permission from Microsoft | ‘People vectors’ designed by Freepik | ‘PDCA circle’ by Christoph Roser. CC BY-SA 4.0 | ‘The world is

wrong side up’ by Eric May. CC BY-NC 2.0

Thank you