Impact of pharmacy validation in a computerized physician order entry context

Estellat, Candice; Colombet, Isabelle; Vautier, Sarah; Huault-Quentel, Julie; Durieux, Pierre; Sabatier, Brigitte

doi:10.1093/intqhc/mzm025

Cited by 58 publications

(43 citation statements)

References 24 publications

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“…In the field of medical informatics, numerous experts recognize that the majority of e-Rx systems need further refining (15,38). If community pharmacists want this technology to contribute to their professionalization, they need to collaborate in this development in order to ensure that systems marketed are well-adapted to their needs and practices (39).…”

Section: The Quality Of E-rx and Prescription Executionmentioning

confidence: 99%

The Impact of Electronic Prescribing on the Professionalization of Community Pharmacists: A Qualitative Study of Pharmacists’ Perception

et al. 2008

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-PURPOSE.To understand how the technology of electronic prescription (e-Rx) can transform the community pharmacist's role through its effects on professionalization. We define professionalization as a pharmaceutical practice centred on clinical activities and made possible by the establishment of professional pharmaceutical services. METHODS. We asked 12 community pharmacists who had participated in an e-Rx pilot project in the Canadian province of Quebec to fill out a qualitative survey on their experience. We then analyzed the pharmacists' perceptions of this new technology using a conceptual framework based on the Davenport typology that presents an exhaustive list of mechanisms, specific to Information Technologies, and thus e-Rx, that can potentially modify information management process and then the role of pharmacists. RESULTS. The pharmacists identified five main mechanisms by which e-Rx could affect the professionalization of community pharmacists: analytical capabilities of the pharmacist and physician, dissemination of knowledge, integration of process tasks, process automation and elimination of intermediaries. These mechanisms can assist pharmacists in exercising their professional judgement by improving the quality of available information and facilitate the execution of prescriptions by improving the quality of orders. E-Rx technology can also strengthen pharmacists' credibility as medication specialists in the eyes of both patients and physicians. Thus, e-Rx can become a collaborative technology to the extent that it improves collaboration between community pharmacists and prescribing physicians. However, the potential benefits of this technology would appear to depend on its characteristics and how prescribing physicians use it. CONCLUSIONS. ERx proposes ways of working and communicating that were previously unimaginable. These new possibilities pave the way for transformations that can significantly increase the professionalization of community pharmacists. The results of this study indicate that community pharmacists have a favourable opinion of e-Rx, believing it can be an ally in their professionalization.

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Section: The Quality Of E-rx and Prescription Executionmentioning

confidence: 99%

The Impact of Electronic Prescribing on the Professionalization of Community Pharmacists: A Qualitative Study of Pharmacists’ Perception

et al. 2008

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“…Previous studies have shown that while implementing CPOE can improve the safety and efficiency of order processing, it can create new challenges and resource demands that place increased burden on pharmacists, such as increasing new types of errors and problems caused by CPOE systems. [26][27][28][29] While CPOE systems can increase efficiency in many areas, such systems should be monitored by management so any new problems that arise can be addressed.…”

Section: A Particular Facet Of the Results Is That While Time Spent Onmentioning

confidence: 99%

Impact of Computerized Provider Order Entry Systems on hospital staff pharmacist workflow productivity: A three site comparative analysis based on level of CPOE implementation

Lewing

Hatfield

Sansgiry

2017

JHA

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Objective: Computerized Provider Order Entry (CPOE) is a system that enables physicians to send medication orders electronically rather than physically writing out the order. CPOE can reduce handwriting and transcription related medication errors and has been a major implementation goal for health systems. The objective of this study was to quantify and examine differences seen in the workflow of pharmacists at hospitals, with different levels of CPOE implementation. Methods: An observational, prospective time and motion study was conducted among three hospitals within the same health system: one classified as a non-CPOE system, one as short-term CPOE, and one as long-term CPOE. Pharmacists were observed in one-hour blocks, in which a data instrument was used to record 38 different tasks, which were grouped into four activities: clinical, distributive, administrative, and miscellaneous. The distributive category was further divided into three sub-categories. The average time associated with performing activities across the three hospitals was compared by descriptive and comparative analyses using ANOVAs and the post-hoc Tukey's range test. Results: A total of 252 hours were collected and 235 met the inclusion criteria. The significant differences in time spent on task categories among hospitals were as follows: Non-CPOE vs. short-term CPOE vs. long-term CPOE (mean ± SD in min/h) clinical tasks: (6.55 ± 6.40) vs. Conclusions: The presence of a CPOE system could affect pharmacists' workflow and time allotment on different types of pharmacy activities. Further, the time spent on certain activities was associated with the amount of time the CPOE system was implemented.

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“…patient selection in the context of a more personalized practice of medicine) [44][45][46]. In the pharmaceutical domain at HEGP, the EHR/CDW integration was found invaluable in the evaluation of the frequency of both drug prescription and drug dispensing errors [47][48], the impact of alerts on drug dosage adjustment [49], the role of pharmacy drug order validation [50], but also to automatically detect drug-drug interactions [51] or to perform in-silico evaluations of decision rules for further integration into the operational environment of the CPOE [52].…”

Section: The Use-quality Circlementioning

confidence: 99%

The Virtuous Circles of Clinical Information Systems: a Modern Utopia

Degoulet

2016

Yearb Med Inform

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SummaryContext: Clinical information systems (CIS) are developed with the aim of improving both the efficiency and the quality of care. Objective: This position paper is based on the hypothesis that such vision is partly a utopian view of the emerging eSociety. Methods: Examples are drawn from 15 years of experience with the fully integrated Georges Pompidou University Hospital (HEGP) CIS and temporal data series extracted from the data warehouses of Assistance Publique -Hôpitaux de Paris (AP-HP) acute care hospitals which share the same administrative organization as HEGP. Three main virtuous circles are considered: user satisfaction vs. system use, system use vs. cost efficiency, and system use vs quality of care. Results: In structural equation models (SEM), the positive bidirectional relationship between user satisfaction and use was only observed in the early HEGP CIS deployment phase (first four years) but disappeared in late post-adoption (≥8 years). From 2009 to 2013, financial efficiency of 20 AP-HP hospitals evaluated with stochastic frontier analysis (SFA) models diminished by 0.5% per year. The lower decrease of efficiency observed between the three hospitals equipped with a more mature CIS and the 17 other hospitals was of the same order of magnitude than the difference observed between pediatric and non-pediatric hospitals. Outcome quality benefits that would bring evidence to the system use vs. quality loop are unlikely to be obtained in a near future since they require integration with population-based outcome measures including mortality, morbidity, and quality of life that may not be easily available. Conclusion: Barriers to making the transformation of the utopian part of the CIS virtuous circles happen should be overcome to actually benefit the emerging eSociety. KeywordsEvaluation of clinical information systems; return on investment; outcome research; acceptance models; information system success criteria Yearb Med Inform 2016:256-63 http://dx

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Impact of pharmacy validation in a computerized physician order entry context

Cited by 58 publications

References 24 publications

The Impact of Electronic Prescribing on the Professionalization of Community Pharmacists: A Qualitative Study of Pharmacists’ Perception

The Impact of Electronic Prescribing on the Professionalization of Community Pharmacists: A Qualitative Study of Pharmacists’ Perception

Impact of Computerized Provider Order Entry Systems on hospital staff pharmacist workflow productivity: A three site comparative analysis based on level of CPOE implementation

The Virtuous Circles of Clinical Information Systems: a Modern Utopia

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