Establishing data-intensive healthcare: the case of Hospital Electronic Prescribing and Medicines Administration systems in Scotland

Abstract

Background Creating learning health systems, characterised by the use and repeated reuse of demographic, process and clinical data to improve the safety, quality and efficiency of care, is a key aim in realising the potential benefits and efficiency savings associated with the implementation of health information technology. Objectives We sought to investigate stakeholder perspectives on and experiences of the implementation of hospital electronic prescribing and medicines administration (HEPMA) systems in Scotland and use these to inform political decisions on approaches to promoting the use and reuse of digitised prescribing and medication administration data in order to improve care processes and outcomes. Methods We identified and recruited key national stakeholders involved in implementing and/or using HEPMA data from generic and specialty systems. These included representatives from healthcare settings (i.e. doctors, pharmacists and nurses), managers of existing national databases, policy makers, healthcare analytics companies, system suppliers and patient representatives. We conducted multi-disciplinary focus group discussions, audio-recorded these, transcribed data verbatim and thematically analysed the transcripts with the help of NVivo10. In analysing the data, we drew on theoretical and previous empirical work on information infrastructures. Results We identified the following key themes: 1) micro-factors -usability of systems and motivating users to input data; 2) meso-factors -developing technical and organisational infrastructures to facilitate the aggregation of data; and 3) macro-factors -facilitating interoperability and data reuse at larger scales to ensure that data are effectively generated and used.

Challenges associated with missing data in electronic health records: A case study of a risk prediction model for diabetes using data from Slovenian primary care

“…Out of 952 participants from the two remaining institutions, 477 (50.1%) were female with mean age of 55. 4…”

“…1,2 A major challenge to achieving this, however, is the recording of high-quality data in electronic health records (EHRs). 3 A recent study by Cresswell et al 4 identified a range of micro-, meso-and macro-level factors that contribute to better use and repeated reuse of demographic, process and healthcare data to improve the quality and safety of care. The lack of motivation and prioritisation by professionals to enter data was identified as key barriers that need to be overcome.…”

How do stakeholders experience the adoption of electronic prescribing systems in hospitals? A systematic review and thematic synthesis of qualitative studies

“…Other studies reported how ePrescribing/CPOE systems enable the generation of, and access to, new data and metrics about individuals, teams, services and organisations9 20 47 62 93 to inform service evaluation and improvement, but with the proviso that appropriate strategies and resources for data monitoring, analysis and follow-up had to be in place to enable improvements 62 92 109…”

In this issue - Don’t make assumptions about integrated systems, data quality, utilisation of technology, or access to routine data

“…The second paper in this issue is a stakeholder analysis of a prescribing system 3. There are many parallels between the first article and this one.…”