Evaluation of computerized provider order entry systems: assessing the usability of systems for electronic prescription

Abstract

BackgroundThe field of medicine has been influenced by the growth and development of information systems such as the Computerized Provider Order Entry (CPOE) System.ObjectiveThis study aimed to evaluate the usability of CPOE systems for electronic prescription in Tehran, Iran.MethodsThis was an evaluation study conducted in 2017. The research population consisted of the CPOE systems used in hospitals of Tehran (Iran) and nurses who had access to, and used, the CPOE systems. Five hospitals with CPOE systems were included in the research sample. The data were collected using a questionnaire, and included a total of 50 questions. The questionnaires were distributed among 254 nurses who were the users of the systems. Data analysis was performed by IBM-SPSS version 21, using independent-samples t-test. A p-value of ≤0.05 was considered statistically significant.ResultsAmong the four aspects assessed, the “user-friendliness” (3.87±0.59) had the highest mean score. The lowest mean score (2.01±0.58) was related to the “decision support” feature of the systems. The highest and lowest mean scores for “prescription support” criterion belonged to system E (3.26±0.23) and system C (1.90±0.16), respectively. There was a statistically significant difference between the usability of the systems used in the private and the public hospitals (p<0.001). It was found that the CPOE systems in private hospitals had a higher level of usability (3.42+0.10) compared to those in public hospitals (2.91+0.25).ConclusionTwo main functions of the studied CPOE systems i.e., decision support and prescription support should be developed to make electronic prescription safer and more intuitive. Addressing usability aspects of CPOE systems in practice could improve the usability of these systems for prescription.

Usability evaluation of the computerized physician order entry system: A study in a developing country

“…In previous studies, the e ciency and usefulness of the electronic prescribing system have been measured from the perspective of patients and physicians, and in most of these studies, physicians believe that the use of the electronic prescribing system leads to a reduction in costs and the number of prescriptions [9,10]. Also, increasing patient safety and reducing medical errors are among the most important factors that make electronic prescribing e cient [30,31].…”

“…The accuracy factor in Iranian CPOE system has been evaluated at an average level. Also, the Iranian CPOE system has been evaluated as close to good in the exibility factor; according to the studies conducted in this eld, a CPOE system should be exible and allow the users to customize it according to their needs [8,9,37]. It should allow the users to create templates, order sets, and other tools that help them work more e ciently [38].…”

“…Recording manual orders was a method done using pen and paper, and the high risk of human errors and many recording mistakes that existed in this method caused a lot of burden on the national health care systems [7,8]. The effort to overcome the problems and limitations of recording paper orders led to the development of a computerized system for recording physicians' orders in Iran, which was used as a trial in several cities in Iran since 2015 [8,9]. This process continued until 2021 and according to the noti cation of the Iranian Ministry of Health, the use of paper prescriptions will be prohibited from December 22, 2021 [8, 10].…”

“…In general, prescription writing is one of the most important and vital processes in every country, and the implementation of a computerized system for recording physicians' orders can provide countless opportunities for more effective and useful recording of physicians' orders [8][9][10]. It should be noted that not all countries have succeeded in implementing electronic prescribing and some countries have failed in its development or implementation [11,12].…”

“…The issue that can determine the usefulness and applicability of these types of newly launched systems is usability evaluation studies [15,16]. These types of studies, which are carried out with different methods, can be very useful because they can raise possible errors and measure the level of user satisfaction in that system [9,10,16,17].…”