The impact of electronic prescribing systems on healthcare professionals’ working practices in the hospital setting: a systematic review and narrative synthesis

Mohsin-Shaikh, Soomal; Furniss, Dominic; Blandford, Ann; McLeod, Monsey; Ma, Tiantian; Beykloo, Maedeh Y; Franklin, Bryony Dean

doi:10.1186/s12913-019-4554-7

Cited by 26 publications

(24 citation statements)

References 26 publications

(107 reference statements)

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“…Digital health tools have the potential to provide health care workers with a holistic view of patients’ medical conditions through access to their health-related data and improved communication, regardless of distance and access [ 5 ]. Furthermore, the use of digital technology in health care could potentially reduce turnaround times, resource use, medication errors, and adverse drug events; increase the use of preventive care; and enable greater adherence to clinical guidelines [ 6 - 8 ].…”

Section: Introductionmentioning

confidence: 99%

A Digitally Competent Health Workforce: Scoping Review of Educational Frameworks

Nazeha¹,

Pavagadhi²,

Kyaw³

et al. 2020

J Med Internet Res

101

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Background Digital health technologies can be key to improving health outcomes, provided health care workers are adequately trained to use these technologies. There have been efforts to identify digital competencies for different health care worker groups; however, an overview of these efforts has yet to be consolidated and analyzed. Objective The review aims to identify and study existing digital health competency frameworks for health care workers and provide recommendations for future digital health training initiatives and framework development. Methods A literature search was performed to collate digital health competency frameworks published from 2000. A total of 6 databases including gray literature sources such as OpenGrey, ResearchGate, Google Scholar, Google, and websites of relevant associations were searched in November 2019. Screening and data extraction were performed in parallel by the reviewers. The included evidence is narratively described in terms of characteristics, evolution, and structural composition of frameworks. A thematic analysis was also performed to identify common themes across the included frameworks. Results In total, 30 frameworks were included in this review, a majority of which aimed at nurses, originated from high-income countries, were published since 2016, and were developed via literature reviews, followed by expert consultations. The thematic analysis uncovered 28 digital health competency domains across the included frameworks. The most prevalent domains pertained to basic information technology literacy, health information management, digital communication, ethical, legal, or regulatory requirements, and data privacy and security. The Health Information Technology Competencies framework was found to be the most comprehensive framework, as it presented 21 out of the 28 identified domains, had the highest number of competencies, and targeted a wide variety of health care workers. Conclusions Digital health training initiatives should focus on competencies relevant to a particular health care worker group, role, level of seniority, and setting. The findings from this review can inform and guide digital health training initiatives. The most prevalent competency domains identified represent essential interprofessional competencies to be incorporated into health care workers’ training. Digital health frameworks should be regularly updated with novel digital health technologies, be applicable to low- and middle-income countries, and include overlooked health care worker groups such as allied health professionals.

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Section: Introductionmentioning

confidence: 99%

A Digitally Competent Health Workforce: Scoping Review of Educational Frameworks

Nazeha¹,

Pavagadhi²,

Kyaw³

et al. 2020

J Med Internet Res

101

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“…As electronic prescribing was perceived to be more effective by respondents not currently using it, this may indicate optimism regarding the ability of electronic systems to reduce insulin prescribing errors in hospitals using paper‐based systems. In light of the current drive to implement electronic prescribing across all hospitals, we emphasize the need to carefully design and implement these systems in such a way that the potential benefits regarding insulin prescribing safety can be maximized, and the shortcomings, such as any negative impacts on healthcare professional working practices, can be minimized [26].…”

Section: Discussionmentioning

confidence: 99%

Use and validation of a survey tool to measure the perceived effectiveness of insulin prescribing safety interventions in UK hospitals

et al. 2020

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Aims To describe the use and validation of a survey tool to elicit the opinion of hospital pharmacists and medicines safety officers in the UK regarding the perceived effectiveness of strategies to improve insulin prescribing safety in hospitals. Methods One respondent from each participating organization completed the survey on behalf of the main acute hospital in their trust (n = 92). A five-point Likert scale was used to determine opinion on how effective 22 different interventions were at promoting insulin safety at the respondent's trust. The tool, the Perception of Effectiveness of Prescribing Safety Interventions for Insulin (PEPSII) questionnaire, underwent content validity testing. The reliability was estimated using Cronbach's alpha (a). Results The PEPSII questionnaire demonstrated good reliability (a = 0.867). Outreach team review and mandatory insulin education were the highest-scoring interventions; the insulin passport was amongst the lowest scoring interventions. Most interventions were considered more effective by trusts using them compared to those who didn't, except for self-administration policies, electronic prescribing and the insulin passport. Conclusions The perceived effectiveness of a variety of insulin prescribing safety strategies in UK hospitals was described by leveraging a purposely developed survey tool. The results describe current levels of support for recommended interventions, and may facilitate the direction of both local and national insulin prescribing safety improvement efforts.

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“…As described, changes to clinical workflow and working habits as a consequence of introducing EPR were also observed [ 15 , 21 , 36 , 37 ]. Researchers have often attributed negative changes to a lack of knowledge on the side of clinical management and software developers about best practices for workflows [ 37 ].…”

Section: Introductionmentioning

confidence: 99%

“…Likewise, the availability of data such as real-time patient data as well as easier access to information [ 13 ] are also emphasized as benefits [ 14 ] and could result in increased patient’s safety [ 12 ]. Mohsin-Shaikh et al [ 15 ] noted improved readability, the possibility of remote access and reduced time for certain tasks, while Saranto and Kinnunen [ 16 ] demonstrated that the standardization from EPR produces more positive than negative effects concerning the documentation quality of nurses.…”

Section: Introductionmentioning

confidence: 99%

“…Focusing on healthcare professionals’ daily work, researchers have stated that some processes seem to be more time-consuming when using the EPR system [ 22 ], resulting in fewer possibilities for team-wide consultations [ 15 ]. In addition, several studies have identified the potentially increased workload due to the introduction of EPR [ 13 , 15 , 23 , 18 , 22 ]. For example, Pelland and colleagues [ 23 ] measured a decrease in patient-physician interaction caused by an increase in time on the computer, from physicians’ perspective.…”

Section: Introductionmentioning

confidence: 99%

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Electronic patient record and its effects on social aspects of interprofessional collaboration and clinical workflows in hospitals (eCoCo): a mixed methods study protocol

Beckmann

Dittmer

Jaschke

et al. 2021

BMC Health Serv Res

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Background The need for and usage of electronic patient records within hospitals has steadily increased over the last decade for economic reasons as well as the proceeding digitalization. While there are numerous benefits from this system, the potential risks of using electronic patient records for hospitals, patients and healthcare professionals must also be discussed. There is a lack in research, particularly regarding effects on healthcare professionals and their daily work in health services. The study eCoCo aims to gain insight into changes in interprofessional collaboration and clinical workflows resulting from introducing electronic patient records. Methods eCoCo is a multi-center case study integrating mixed methods from qualitative and quantitative social research. The case studies include three hospitals that undergo the process of introducing electronic patient records. Data are collected before and after the introduction of electronic patient records using participant observation, interviews, focus groups, time measurement, patient and employee questionnaires and a questionnaire to measure the level of digitalization. Furthermore, documents (patient records) as well as structural and administrative data are gathered. To analyze the interprofessional collaboration qualitative network analyses, reconstructive-hermeneutic analyses and document analyses are conducted. The workflow analyses, patient and employee assessment analyses and classification within the clinical adoption meta-model are conducted to provide insights into clinical workflows. Discussion This study will be the first to investigate the effects of introducing electronic patient records on interprofessional collaboration and clinical workflows from the perspective of healthcare professionals. Thereby, it will consider patients’ safety, legal and ethical concerns and quality of care. The results will help to understand the organization and thereby improve the performance of health services working with electronic patient records. Trial registration The study was registered at the German clinical trials register (DRKS00023343, Pre-Results) on November 17, 2020.

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The impact of electronic prescribing systems on healthcare professionals’ working practices in the hospital setting: a systematic review and narrative synthesis

Cited by 26 publications

References 26 publications

A Digitally Competent Health Workforce: Scoping Review of Educational Frameworks

A Digitally Competent Health Workforce: Scoping Review of Educational Frameworks

Use and validation of a survey tool to measure the perceived effectiveness of insulin prescribing safety interventions in UK hospitals

Electronic patient record and its effects on social aspects of interprofessional collaboration and clinical workflows in hospitals (eCoCo): a mixed methods study protocol

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