Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy

Karen C. Nanji, Jeffrey M. Rothschild, Jennifer J. Boehne, Carol A. Keohane, Joan Ash, Eric G. Poon

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Introduction: Electronic prescribing systems have often been promoted as a tool for reducing medication errors and adverse drug events. Recent evidence has revealed that adoption of electronic prescribing systems can lead to unintended consequences such as the introduction of new errors. The purpose of this study is to identify and characterize the unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in an outpatient pharmacy. Methods: A multidisciplinary team conducted direct observations of workflow in an independent pharmacy and semi-structured interviews with pharmacy staff members about their perceptions of the unrealized potential and residual consequences of electronic prescribing systems. We used qualitative methods to iteratively analyze text data using a grounded theory approach, and derive a list of major themes and subthemes related to the unrealized potential and residual consequences of electronic prescribing. Results: We identified the following five themes: Communication, workflow disruption, cost, technology, and opportunity for new errors. These contained 26 unique subthemes representing different facets of our observations and the pharmacy staff's perceptions of the unrealized potential and residual consequences of electronic prescribing. Discussion: We offer targeted solutions to improve electronic prescribing systems by addressing the unrealized potential and residual consequences that we identified. These recommendations may be applied not only to improve staff perceptions of electronic prescribing systems but also to improve the design and/or selection of these systems in order to optimize communication and workflow within pharmacies while minimizing both cost and the potential for the introduction of new errors.

Original languageEnglish (US)
Pages (from-to)481-486
Number of pages6
JournalJournal of the American Medical Informatics Association
Volume21
Issue number3
DOIs
StatePublished - 2014

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Electronic Prescribing
Workflow
Outpatients
Communication
Costs and Cost Analysis
Medication Errors
Pharmacies
Drug-Related Side Effects and Adverse Reactions
Interviews
Technology

ASJC Scopus subject areas

  • Health Informatics
  • Medicine(all)

Cite this

Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy. / Nanji, Karen C.; Rothschild, Jeffrey M.; Boehne, Jennifer J.; Keohane, Carol A.; Ash, Joan; Poon, Eric G.

In: Journal of the American Medical Informatics Association, Vol. 21, No. 3, 2014, p. 481-486.

Research output: Contribution to journalArticle

Nanji, Karen C. ; Rothschild, Jeffrey M. ; Boehne, Jennifer J. ; Keohane, Carol A. ; Ash, Joan ; Poon, Eric G. / Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy. In: Journal of the American Medical Informatics Association. 2014 ; Vol. 21, No. 3. pp. 481-486.
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