More and more hospitals in the UK are making the transition from paper-based prescription charts to electronic prescribing in response to a challenge set by Health Secretary Jeremy Hunt for the NHS to go paperless by 2018. The prescribing of medicines needs to be accurate and legible to those reading them to ensure patients receive the right medicine at the right time. There are currently no standards on the design of electronic prescribing systems used by NHS hospitals.
Research conducted by pharmacist Katherine Shemilt and presented at the Royal Pharmaceutical Society Annual Conference (7 September 2014), aimed to explore the perspectives of healthcare professionals on their ability to use electronic systems to obtain clear and accurate information.
Fifty-five participants, including pharmacists, doctors and nurses, from two hospitals that had recently implemented electronic prescribing were invited to attend one of the eight focus groups designed to gather views on using an electronic prescribing system.
The two main topics that emerged from thematic analysis of the focus groups were legibility and design of electronic prescriptions. Regarding legibility, some participants raised concerns that with an electronic prescription they lost the ability to identify uncertainty in prescribing. Although it was a benefit that the prescription was clear and explicit, they described how misspelt medicines on paper prescription charts prompted them to query the prescription with prescribers and often revealed medication errors.
Participants also discussed how the design of the electronic systems used made it difficult for them to comprehend the chronology and overview of the patient’s medication because they needed to navigate through multiple sections to obtain the information they needed to review the prescriptions. “Navigating through different screens and remembering to do during busy periods was becoming a difficulty [for participants] and they felt that it had additional implications for patient safety,” explained Shemilt.
Some participants also reported they felt there was too much information displayed on the screens and the important information was often difficult to extract.
“If we are going to develop new standards for the design of electronic inpatient prescriptions, we need to be looking at how electronic prescribing systems are showing information and what the best options might be,” concluded Shemilt.
The conference abstract is published in the
International Journal of Pharmacy Practice