Product Diversity and Spectrum of Choice in Hospital ePrescribing Systems in England

Background ePrescribing systems have considerable potential for improving healthcare quality and safety. With growing expectations about the benefits of such systems, there is evidence of widespread plans to implement these systems in hospitals in England where hitherto they have had a low uptake. Given the international drive away from developing home-grown to systems to procuring commercial applications, we aimed to identify available ePrescribing systems in England and to use the findings to develop a taxonomy of the systems offered by suppliers. Methods and Findings We undertook a scoping review of the published and grey literature, and conducted expert interviews with vendors, healthcare organisations and national ePrescribing experts in order to identify the spectrum of available systems, identify and map their key features, and then iteratively develop and validate a taxonomy of commercial ePrescribing systems available to English hospitals. There is a wide range of available systems including 13 hospital-wide applications and a range of specialty systems. These commercial applications can be grouped into four sub-categories: standalone systems, modules within integrated systems, functionalities spread over several modules, and specialty systems. The findings also reveal that apart from four packaged applications (two of which are specialty systems), all other systems have none or less than two live implementations across England. Conclusions The wide range of products developed in the last few years by different national and international suppliers, and the low uptake of these products by English hospitals indicate that the English ePrescribing market is still in its infancy. This market is undergoing rapid cycles of change, both with respect to the number of suppliers and their diversity of offerings. Constant renewal of knowledge is needed on the status of this evolving market, encompassing the products development and adoption, to assist implementation decisions and facilitate market maturity.

[1]  D. Bates,et al.  Qualitative Analysis of Round-Table Discussions on the Business Case and Procurement Challenges for Hospital Electronic Prescribing Systems , 2013, PloS one.

[2]  Robin Williams,et al.  Software and Organisations: The Biography of the Enterprise-Wide System or How SAP Conquered the World , 2008 .

[3]  Tony Cornford,et al.  Safer, faster, better? Evaluating electronic prescribing , 2006 .

[4]  Sia Siew Kien,et al.  An institutional perspective on sources of ERP package-organisation misalignments , 2004, J. Strateg. Inf. Syst..

[5]  D. Bates,et al.  Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. , 2003, Archives of internal medicine.

[6]  Martin Campbell-Kelly,et al.  Development and Structure of the International Software Industry, 1950-1990 , 1995 .

[7]  K. McDonald,et al.  Making health care safer: a critical analysis of patient safety practices. , 2001, Evidence report/technology assessment.

[8]  S. Corley.  Electronic prescribing: a review of costs and benefits. , 2003, Topics in health information management.

[9]  J. Braithwaite,et al.  Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study , 2012, PLoS medicine.

[10]  ELSKE AMMENWERTH,et al.  Review Paper: The Effect of Electronic Prescribing on Medication Errors and Adverse Drug Events: A Systematic Review , 2008, J. Am. Medical Informatics Assoc..

[11]  T. Davenport.  Putting the enterprise into the enterprise system. , 1998, Harvard business review.

[12]  Pranee Liamputtong,et al.  Comprar Qualitative Research Methods | Pranee Liamputtong | 9780195551433 | Oxford University Press , 2009 .

[13]  D. James.  Buying Information Systems: Selecting, Implementing and Assessing Off-The-Shelf Systems , 2004 .

[14]  Margaret Volante.  Qualitative research. , 2008, Nurse researcher.

[15]  A. Sheikh,et al.  Investigating and Learning Lessons from Early Experiences of Implementing ePrescribing Systems into NHS Hospitals: A Questionnaire Study , 2013, PloS one.

[16]  Steven Sawyer,et al.  Packaged software: implications of the differences from custom approaches to software development , 2000, Eur. J. Inf. Syst..

[17]  C. Anandan,et al.  The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview , 2011, PLoS medicine.

[18]  References , 1971 .

[19]  Ben Light,et al.  Enterprise resource planning: a business approach to systems development , 1999, Proceedings of the 32nd Annual Hawaii International Conference on Systems Sciences. 1999. HICSS-32. Abstracts and CD-ROM of Full Papers.

[20]  N. L. Ensmenger.  From airline reservations to sonic the hedgehog , 2004 .

[21]  Peter Short,et al.  Connecting for health. , 2008, The British journal of general practice : the journal of the Royal College of General Practitioners.

[22]  M. Campbell-Kelly.  From Airline Reservations to Sonic the Hedgehog , 2003 .

[23]  R. Platt,et al.  Computerized Prescribing Alerts and Group Academic Detailing to Reduce the Use of Potentially Inappropriate Medications in Older People , 2006, Journal of the American Geriatrics Society.

[24]  Johanna I Westbrook,et al.  Review Paper: Does Computerized Provider Order Entry Reduce Prescribing Errors for Hospital Inpatients? A Systematic Review , 2009, J. Am. Medical Informatics Assoc..

[25]  R. Kane,et al.  Just what the doctor ordered. Review of the evidence of the impact of computerized physician order entry system on medication errors. , 2007, Health services research.

[26]  Andrew J. Rohm,et al.  Just what the doctor ordered: The role of information sensitivity and trust in reducing medical information privacy concern , 2004 .

[27]  Rob Procter,et al.  The Impact of eHealth on the Quality and Safety of Healthcare , 2009, EuropeComm.

[28]  Antonios Kaniadakis,et al.  Software and Organisations: The biography of the enterprise-wide system or , 2009 .

[29]  D. Bates,et al.  Ten key considerations for the successful implementation and adoption of large-scale health information technology. , 2013, Journal of the American Medical Informatics Association : JAMIA.

[30]  A. Sheikh,et al.  Planned implementations of ePrescribing systems in NHS hospitals in England: a questionnaire study , 2010, JRSM short reports.

[31]  Aziz Sheikh,et al.  Information technology for patient safety , 2010, Quality and Safety in Health Care.

[32]  P. Liamputtong.  Qualitative Research Methods , 2005 .

[33]  D. Bates,et al.  The rise and fall of England's National Programme for IT , 2011, Journal of the Royal Society of Medicine.

[34]  T. Cornford,et al.  Electronic prescribing in hospitals - challenges and lessons learned. , 2009 .

[35]  Qing Hu,et al.  Implications of the fit between organizational structure and ERP: A structural contingency theory perspective , 2008, Int. J. Inf. Manag..