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Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry

BACKGROUND: Hospitals across Australia are implementing Clinical Information Systems, e.g. Electronic Medication Management Systems (EMMS) at a rapid pace to moderate health services. The benefits of the EMMS depend on the acceptance of the system by the clinicians. The study hospital used a unique...

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Autores principales: Vaghasiya, Milan Rasikbhai, Penm, Jonathan, Kuan, Kevin K. Y., Gunja, Naren, Liu, Yiren, Kim, Eui Dong, Petrina, Neysa, Poon, Simon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314474/
https://www.ncbi.nlm.nih.gov/pubmed/34315447
http://dx.doi.org/10.1186/s12911-021-01584-w
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author Vaghasiya, Milan Rasikbhai
Penm, Jonathan
Kuan, Kevin K. Y.
Gunja, Naren
Liu, Yiren
Kim, Eui Dong
Petrina, Neysa
Poon, Simon
author_facet Vaghasiya, Milan Rasikbhai
Penm, Jonathan
Kuan, Kevin K. Y.
Gunja, Naren
Liu, Yiren
Kim, Eui Dong
Petrina, Neysa
Poon, Simon
author_sort Vaghasiya, Milan Rasikbhai
collection PubMed
description BACKGROUND: Hospitals across Australia are implementing Clinical Information Systems, e.g. Electronic Medication Management Systems (EMMS) at a rapid pace to moderate health services. The benefits of the EMMS depend on the acceptance of the system by the clinicians. The study hospital used a unique patient-centric implementation strategy that was based on the guiding principle of “one patient, one chart” to avoid a patient being on a hybrid medication chart. This paper aims to study the factors facilitating or hindering the adoption of the EMMS as viewed by clinicians and the implementation team. METHODS: Four focus groups (FG), one each for (1) doctors, (2) nurses, (3) pharmacists, and (4) implementation team, were conducted. A guide for the FG was based on the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS: A total of 23 unique subthemes were identified and were grouped into five main themes (1) implementation strategy, (2) organisational outcome of EMMS, (3) individual impact of EMMS, (4) IT product, and (5) organisational culture. Clinicians reported improvement in their workflow efficiency post-EMMS implementation. They also reported some challenges in using the EMMS that centered around the area of infrastructure, technical and design issues. Additionally, the implementation team highlighted two crucial factors influencing the success of EMMS implementation, namely: (1) the patient-centric implementation strategy, and (2) the organisation readiness. CONCLUSION: Overall, this study outlines the implementation process of the EMMS in a large healthcare facility from the clinicians’ and the implementation team’s perspectives using UTAUT model. The result suggests that clinicians’ acceptance of the EMMS was highly influenced by the unique implementation strategy (namely, patient-centric approach and clinical leadership in the implementation team). Whereas the level of adoption of EMMS by clinicians was determined by their level of perceived and realised benefits. On the other hand, a number of barriers to the adoption of EMMS were discovered, namely, general training instead of customised training based on local needs, technical and design issues and lack of availability of computer systems. It is suggested that promptly resolving these issues can improve the adoption of the EMMS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-021-01584-w.
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spelling pubmed-83144742021-07-28 Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry Vaghasiya, Milan Rasikbhai Penm, Jonathan Kuan, Kevin K. Y. Gunja, Naren Liu, Yiren Kim, Eui Dong Petrina, Neysa Poon, Simon BMC Med Inform Decis Mak Research Article BACKGROUND: Hospitals across Australia are implementing Clinical Information Systems, e.g. Electronic Medication Management Systems (EMMS) at a rapid pace to moderate health services. The benefits of the EMMS depend on the acceptance of the system by the clinicians. The study hospital used a unique patient-centric implementation strategy that was based on the guiding principle of “one patient, one chart” to avoid a patient being on a hybrid medication chart. This paper aims to study the factors facilitating or hindering the adoption of the EMMS as viewed by clinicians and the implementation team. METHODS: Four focus groups (FG), one each for (1) doctors, (2) nurses, (3) pharmacists, and (4) implementation team, were conducted. A guide for the FG was based on the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS: A total of 23 unique subthemes were identified and were grouped into five main themes (1) implementation strategy, (2) organisational outcome of EMMS, (3) individual impact of EMMS, (4) IT product, and (5) organisational culture. Clinicians reported improvement in their workflow efficiency post-EMMS implementation. They also reported some challenges in using the EMMS that centered around the area of infrastructure, technical and design issues. Additionally, the implementation team highlighted two crucial factors influencing the success of EMMS implementation, namely: (1) the patient-centric implementation strategy, and (2) the organisation readiness. CONCLUSION: Overall, this study outlines the implementation process of the EMMS in a large healthcare facility from the clinicians’ and the implementation team’s perspectives using UTAUT model. The result suggests that clinicians’ acceptance of the EMMS was highly influenced by the unique implementation strategy (namely, patient-centric approach and clinical leadership in the implementation team). Whereas the level of adoption of EMMS by clinicians was determined by their level of perceived and realised benefits. On the other hand, a number of barriers to the adoption of EMMS were discovered, namely, general training instead of customised training based on local needs, technical and design issues and lack of availability of computer systems. It is suggested that promptly resolving these issues can improve the adoption of the EMMS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-021-01584-w. BioMed Central 2021-07-27 /pmc/articles/PMC8314474/ /pubmed/34315447 http://dx.doi.org/10.1186/s12911-021-01584-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Vaghasiya, Milan Rasikbhai
Penm, Jonathan
Kuan, Kevin K. Y.
Gunja, Naren
Liu, Yiren
Kim, Eui Dong
Petrina, Neysa
Poon, Simon
Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry
title Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry
title_full Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry
title_fullStr Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry
title_full_unstemmed Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry
title_short Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry
title_sort implementation of an electronic medication management system in a large tertiary hospital: a case of qualitative inquiry
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314474/
https://www.ncbi.nlm.nih.gov/pubmed/34315447
http://dx.doi.org/10.1186/s12911-021-01584-w
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