Barriers and facilitators to implementing electronic prescription: a systematic review of user groups' perceptions

J Am Med Inform Assoc. 2014 May-Jun;21(3):535-41. doi: 10.1136/amiajnl-2013-002203. Epub 2013 Oct 15.


Objective: We conducted a systematic review identifying users groups' perceptions of barriers and facilitators to implementing electronic prescription (e-prescribing) in primary care.

Methods: We included studies following these criteria: presence of an empirical design, focus on the users' experience of e-prescribing implementation, conducted in primary care, and providing data on barriers and facilitators to e-prescribing implementation. We used the Donabedian logical model of healthcare quality (adapted by Barber et al) to analyze our findings.

Results: We found 34 publications (related to 28 individual studies) eligible to be included in this review. These studies identified a total of 594 elements as barriers or facilitators to e-prescribing implementation. Most user groups perceived that e-prescribing was facilitated by design and technical concerns, interoperability, content appropriate for the users, attitude towards e-prescribing, productivity, and available resources.

Discussion: This review highlights the importance of technical and organizational support for the successful implementation of e-prescribing systems. It also shows that the same factor can be seen as a barrier or a facilitator depending on the project's own circumstances. Moreover, a factor can change in nature, from a barrier to a facilitator and vice versa, in the process of e-prescribing implementation.

Conclusions: This review summarizes current knowledge on factors related to e-prescribing implementation in primary care that could support decision makers in their design of effective implementation strategies. Finally, future studies should emphasize on the perceptions of other user groups, such as pharmacists, managers, vendors, and patients, who remain neglected in the literature.

Keywords: Electronic Prescribing; Implementation Factors; Primary Care; Systematic Review; Users' Perceptions.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Attitude of Health Personnel*
  • Attitude to Computers
  • Efficiency
  • Electronic Prescribing*
  • Humans
  • Nurses
  • Pharmacists
  • Physicians, Primary Care
  • Primary Health Care / organization & administration*
  • Workforce