Medication safety and the usability of electronic prescribing as perceived by physicians-A semistructured interview among primary health care physicians in Finland

Hanna Kauppinen; Riitta Ahonen; Pekka Mäntyselkä; Johanna Timonen

doi:10.1111/jep.12759

Medication safety and the usability of electronic prescribing as perceived by physicians-A semistructured interview among primary health care physicians in Finland

J Eval Clin Pract. 2017 Dec;23(6):1187-1194. doi: 10.1111/jep.12759. Epub 2017 May 4.

Authors

Hanna Kauppinen¹, Riitta Ahonen¹, Pekka Mäntyselkä^{2

3}, Johanna Timonen¹

Affiliations

¹ School of Pharmacy/Social Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
² Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
³ Primary Health Care Unit, Hospital District of Northern Savo, Kuopio University Hospital, Kuopio, Finland.

PMID: 28474487
DOI: 10.1111/jep.12759

Abstract

Rationale, aims and objectives: In Finland, a fully operational and nationwide electronic prescription (ePrescription) system was implemented by law in 2012 to 2015. From 2017, all prescriptions have to be electronic. ePrescriptions are intended to facilitate prescribing and to improve medication safety in Finnish health care. In this study, the aim was to explore physicians' experiences with the impacts of ePrescriptions on prescribing and medication safety in Finland.

Method: Data were collected by conducting 42 interviews among primary health care physicians in spring 2015. The data obtained were analyzed by means of qualitative content analysis.

Results: Most of the physicians considered ePrescriptions to be convenient to issue because of the paperless procedure. Additionally, physicians stated that information concerning patients' prescriptions was better available through the Prescription Centre since physicians were able to check patients' prescriptions, including those issued elsewhere. In particular, ePrescriptions have improved the control of narcotics and medicines classified as primarily affecting the central nervous system. However, establishing a patient's overall medication through the Prescription Centre was regarded as difficult because prescription information was sometimes incoherent and had not been updated. The ePrescribing system was also described as inflexible, especially the correcting, cancelling, or renewing of ePrescriptions. For example, the system required too many "mouse clicks" and PIN entries to justify the actions taken in prescriptions. The system's slowness and the poor connection between physicians' electronic patient records and the Prescription Centre were also underlined.

Conclusions: According to the Finnish physicians interviewed, ePrescriptions have facilitated prescribing in some respects. However, the ePrescribing system still has problems and the Prescription Centre cannot be fully used for the management of a patient's overall medication.

Keywords: Finland; electronic prescription; interview; medication safety; physician; prescribing.

MeSH terms

Adult
Aged
Electronic Prescribing*
Female
Finland
Humans
Interviews as Topic
Male
Medication Errors / prevention & control*
Middle Aged
Patient Safety
Perception*
Physicians, Primary Care / psychology*
User-Computer Interface