Optimization of the Danish National Electronic Prescribing System to Improve Patient Safety: Development of a User-Friendly Prototype of the Digital Platform Shared Medication Record
Abstract
:1. Introduction
2. Methods
2.1. Shared Medication Record
2.2. Setting
2.3. Design and Participants
2.4. Semi-Structured Interview
- What is the role of the SMR in your work?
- What are your experiences with the SMR?
- Do you have any suggestions for how to improve the SMR functionality?
2.5. Iterative Design
3. Results
3.1. Themes
- 1.
- The SMR does not get updated regularly
“It is a requirement that the patients get a medical note. We can’t even print this note because the doctors technically have not approved it in SMR. This affects us and makes it difficult for us to do our jobs.”
- 2.
- It is unclear who has the responsibility to update the SMR
“I think that a part of the issue is that the responsibility is complex in some matters. I mean, you need to consider, when a patient gets prescribed medicine, it is usually not just one person, but several medical professions who is a part of this process...”
- 3.
- The system is complex, time-consuming, and unintuitive
“The thing with SMR as is that the concept works well, and it is really handy that it is available on every device. The problem with SMR is the integration with the health platform. This is horrible.”
- 4.
- Patients are often unaware that they can access the SMR, so they do not have complete insight into their medication
“Not a lot of those who use SMR have an overview over their medicine. It is rare that I experience people using it—including the younger patients.”
- 5.
- There is a need for other professional groups and/or patients to be involved in the prescribing process
“It may be linked to age and tech flair, but I think a lot of patients will benefit from more involvement... I think it could create dialogue and be easier for doctors to clean up old medicine or update the SMR.”
3.2. Prototype for an Optimized SMR
4. Discussion
4.1. Patient Safety
4.2. Workflow Efficiency
4.3. Healthcare Costs
4.4. Strength and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Current Version of the Shared Medication Record (SMR)
Appendix B. Identified Codes and Themes
Code | Count | Theme |
“Updating” | 19 | The SMR does not get updated |
“Responsibility” | 18 | Uncertainties as to who has the primary responsibility of updating the SMR |
“The system” | 45 | The system is too complex, time-consuming, and lacks an intuitive approach |
“Familiarity” | 25 | There is an absence of familiarity with the SMR from the patient’s side, which makes their overview of actual medicine non-efficient |
“Involvement” | 13 | There is a need for involvement by other relevant medical professionals and/or the patients |
Appendix C. Codes and Key Citations from Interviews
Updating | Responsibility | The System | Familiarity | Involvement |
Nurse 1:
| Pharmacist 1:
| Doctor 3:
| Patient 2:
| Doctor 2:
|
Nurse 2:
| Pharmacy technician 1:
| Nurse 1:
| Nurse 3:
| Pharmacy technician 1:
|
Doctor 1:
| Doctor 2:
| Pharmacist 1:
| Doctor 1:
| Pharmacist 2:
|
Appendix D. Prototype
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Implementation | Description |
---|---|
Overall redesign | A more manageable, navigable, and straightforward interface that facilitates up-to-date, complete, and accurate medication records as well as knowledge and information sharing |
‘Last updated’-field (A) | States when the medication record was last updated. A notification will appear if it has not been updated for X-months |
‘Edit’-button (B) | Current medication can be edited so that the risk of double/incorrect prescriptions is reduced |
‘Renew’-button (C) | Current medication can be renewed so that the risk of double prescriptions is reduced * |
‘Delete’-button (D) | Current medication can be deleted so that the risk of double/incorrect prescriptions is reduced |
‘Note’-button (E) | It makes it possible to write notes to a specific medication (if important, it is indicated with a red exclamation mark) |
‘Send notification’-button (F) | It makes it possible to notify a patient’s general practitioner or other relevant parties about any changes, suggestions, notes, etc. in medication |
‘Attach file/document’-button (G) | It makes it possible to attach relevant files/pictures/documents in connection with the ‘send notification’ and/or ’note’-button |
‘End date’-field (H) | End date requirements in connection with the creation of prescriptions * |
‘Medication is about to expire’-function (I) | A notification will appear as the medication is about to expire. If the user does not renew the medication, it will be removed from the ‘current medication’ list and then appear on the list of ‘completed medication.’ |
‘Irregularities in effectuation’-function (J) | A notification will appear if there are irregularities in the effectuated medication |
‘Contact patient’-button (K) | It makes it possible to contact the patient directly via the SMR, either per phone or virtually (with video) |
‘Dropdown navigation menu’ (L) | The dropdown navigation menu for more straightforward navigation |
‘Add shortcut’-button (M) | Personalized frontpage that lets users select and add the most frequently used shortcuts to the frontpage |
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Share and Cite
Aharaz, A.; Kejser, C.L.; Poulsen, M.W.; Jeftic, S.; Ulstrup-Hansen, A.I.; Jørgensen, L.M.; Iversen, E.; Thorhauge, A.M.; Houlind, M.B. Optimization of the Danish National Electronic Prescribing System to Improve Patient Safety: Development of a User-Friendly Prototype of the Digital Platform Shared Medication Record. Pharmacy 2023, 11, 41. https://doi.org/10.3390/pharmacy11020041
Aharaz A, Kejser CL, Poulsen MW, Jeftic S, Ulstrup-Hansen AI, Jørgensen LM, Iversen E, Thorhauge AM, Houlind MB. Optimization of the Danish National Electronic Prescribing System to Improve Patient Safety: Development of a User-Friendly Prototype of the Digital Platform Shared Medication Record. Pharmacy. 2023; 11(2):41. https://doi.org/10.3390/pharmacy11020041
Chicago/Turabian StyleAharaz, Anissa, Cecillie Louise Kejser, Mille Wilhjelm Poulsen, Sara Jeftic, Aisha Isabella Ulstrup-Hansen, Lillian Mørch Jørgensen, Esben Iversen, Anne Mette Thorhauge, and Morten Baltzer Houlind. 2023. "Optimization of the Danish National Electronic Prescribing System to Improve Patient Safety: Development of a User-Friendly Prototype of the Digital Platform Shared Medication Record" Pharmacy 11, no. 2: 41. https://doi.org/10.3390/pharmacy11020041