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J Am Med Inform Assoc. 2004 Jan-Feb;11(1):60-70. Epub 2003 Oct 5.

A conceptual framework for evaluating outpatient electronic prescribing systems based on their functional capabilities.

Author information

1
RAND Health, Santa Monica, CA, USA. dbell@ucla.edu

Abstract

OBJECTIVE:

Electronic prescribing (e-prescribing) may substantially improve health care quality and efficiency, but the available systems are complex and their heterogeneity makes comparing and evaluating them a challenge. The authors aimed to develop a conceptual framework for anticipating the effects of alternative designs for outpatient e-prescribing systems.

DESIGN:

Based on a literature review and on telephone interviews with e-prescribing vendors, the authors identified distinct e-prescribing functional capabilities and developed a conceptual framework for evaluating e-prescribing systems' potential effects based on their capabilities. Analyses of two commercial e-prescribing systems are presented as examples of applying the conceptual framework.

MEASUREMENTS:

Major e-prescribing functional capabilities identified and the availability of evidence to support their specific effects.

RESULTS:

The proposed framework for evaluating e-prescribing systems is organized using a process model of medication management. Fourteen e-prescribing functional capabilities are identified within the model. Evidence is identified to support eight specific effects for six of the functional capabilities. The evidence also shows that a functional capability with generally positive effects can be implemented in a way that creates unintended hazards. Applying the framework involves identifying an e-prescribing system's functional capabilities within the process model and then assessing the effects that could be expected from each capability in the proposed clinical environment.

CONCLUSION:

The proposed conceptual framework supports the integration of available evidence in considering the full range of effects from e-prescribing design alternatives. More research is needed into the effects of specific e-prescribing functional alternatives. Until more is known, e-prescribing initiatives should include provisions to monitor for unintended hazards.

PMID:
14527975
PMCID:
PMC305459
DOI:
10.1197/jamia.M1374
[Indexed for MEDLINE]
Free PMC Article
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