One of the main contributing factors to safety and workflow problems in community pharmacies are associated with problematic, confusing, or erroneous e-prescriptions that are generated by prescriber and transmission computer systems upstream from the pharmacy. We hypothesize that the reasons that the prevalence of problematic e-prescriptions is high is because prescribers or prescriber agents are 1 struggling with technology design such as pop down menus and small text boxes that does not support their cognitive processes when writing and transmitting e-prescriptions, 2 there is a lack of transparency and opportunity to double-check what the prescriber intended to prescribe and what actually is transmitted to the pharmacy, 3 prescribers and pharmacists have a limited understanding of the specific issues facing each discipline when addressing e-prescriptions.The overarching goal of this project is to examine the process by which electronic prescriptions are generated in prescriber offices and transmitted to community pharmacies, and to use a collaborative approach to develop feasible interventions to mitigating e-prescribing errors community pharmacies. The study design would involve a systematic analysis of e-prescription generation, transmission, and processing between primary care clinics and community pharmacies. First, naturalistic observations and semi-structured interviews would be conducted with prescriber clinic staff directly involved with e-prescription generation and pharmacy staff involved with e-prescription processing. Second, scenarios of common e-prescribing problems would be presented to focus groups of prescribers and pharmacy staff to identify possible solutions to mitigating e-prescribing problems in clinics and community pharmacies. This cooperative re-design and re-engineering of work systems method will be used to improve e-prescribing use to create awareness among prescribers and physicians about issues with e-prescribing in their respective settings to facilitate early identification, detection and prevention of errors so as to improve patient safety when using e-prescribing in both pharmacies and primary care clinics.
School of Pharmacy, University of Wisconsin