A conceptual framework for evaluating outpatient electronic prescribing systems based on their functional capabilities
A conceptual framework for evaluating outpatient electronic prescribing systems based on their functional capabilities
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DOI：
10.1197/jamia.m1374
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发表时间：
2004-01-01
影响因子：
6.4
通讯作者：
Landman, AB
中科院分区：
文献类型：
--
作者：
Bell, DS;Cretin, S;Landman, AB
目的：电子处方（e-prescribing）可以大大提高医疗质量和效率，但现有的系统是复杂的，它们的异质性使比较和评估它们成为一个挑战。作者的目的是开发一个概念框架，用于预测门诊电子处方system.Design替代设计的影响：基于文献综述和电话采访的电子处方供应商，作者确定了不同的电子处方功能的能力，并开发了一个概念框架，用于评估电子处方系统的潜在影响，根据他们的能力。两个商业电子处方系统的分析作为应用的概念framework.Measurements的例子：主要的电子处方功能的能力，确定和证据的可用性，以支持其特定的effects.Results：建议的框架，用于评估电子处方系统的组织使用的过程模型的药物管理。在模型中确定了14个电子处方功能。证据被确定为支持六个功能的八个具体的影响。证据还表明，一项具有普遍积极影响的功能性能力的实施方式可能会造成意外的危险。应用框架涉及到确定一个电子处方系统的功能能力的过程模型，然后评估的影响，可以预期从每个能力在拟议的临床environment.Conclusion：建议的概念框架支持整合现有的证据，考虑从电子处方设计方案的全方位的影响。需要对特定电子处方功能替代品的影响进行更多的研究。在了解更多信息之前，电子处方计划应包括监测意外危害的规定。
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.