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Title: The evolving landscape of electronic prescribing in UK secondary care : exploration of uptake, benefits, and challenges
Author: Ahmed, Z. M. I.
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2016
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Computerisation of healthcare delivery is frequently proposed as a solution to improve the quality and safety of patient care, both internationally and within the UK. This includes electronic prescribing (EP) in the hospital setting, which is the focus of this thesis. This work aims to shed some light into issues related to EP utilisation including the extent of usage in UK hospitals, potential challenges of deployment process and the economic impact of EP systems use. A census of EP systems in English acute trusts found that some form of EP was used by 69% of 101 respondent hospitals. More than half had more than one system in use, representing 60 different systems. The most common were systems used for discharge prescribing followed by specialist chemotherapy systems. Only 13% of respondent hospitals used inpatient electronic prescribing across all adult medical and surgical wards. Overall, 40% of systems were developed 'in-house'. Decision support functionality varied widely. Semi structured interviews were conducted to further explore the phenomenon of multiple EP systems within a single hospital. An evaluative framework was adapted to analyse data and interviews from a case study of an integrated EP system adoption to explore the complexity of the implementation process, establish key elements which facilitate the process and identify potential challenges. A systematic review of international EP economic evaluations seems to suggest potential financial benefits of EP systems. However, it is difficult to reach a definitive answer as to whether EP provides value for money due to uncertainty surrounding costs and outcomes measured, and limitations in study design. Moreover, extrapolating the evidence to the UK context is difficult. In conclusion, UK healthcare is in an interim phase aiming to achieve complete systems interoperability. The challenge is to manage the implications of the current interim phase while driving technology use forward.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available