E-prescription: views and acceptance of general practitioners and pharmacists in Greater Sydney
Phyllis Lau A B * , Minh Thuan Tran A , Ricky Yong Kim A , Alsayed Hashem Alrefae A , Sangwoo Ryu A and Jim Chyuan Teh AA
B
Abstract
Electronic prescription (e-prescription) was introduced in 2020 in Australia during the COVID-19 pandemic. This research aimed to explore general practitioners (GPs) and community pharmacists’ experience with, and facilitators and barriers to, the use of e-prescription.
This qualitative study used semi-structured interviews with GPs and pharmacists in Greater Sydney to explore their experience with e-prescription. Thematic analysis used descriptive and mixed inductive and deductive approaches. The Technology Acceptance Model (TAM) was used to further interpret and organise the themes.
Eleven GPs and nine pharmacists were interviewed. Thirteen themes were elicited, seven of which were categorised as benefits (facilitators) and six were challenges (barriers). Four facilitator themes (convenience for healthcare providers (HCPs) and patients, addressing issues with paper prescriptions, contactless nature reducing access barriers during COVID-19 lockdown, and enabling patients to manage multiple prescriptions) were mapped to the TAM construct of ‘perceived usefulness’; and one facilitator (an easier process) and two barrier themes (lack of information during implementation, and technological issues) were mapped to the TAM construct of ‘perceived ease of use’. Themes that fell outside these constructs were separately categorised: four barrier themes (reluctance of some patients and HCPs to change, patient expectations of ‘instant prescription’ and lost opportunities for best-practice care, HCPs’ perceptions of inadequate governmental governance, and ongoing costs) were ‘other issues with e-prescription’, and two facilitator themes (providing training on the use of e-prescription for HCPs and patients, and making e-prescription more streamlined) were ‘suggestions to improve’.
There are many facilitators and barriers to the use of e-prescription. Our findings may inform the future promotion of e-prescription post-COVID-19 pandemic. Further research should focus on consumers’ perspectives of e-prescription.
Keywords: barriers, community pharmacists, facilitators, general practitioners, healthcare providers, perceptions, technology acceptance model, telehealth.
References
Achar S, Sinha N, Norcross W (2021) The adoption and increased use of electronic prescribing of controlled substances. Journal of Medical Regulation 107, 8-16.
| Crossref | Google Scholar |
Aldughayfiq B, Sampalli S (2021) Digital health in physicians’ and pharmacists’ office: a comparative study of e-prescription systems’ architecture and digital security in eight countries. OMICS: A Journal of Integrative Biology 25, 102-122.
| Crossref | Google Scholar | PubMed |
Ang A (2023) Fred IT bags contract for national e-prescription service. Healthcare IT News Australia. Available at https://www.healthcareitnews.com/news/anz/fred-it-bags-contract-national-e-prescription-service [Retrieved 24 July 2023]
Archibald MM, Ambagtsheer RC, Casey MG, Lawless M (2019) Using zoom videoconferencing for qualitative data collection: perceptions and experiences of researchers and participants. International Journal of Qualitative Methods 18, 1609406919874596.
| Crossref | Google Scholar |
Australian Bureau of Statistics (2021) Greater Sydney: census all persons QuickStats. Australian Commonwealth Government, Canberra. Available at https://abs.gov.au/census/find-census-data/quickstats/2021/1GSYD
Australian Digital Health Agency (2021–2022) Electronic transfer of prescriptions. Available at https://developer.digitalhealth.gov.au/products/electronic-transfer-prescription [accessed 17 October 2022]
Australian Digital Health Agency (2022a) Electronic prescribing: for prescribers. Available at https://www.digitalhealth.gov.au/healthcare-providers/initiatives-and-programs/electronic-prescribing/for-prescribers [accessed 16 October 2022]
Australian Digital Health Agency (2022b) Electronic prescribing: a convenient alternative to paper prescriptions. Available at https://www.digitalhealth.gov.au/healthcare-providers/initiatives-and-programs/electronic-prescribing [accessed 17 October 2022]
Australian Digital Health Agency (2023) Training and support: electronic prescribing. Available at https://www.digitalhealth.gov.au/healthcare-providers/training-and-support/electronic-prescribing-training-and-support
Australian Government (2022) Closed ATM view – RFTHealth/E21-576909: request for tender – electronic prescription services. Available at https://www.tenders.gov.au/Atm/ShowClosed/f318621c-7a5e-4a7f-8337-8e6a74114f6a?PreviewMode=False [accessed 22 October 2022]
Australian Government Department of Health (2021) Electronic prescriptions: active script list release 1 – privacy framework (Version 1.0). Available at https://www.health.gov.au/sites/default/files/documents/2021/05/electronic-prescribing-active-script-list-privacy-framework.pdf [accessed 17 October 2022]
Australian Government Department of Health and Aged Care (2022a) MBS telehealth services from January 2022. Available at http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-Telehealth-Arrangements-Jan22 [accessed 16 October 2022]
Australian Government Department of Health and Aged Care (2022b) Telehealth. Available at https://www.health.gov.au/health-topics/health-technologies-and-digital-health/about/telehealth [accessed 16 October 2022]
Australian Government Department of Health and Aged Care (2022c) Electronic prescribing. Available at https://www.health.gov.au/initiatives-and-programs/electronic-prescribing [accessed 17 October 2022]
Australian Government Department of Health and Aged Care (2022d) About prescriptions. Available at https://www.health.gov.au/topics/medicines/about-prescriptions
Australian Government Department of the Prime Minister and Cabinet (2011) Telehealth transforming health care. Available at https://pmtranscripts.pmc.gov.au/release/transcript-17939 [accessed 17 October 2022]
Australian Medical Association (2021) ePrescription SMS subsidy extension to 30 June 2022. Available at https://www.ama.com.au/gpnn/issue-21-number-31/articles/eprescription-sms-subsidy-extension-30-june-2022. [accessed 22 October 2022]
Australian Medical Association (2022) ePrescription SMS subsidy extension to 30 September 2022. Available at https://www.ama.com.au/index.php/ama-rounds/3-june-2022/articles/eprescription-sms-subsidy-extension-30-september-2022. [accessed 22 October 2022]
Bulut S, Yıldız A, Kaya S (2019) Evaluation of transition to electronic prescriptions in turkey: perspective of family physicians. International Journal of Health Policy and Management 8, 40-48.
| Crossref | Google Scholar | PubMed |
Burroughs M, Urits I, Viswanath O, Simopoulos T, Hasoon J (2020) Benefits and shortcomings of utilizing telemedicine during the COVID-19 pandemic. Baylor University Medical Center Proceedings 33, 699-700.
| Crossref | Google Scholar | PubMed |
Davis FD (1989) Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly 13, 319-340.
| Crossref | Google Scholar |
Fisher K, Davey AR, Magin P (2022) Telehealth for Australian general practice: the present and the future. Australian Journal for General Practitioners 51, 626-629.
| Crossref | Google Scholar |
Gabriel MH, Smith JY, Sow M, Joseph S, Wilkins TL (2016) Electronic prescribing of controlled substances: a tool to help promote better patient care. American Journal of Pharmacy Benefits 8, 185-189.
| Google Scholar |
Gagnon M-P, Nsangou É-R, Payne-Gagnon J, Grenier S, Sicotte C (2014) Barriers and facilitators to implementing electronic prescription: a systematic review of user groups’ perceptions. Journal of the American Medical Informatics Association 21, 535-541.
| Crossref | Google Scholar | PubMed |
Harvey J, Avery AJ, Barber N (2014) A qualitative study of community pharmacy perceptions of the Electronic Prescriptions Service in England. International Journal of Pharmacy Practice 22, 440-444.
| Crossref | Google Scholar | PubMed |
Lanham AE, Cochran GL, Klepser DG (2016) Electronic prescriptions: opportunities and challenges for the patient and pharmacist. Advanced Health Care Technologies 2, 1-11.
| Crossref | Google Scholar |
Liotta M (2022) Extension to subsidised SMS e-scripts ‘needs long-term plan’. NewsGP. Available at https://www1.racgp.org.au/newsgp/professional/extension-to-subsidised-sms-e-scripts-needs-long-t#:~:text=Reimbursements%20of%20electronic%20prescription%20tokens,at%20least%2030%20September%202022 [accessed 16 October 2022]
Neergaard MA, Olesen F, Andersen RS, Sondergaard J (2009) Qualitative description - the poor cousin of health research? BMC Medical Research Methodology 9, 52.
| Crossref | Google Scholar | PubMed |
New South Wales Government (2020) City of Sydney: the city at a glance. Available at https://www.cityofsydney.nsw.gov.au/guides/city-at-a-glance. [accessed 17 December]
New South Wales Government (2022) Our structure. Available at https://www.health.nsw.gov.au/about/nswhealth/Pages/structure.aspx [accessed 17 December]
NSW Government (2023) Lost, stolen or forged prescriptions. Available at https://www.health.nsw.gov.au/pharmaceutical/Pages/lost-stolen-prescriptions.aspx
Oktarlina RZ (2020) E-Prescribing: benefit, barrier, and adopting challenge in electronic prescribing. Journal of Medicine 21, 98-101.
| Crossref | Google Scholar |
Porterfield A, Engelbert K, Coustasse A (2014) Electronic prescribing: improving the efficiency and accuracy of prescribing in the ambulatory care setting. Perspectives in Health Information Management 11, 1g.
| Google Scholar | PubMed |
Rondan-Cataluña FJ, Arenas-Gaitán J, Ramírez-Correa PE (2015) A comparison of the different versions of popular technology acceptance models. Kybernetes 44(5), 788-805.
| Crossref | Google Scholar |
Samadbeik M, Ahmadi M, Sadoughi F, Garavand A (2017) A comparative review of electronic prescription systems: lessons learned from developed countries. Journal of Research in Pharmacy Practice 6, 3-11.
| Crossref | Google Scholar | PubMed |
Sandelowski M (2000) Whatever happened to qualitative description? Research in Nursing & Health 23(4), 334-340.
| Crossref | Google Scholar | PubMed |
Schleiden LJ, Odukoya OK, Chui MA (2015) Older adults’ perceptions of E-prescribing: impact on patient care. Perspectives in Health Information Management 12, 1d.
| Google Scholar | PubMed |
Taylor A, Caffery LJ, Gesesew HA, King A, Bassal A-R, Ford K, Kealey J, Maeder A, McGuirk M, Parkes D, Ward PR (2021) How Australian health care services adapted to telehealth during the COVID-19 pandemic: a survey of telehealth professionals. Frontiers in Public Health 9, 648009.
| Crossref | Google Scholar | PubMed |
Tsirtsakis A (2020) What does electronic prescribing mean for GPs in the fight against coronavirus? NewsGP. Available at https://www1.racgp.org.au/newsgp/professional/what-does-electronic-prescribing-mean-for-gps-in-t. [accessed 7 April 2022]
Velo GP, Minuz P (2009) Medication errors: prescribing faults and prescription errors. British Journal of Clinical Pharmacology 67, 624-628.
| Crossref | Google Scholar | PubMed |
Wong LP (2008) Data analysis in qualitative research: a brief guide to using nvivo. Malaysian Family Physician 3(1), 14-20.
| Google Scholar | PubMed |
Wrzosek N, Zimmermann A, Balwicki Ł (2020) Doctors’ perceptions of E-Prescribing upon its mandatory adoption in Poland, using the unified theory of acceptance and use of technology method. Healthcare 8(4), 563.
| Crossref | Google Scholar | PubMed |