| 1. |
- Hellström, Lina, 1975-, et al.
(författare)
-
Physicians' attitudes towards ePrescribing : evaluation of a Swedish full-scale implementation
- 2009
-
Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 9:August, s. Article number: 37-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The penetration rate of Electronic Health Record (EHR) systems in health care is increasing. However, many different EHR-systems are used with varying ePrescription designs and functionalities. The aim of the present study was to evaluate experienced ePrescribers' attitudes towards ePrescribing for suggesting improvements. METHODS: Physicians (n = 431) from seven out of the 21 Swedish health care regions, using one of the six most widely implemented EHR-systems with integrated electronic prescribing modules, were recruited from primary care centers and hospital clinics of internal medicine, orthopaedics and surgery. The physicians received a web survey that comprised eight questions on background data and 19 items covering attitudes towards ePrescribing. Forty-two percent (n = 199) of the physicians answered the questionnaire; 90% (n = 180) of the respondents met the inclusion criteria and were included in the final analysis. RESULTS: A majority of the respondents regarded their EHR-system easy to use in general (81%), and for the prescribing of drugs (88%). Most respondents believed they were able to provide the patients better service by ePrescribing (92%), and regarded ePrescriptions to be time saving (91%) and to be safer (83%), compared to handwritten prescriptions. Some of the most frequently reported weaknesses were: not clearly displayed price of drugs (43%), complicated drug choice (21%), and the perception that it was possible to handle more than one patient at a time when ePrescribing (13%). Moreover, 62% reported a lack of receipt from the pharmacy after successful transmission of an ePrescription. Although a majority (73%) of the physicians reported that they were always or often checking the ePrescription a last time before transmitting, 25% declared that they were seldom or never doing a last check. The respondents suggested a number of improvements, among others, to simplify the drug choice and the cancellation of ePrescriptions. CONCLUSION: The Swedish physicians in the group studied were generally satisfied with their specific EHR-system and with ePrescribing as such. However, identified weaknesses warrant improvements of the EHR-systems as well as of their implementation in the individual health care organisation.
|
|
| 2. |
- Mikkelsen, Anders, et al.
(författare)
-
Low temperature Ga surface diffusion from focused ion beam milled grooves.
- 2009
-
Ingår i: Nanotechnology. - : IOP Publishing. - 0957-4484 .- 1361-6528. ; 20:32
-
Tidskriftsartikel (refereegranskat)abstract
- Ga diffusion from focused ion beam (FIB) milled grooves has been studied using x-ray photoemission electron microscopy (XPEEM) and mirror electron microscopy (MEM). We analyze the surface chemistry of the FIB structures measuring the Ga presence in the top layers of the milled grooves and morphological defects inside the grooves. The Ga is initially strictly confined to the grooves. However, annealing at temperatures as low as 150 degrees C leads to rapid and significant Ga surface diffusion from the FIB structures. The out-diffused Ga forms a thin layer extending up to several microns laterally in a non-regular pattern. The diffusion is significantly enhanced at small crystallites at the edges of the grooves. We explain the general behavior with an atomic scale model in which interstitial Ga in the milled areas diffuses out and substitutes silanol groups on the surface.
|
|
| 3. |
- Montelius, Emelie, 1984-, et al.
(författare)
-
Individuals Appreciate Having Their Medication Record on the Web : A Survey of Attitudes to a National Pharmacy Register
- 2008
-
Ingår i: Journal of Medical Internet Research. - Toronto : JMIR Publications Inc.. - 1438-8871. ; 10:4, s. e35-
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundMany patients receive health care in different settings. Thus, a limitation of clinical care may be inaccurate medication lists, since data exchange between settings is often lacking and patients do not regularly self-report on changes in their medication. Health care professionals and patients are both interested in utilizing electronic health information. However, opinion is divided as to who should take responsibility for maintaining personal health records. In Sweden, the government has passed a law to enforce and fund a national register of dispensed medications. The register comprises all individuals with dispensed medications (6.4 million individuals, September 2006) and can be accessed by the individual online via “My dispensed medications”. The individual has the right to restrict the accessibility of the information in health care settings. ObjectiveThe aim of the present study was to evaluate the users’ attitudes towards their access to “My dispensed medications” as part of a new interactive Internet service on prescribed medications.MethodA password-protected Web survey was conducted among a first group of users of “My dispensed medications”. Data was anonymously collected and analyzed with regard to the usefulness and design of the Web site, the respondents’ willingness to discuss their “My dispensed medications” with others, their reasons for access, and their source of information about the service. ResultsDuring the study period (January-March, 2007), all 7860 unique site visitors were invited to answer the survey. Invitations were accepted by 2663 individuals, and 1716 responded to the online survey yielding a view rate of 21.8% (1716/7860) and a completion rate of 64.4% (1716/2663). The completeness rate for each question was in the range of 94.9% (1629/1716) to 99.5% (1707/1716). In general, the respondents’ expectations of the usefulness of “My dispensed medications” were high (total median grade 5; Inter Quartile Range [IQR] 3, on a scale 1-6). They were also positive about the design of the Web site (total median grade 5; IQR 1, on a scale 1-6). The high grades were not dependent on age or number of drugs. A majority of the respondents, 60.4% (1037/1716), had learned about “My dispensed medications” from pharmacies. 70.4% (1208/1716) of all respondents said they visited “My dispensed medications” to get control or an overview of their drugs. Getting control was a more common (P < .001) answer for the elderly (age 75 or above), whereas curiosity was more common (P < .001) for the younger age group (18-44 years).ConclusionWe found that users of the provider-based personal medication record “My dispensed medications” appreciated the access to their record. Since we found that the respondents liked the design of the Web site and perceived that the information was easy to understand, the study provided no reason for system changes. However, a need for more information about the register, and to extend its use, was recognized.
|
|
| 4. |
- Åstrand, Bengt, et al.
(författare)
-
Assessment of ePrescription quality : an observational study at three mail-order pharmacies
- 2009
-
Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 9:1, s. Article number: 8-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The introduction of electronic transfer of prescriptions (ETP) or ePrescriptions in ambulatory health care has been suggested to have a positive impact on the prescribing and dispensing processes. Thereby, implying that ePrescribing can improve safety, quality, efficiency, and cost-effectiveness. In December 2007, 68% of all new prescriptions were transferred electronically in Sweden. The aim of the present study was to assess the quality of ePrescriptions by comparing the proportions of ePrescriptions and non-electronic prescriptions necessitating a clarification contact (correction, completion or change) with the prescriber at the time of dispensing.Methods: A direct observational study was performed at three Swedish mail-order pharmacies which were known to dispense a large proportion of ePrescriptions (38–75%). Data were gathered on all ePrescriptions dispensed at these pharmacies over a three week period in February 2006. All clarification contacts with prescribers were included in the study and were classified and assessed in comparison with all drug prescriptions dispensed at the same pharmacies over the specified period.Results: Of the 31225 prescriptions dispensed during the study period, clarification contacts were made for 2.0% (147/7532) of new ePrescriptions and 1.2% (79/6833) of new non-electronic prescriptions. This represented a relative risk (RR) of 1.7 (95% CI 1.3–2.2) for new ePrescriptions compared to new non-electronic prescriptions. The increased RR was mainly due to 'Dosage and directions for use', which had an RR of 7.6 (95% CI 2.8–20.4) when compared to other clarification contacts. In all, 89.5% of the suggested pharmacist interventions were accepted by the prescriber, 77.7% (192/247) as suggested and an additional 11.7% (29/247) after a modification during contact with the prescriber.Conclusion: The increased proportion of prescriptions necessitating a clarification contact for new ePrescriptions compared to new non-electronic prescriptions indicates the need for an increased focus on quality aspects in ePrescribing deployment. ETP technology should be developed towards a two-way communication between the prescriber and the pharmacist with automated checks of missing, inaccurate, or ambiguous information. This would enhance safety and quality for the patient and also improve efficiency and cost-effectiveness within the health care system.
|
|
