Safety, quality and usefulness of general practice prescribing software study
NPS has an interest in how general practice prescribing systems can support the quality use of medicines (QUM). Australia has one of the highest rates of computerisation of general practice in the world; with many general practitioners (GPs) using computers to generate prescriptions, record progress notes and pathology results, send referrals, etc. There are numerous systems available to GPs; however there are few criteria to assist practices in making decisions about selecting a system that can support safe prescribing. Similarly, there are few standards or guidelines for healthcare funders and software vendors about which features should be implemented in these systems to support safety and quality in the provision of healthcare. This study was undertaken as a first step towards addressing these issues.
The aims of this project were to:
- identify the key features of general practice prescribing systems that support patient safety and quality of care and are useful for clinicians and patients
- establish consensus on the most important features
- assess the current safety, quality and usefulness of seven commonly used general practice prescribing software systems
- make recommendations about the most important features.
The study consisted of three parts and was carried out from late 2006 to early 2009.
- A prioritised list of features of prescribing software systems was developed that would support patient safety and the delivery of high quality care. The initial list of features was based on a review of the literature and key informant interviews.
- An expert panel rated and prioritised the features via a modified Delphi process, based on the expected impact of each feature across four domains and taking a quality use of medicines perspective: patient safety, quality of care, usefulness to the clinician and usefulness to the patient.
- In the third part of the study we developed a method for testing the features in prescribing software systems, and subsequently tested seven commonly used systems to find out if the features had been implemented. The systems tested were: Best Practice, Genie, Medical Director 2 and 3, MedTech32, Practix and Profile.
The study was conducted by the NPS Research and eHealth and Decision Support teams, with input from many others. The study guidance group, expert panel members and key informants included Australian general practitioners, pharmacists, consumers, public health practitioners and health informaticians, as well as representatives from the Royal Australian College of General Practitioners, Medical Software Industry Association, National e-Health Transition Authority, and Australian Commission for Safety & Quality in Healthcare.
The project is now complete.
Sweidan M, Williamson M, Reeve JF, Harvey K, O'Neill JA, Schattner P, Snowdon T Identification of features of electronic prescribing systems to support quality and safety in primary care using a modified Delphi process, BMC Medical Informatics and Decision Making 2010,10:21 (Full text)
Sweidan M, Williamson M, Reeve JF, Harvey K, O’Neill JA, Schattner P, Snowdon T. Evaluation of features to support safety and quality in general practice clinical software. BMC Medical Informatics and Decision Making 2011(Full text).