Design and implementation of a point-of-care computerized system for drug therapy in Stockholm metropolitan health region--Bridging the gap between knowledge and practice.
BACKGROUND
Stockholm County Council is the largest health care provider in Sweden with an annual budget of US$ 5 billion and catering the needs of a metropolitan population of 2 million people. About 10% of health care costs are used on drugs. In 1996 Stockholm County Council decided to address the main problems associated with the process and the quality of drug prescribing.


METHODS
A multiyear strategy was designed, including the establishment of a strong evidence-based organisation, Drug and Therapeutics Committees and editorial resources to adapt information to the IT-media and the development of the IT-architecture. The development and implementation of computerized tools such as a physician drug order entry system including decision support, a drug information website and electronic transmission of prescriptions were started in 1996.


RESULTS
The implementation was slow at the point-of-care units. It took about 6 years before the implementation process gained speed. In September 2005 almost 1000 doctors could use the decision support system for prescribing drugs and more than 70% of all prescriptions were transmitted electronically in our region.


CONCLUSIONS
The work with the strategy has shown that improvements in drug use can be accomplished by providing access to simple, rapid and safe electronic tools, but the information provided has to be associated with well-recognized regional and national expert organisations.
Sjöborg
Bengt
B
Department of Drug Management and Informatics, Stockholm County Council, Huddinge, Sweden.
Bäckström
Tobias
T
Arvidsson
Lars-Bertil
LB
Andersén-Karlsson
Eva
E
Blomberg
L Bengt
LB
Eiermann
Birgit
B
Eliasson
Marie
M
Henriksson
Kjell
K
Jacobsson
Lennart
L
Jacobsson
Ulf
U
Julander
Margaretha
M
Kaiser
Per-Olof
PO
Landberg
Carina
C
Larsson
Jonas
J
Molin
Björn
B
Gustafsson
Lars L
LL
D003695:Delivery of Health Care; D004059:Diffusion of Innovation; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D050316:Medical Order Entry Systems; D019095:Point-of-Care Systems; D013222:State Medicine; D013548:Sweden