title: Electronic prescriptions and disruptions to the jurisdiction of community pharmacists.
abstract: The practice of community pharmacists is being challenged by the appearance of electronic prescription (e-Rx) technology. This article examines the disruptions caused by e-Rx technology to the jurisdiction of community pharmacists based on a model developed from work by Abbott (1988). The main disruptions to professional activities were investigated by qualitative methods in a series of interviews with pharmacists and physicians separated in two groups: practitioners who tested a typical e-Rx technology and stakeholders involved in the implementation of this large-scale e-Rx project in Quebec, Canada. The findings suggest that the technology may disrupt the jurisdiction of community pharmacists, mainly by changing the distribution of information among physicians and community pharmacists. More specifically, the technology represents both a threat to community pharmacists - by supporting the dominant position held by physicians if it gives them access to information held exclusively by pharmacists - and an opportunity - by redistributing information to the pharmacists' benefit, allowing them to improve the quality of their inferences about medication. However, it would appear that the opportunities offered by the technology generate concerns and tensions, both between physicians and pharmacists and between the pharmacists themselves. This phenomenon may well work against the implementation and use of available tools.
authors.affiliation: Université de Montréal, Administration de la santé, 1420, boul. du Mont-Royal, Montréal, Québec, Canada H2V 4P3. aude.motulsky@umontreal.ca
authors.forename: Aude
authors.initials: A
authors.lastname: Motulsky
authors.forename: Claude
authors.initials: C
authors.lastname: Sicotte
authors.forename: Lise
authors.initials: L
authors.lastname: Lamothe
authors.forename: Nancy
authors.initials: N
authors.lastname: Winslade
authors.forename: Robyn
authors.initials: R
authors.lastname: Tamblyn
mesh_terms: D055695:Electronic Prescribing; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008498:Medical Record Linkage; D009313:National Health Programs; D010594:Pharmacies; D010595:Pharmacists; D058007:Physicians, Primary Care; D017009:Professional Autonomy; D011792:Quebec