title: e-Prescribing: characterisation of patient safety hazards in community pharmacies using a sociotechnical systems approach.
abstract: OBJECTIVE
  To characterise the safety hazards related to e-prescribing in community pharmacies.
  
  
  METHODS
  The sociotechnical systems framework was used to investigate the e-prescribing technology interface in community pharmacies by taking into consideration the social, technical and environmental work elements of a user's interaction with technology. This study focused specifically on aspects of the social subsystem.
  
  
  METHODS
  The study employed a cross-sectional qualitative design and was conducted in seven community pharmacies in Wisconsin. Direct observations, think aloud protocols and group interviews were conducted with 14 pharmacists and 16 technicians, and audio recorded. Recordings were transcribed and subjected to thematic content analysis guided by the sociotechnical systems' theoretical framework.
  
  
  RESULTS
  Three major themes that may increase the potential for medication errors with e-prescribing were identified and described. The three themes included: (1) increased cognitive burden on pharmacy staff, such as having to memorise parts of e-prescriptions or having to perform dosage calculations mentally; (2) interruptions during the e-prescription dispensing process; and (3) communication issues with prescribers, patients and among pharmacy staff. Pharmacy staff reported these consequences of e-prescribing increased the likelihood of medication errors.
  
  
  CONCLUSIONS
  This study is the first of its kind to identify patient safety risks related to e-prescribing in community pharmacies using a sociotechnical systems framework. The findings shed light on potential interventions that may enhance patient safety in pharmacies and facilitate improved e-prescribing use. Future studies should confirm patient safety hazards reported and identify ways to use e-prescribing effectively and safely in community pharmacies.
authors.affiliation: Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin, , Madison, Wisconsin, USA.
authors.forename: Olufunmilola K
authors.initials: OK
authors.lastname: Odukoya
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Chui
mesh_terms: D000328:Adult; D000368:Aged; D003157:Community Pharmacy Services; D003430:Cross-Sectional Studies; D055695:Electronic Prescribing; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors; D008875:Middle Aged; D019370:Observation; D061214:Patient Safety; D036301:Qualitative Research; D014481:United States; D014922:Wisconsin; D055815:Young Adult
keywords: Human factors; Information technology; Patient safety; Pharmacists; Qualitative research