title: Qualitative analysis of round-table discussions on the business case and procurement challenges for hospital electronic prescribing systems.
abstract: OBJECTIVE
  There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making.
  
  
  METHODS
  We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9.
  
  
  RESULTS
  We drew on data from 17 participants (approximately eight per roundtable), six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing "wants" and aspirations from organizational "needs".
  
  
  CONCLUSIONS
  Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management.
authors.affiliation: The School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Kathrin M
authors.initials: KM
authors.lastname: Cresswell
authors.forename: Ann
authors.initials: A
authors.lastname: Slee
authors.forename: Jamie
authors.initials: J
authors.lastname: Coleman
authors.forename: Robin
authors.initials: R
authors.lastname: Williams
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
mesh_terms: D055695:Electronic Prescribing; D006761:Hospitals; D006801:Humans; D006113:United Kingdom