title: Implementation of information systems at pharmacies - a case study from the re-regulated pharmacy market in Sweden.
abstract: BACKGROUND
  When the Swedish pharmacy market was re-regulated in 2009, Sweden moved from one state-owned pharmacy chain to several private pharmacy companies, and four new dispensing systems emerged to replace the one system that had previously been used at all Swedish pharmacies for more than 20 years.
  
  
  OBJECTIVE
  The aim of this case study was to explore the implementation of the new information systems for dispensing at pharmacies.
  
  
  METHODS
  The vendors of the four dispensing systems in Sweden were interviewed, and a questionnaire was sent to the managers of the pharmacy companies. In addition, a questionnaire was sent to 350 pharmacists who used the systems for dispensing prescriptions.
  
  
  RESULTS
  The implementation of four new dispensing systems followed a strict time frame set by political decisions, involved actors completely new to the market, lacked clear regulation and standards for functionality and quality assurance, was complex and resulted in variations in quality. More than half of the pharmacists (58%) perceived their current dispensing system as supporting safe dispensing of medications, 26% were neutral and 15% did not perceive it to support a safe dispensing. Most pharmacists (80%) had experienced problems with their dispensing system during the previous month. The pharmacists experienced problems included reliability issues, usability issues, and missing functionality.
  
  
  CONCLUSIONS
  In this case study exploring the implementation of new information systems for dispensing prescriptions at pharmacies in Sweden, weaknesses related to reliability, functionality and usability were identified and could affect patient safety. The weaknesses of the systems seem to result from the limited time for the development and implementation, the lack of comprehensive and evidence-based requirements for dispensing systems, and the unclear distribution of quality assurance responsibilities among involved stakeholders.
authors.affiliation: eHealth Institute, Department of Medicine and Optometry, Linnaeus University, SE-391 82 Kalmar, Sweden. Electronic address: tora.hammar@lnu.se.
authors.forename: Tora
authors.initials: T
authors.lastname: Hammar
authors.affiliation: Medical Products Agency, P.O. Box 26, SE-751 03 Uppsala, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Ohlson
authors.affiliation: Department of Health and Caring Sciences, Linnaeus University, SE-391 82 Kalmar, Sweden.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hanson
authors.affiliation: eHealth Institute, Department of Medicine and Optometry, Linnaeus University, SE-391 82 Kalmar, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Petersson
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007256:Information Systems; D010595:Pharmacists / Q000458:organization & administration*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Community pharmacy; Dispensing; E-health; Electronic prescribing; Patient safety