Role of Computerized Physician Order Entry Usability in the Reduction of Prescribing Errors

Some hospitals have implemented computerized physician order entry (CPOE) systems to reduce the medical error rates. However, research in this area has been very limited, especially regarding the impact of CPOE use on the reduction of prescribing errors. Moreover, the past studies have dealt with the overall impact of CPOE on the reduction of broadly termed "medical errors", and they have not specified which medical errors have been reduced by CPOE. Furthermore, the majority of the past research in this field has been either qualitative or has not used robust empirical techniques. This research examined the impacts of usability of CPOE systems on the reduction of doctors' prescribing errors. Methods: One hundred and sixty-six questionnaires were used for quantitative data analyses. Since the data was not normally distributed, partial least square path modelling-as the second generation of multivariate data analyses-was applied to analyze data. Results: It was found that the ease of use of the system and information quality can significantly reduce prescribing errors. Moreover, the user interface consistency and system error prevention have a significant positive impact on the perceived ease of use. More than 50% of the respondents believed that CPOE reduces the likelihood of drug allergy, drug interaction, and drug dosing errors thus improving patient safety. Conclusions: Prescribing errors in terms of drug allergy, drug interaction, and drug dosing errors are reduced if the CPOE is not error-prone and easy to use, if the user interface is consistent, and if it provides quality information to doctors

A Framework for Implementing IT Service Management in the Field of Pre-hospital Emergency Management with an Integrated Approach COBIT Maturity Model and ITIL Framework

Introduction: The purpose of this research is to provide an appropriate framework forimplementing IT management services in the field of pre-hospital emergencies with anintegrated approach of COBIT maturity model and ITIL framework.Methods: In a qualitative part, experts familiar with the field of pre-hospital emergency andinformation technology were purposefully selected. In the quantitative phase of the statisticalcommunity, we included experts in the field of information technology management whoare also experts in the field of emergency, as well as university professors who workedin the field of emergency and senior and middle managers in the field of pre-hospitalemergency entered the community. Considering the limitations of the community and thepurposefulness of the selection of individuals to enter the community, 915 individuals wereselected as a sample. To select a sample in the quantitative section, Morgan table was used.They were selected by simple random method using software. To collect information, wefirst reviewed the texts and articles in the field of ITIL and COBIT and then the extractedcodes in this category were reviewed and an overview of the research was obtained; then,in the qualitative part the interview method and in the quantitative part the researchermadequestionnaire were used. To analyze the data in the qualitative section, we used MAXQDA software to review and categorize the information. Then, in the quantitative section,the researcher-made questionnaire was collected and finally the model was fitted usingconfirmatory factor analysis.Results: In the end, it was concluded that the main components such as management,organization, processes, eyes, size, goals of the organization, staff, monitoring and evaluation,support, organization, information architecture and service delivery and their subcomponentswere the main factors that should be paid special attention in the field of prehospitalemergency management.Conclusion: To be more successful in implementing the organization’s framework, it mustidentify the most important problems and then create a controllable domain to implementservice support processes in the organization. The selected processes should be strongly andclearly supported by the general management of the organization. A codified and specificplan for implementation should be developed. A coordinated and planned approach fordesign, implementation should be specified and after the implementation of the mentionedprocesses. After expressing the output measurement indicators of the processes, the outputsshould be measured and based on the changes that exist, these changes should be consideredand returned to the planning stage to re-formulate the steps

Electronic Prescribing Usability: Reduction of Mental Workload and Prescribing Errors Among Community Physicians

Background: Medical errors are common in hospitals, and research is always needed to find ways of reducing these. This study attempts to address three gaps in this field. First, the factors leading to the reduction of mental workload and its relationship with the reduction of prescribing errors by improving electronic prescribing (e-prescribing) usability have not been empirically examined before. Second, the past research in the field of e-prescribing usability lacks robust theoretical models. Third, there are no existing studies to examine the direct influences of user interface consistency and error prevention with the reduction of mental workload and prescribing errors. Materials and Methods: A quantitative survey method was used to collect data from 188 community physicians. The partial least squares path modeling technique was applied to analyze the data. Results: Prescribing errors were reduced by improving the information quality, user interface consistency, system ease of use, and mental workload reduction. Mental workload is reduced by ease of use, error prevention, and consistency. No significant relationships between prescribing error reduction with error prevention and also between information quality with mental workload reduction were found. Conclusions: The designers of e-prescribing should improve the error prevention and consistency of the system and make it easy to use if they wish for the system to reduce users’ mental workload. They should also improve the system information quality, ease of use, and consistency if they claim that their system reduces physicians’ prescribing errors. The system should also reduce users’ mental workload to meet this objective

Ranking of factors related to mobile value-added services in the health sector

Introduction: Mobile value-added services in health encompass all services beyond voice calls and their implementation carries many benefits. The aim of the present study is to rank the factors related to mobile value-added services in the health sector.Research Method: This research is of the applied and descriptive-cross-sectional type with the statistical population of all information technology experts in the Social Security Organization of Tehran province, including 84 people. The measurement tool, with 64 items in 18 components, and its reliability was obtained with Cronbach’s alpha of 0.916. The validity of the questionnaire was confirmed by 5 experts. For data analysis, confirmatory factor analysis method and SmartPLS software were used. For ranking related factors, a pairwise comparison questionnaire was designed and made available to 15 specialized experts and their opinions were calculated and ranked using Expert choice software.Findings: The indices and coefficients obtained from the model of implementing mobile value-added services in the health sector have sufficient validity. The themes of effects and outcomes with a weight of 0.558, user understanding with a weight of 0.165, reliability with a weight of 0.115, mentality and expectations with a weight of 0.071, effective environmental conditions with a weight of 0.054, technology development with a weight of 0.037 have the most impact on the implementation of mobile value-added services in the health sector.Conclusion: Organizations providing health services can implement by considering effective factors such as effects and consequences for using these services and other factors based on priority, in order to improve the acceptance rate, in order to improve processes and increase satisfactio

An investigation into the effective factors on the acceptance and use of integrated health system in the primary health-care centers

BACKGROUND: The successful application of the information systems in the health-care domain requires a reasonable recognition of the factors affecting the acceptance and use of such systems. The study aimed to investigate the factors affecting the acceptance and use of an integrated health system (IHS) in Isfahan primary health centers. MATERIALS AND METHODS: It was an applied and descriptive–analytical survey conducted in Isfahan, Iran. Research population included all IHS's users in the health centers no. 1 and 2 of Isfahan city from which a sample of 320 individuals were selected in total. Data were collected using a questionnaire developed based on the Unified Theory of Acceptance and Use of Technology model. Data were analyzed using partial least squares (PLS) method and SmartPLS software. RESULTS: The users' behavioral intention to use the IHS system was influenced by performance expectancy, effort expectancy, and social influence, but it was not significantly related to facilitating conditions. Behavioral intention to use the IHS also had a significant relationship with the use of system. Furthermore, performance expectancy was the most important predictor. CONCLUSIONS: According to the findings, if the system users perceive the positive role of system in performance improvement, its convenience to use, and positive attitude of others toward it, their willingness to accept and use system will increase. Furthermore, it was important for the users that the system helps them in resolving their daily work-related problems and making rational decisions