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CPOE in Iran-A viable prospect?. Physicians' opinions on using CPOE in an Iranian teaching hospital

Kazemi, A. and Ellenius, J. and Tofighi, S. and Salehi, A. and Eghbalian, F. and Fors, U.G. (2009) CPOE in Iran-A viable prospect?. Physicians' opinions on using CPOE in an Iranian teaching hospital. International Journal of Medical Informatics, 78 (3). pp. 199-207. ISSN 13865056 (ISSN)

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Abstract

Background: In recent years, the theory that on-line clinical decision support systems can improve patients' safety among hospitalised individuals has gained greater acceptance. However, the feasibility of implementing such a system in a middle or low-income country has rarely been studied. Understanding the current prescription process and a proper needs assessment of prescribers can act as the key to successful implementation. Objectives: The aim of this study was to explore physicians' opinions on the current prescription process, and the expected benefits and perceived obstacles to employ Computerised Physician Order Entry in an Iranian teaching hospital. Methods: Initially, the interview guideline was developed through focus group discussions with eight experts. Then semi-structured interviews were held with 19 prescribers. After verbatim transcription, inductive thematic analysis was performed on empirical data. Forty hours of on-looker observations were performed in different wards to explore the current prescription process. Results: The current prescription process was identified as a physician-centred, top-down, model, where prescribers were found to mostly rely on their memories as well as being overconfident. Some errors may occur during different paper-based registrations, transcriptions and transfers. Physician opinions on Computerised Physician Order Entry were categorised into expected benefits and perceived obstacles. Confidentiality issues, reduction of medication errors and educational benefits were identified as three themes in the expected benefits category. High cost, social and cultural barriers, data entry time and problems with technical support emerged as four themes in the perceived obstacles category. Conclusions: The current prescription process has a high possibility of medication errors. Although there are different barriers confronting the implementation and continuation of Computerised Physician Order Entry in Iranian hospitals, physicians have a willingness to use them if these systems provide significant benefits. A pilot study in a limited setting and a comprehensive analysis of health outcomes and economic indicators should be performed, to assess the merits of introducing Computerised Physician Order Entry with decision support capabilities in Iran. © 2008 Elsevier Ireland Ltd. All rights reserved.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Int. J. Med. Informatics [Field not mapped to EPrints] C2 - 18760960 [Field not mapped to EPrints] AD - Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden [Field not mapped to EPrints] AD - Management Information Systems (MIS) Centre, Hamadan University of Medical Sciences, Hamadan, Iran [Field not mapped to EPrints] AD - National Public Health Management Centre (NPMC), Tabriz, Iran [Field not mapped to EPrints] AD - Research Centre for Strategic Studies on Health Care, Baqyatallah University of Medical Sciences, Tehran, Iran [Field not mapped to EPrints] AD - Department of Cardiology, Gorgan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Department of Paediatrics, Hamadan University of Medical Sciences, Hamadan, Iran [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: Adverse effects, Decision support systems, clinical, Iran, Medical Order Entry Systems, Medication errors, Adverse effects, Decision support systems, clinical, Iran, Medical Order Entry Systems, Medication errors, Artificial intelligence, Decision making, Decision support systems, Errors, Hospitals, Planning, Programming theory, Teaching, Transcription, Wireless telecommunication systems, Decision theory, article, computer aided design, confidentiality, cost effectiveness analysis, cultural factor, decision support system, Iran, medical education, medication error, physician, prescription, priority journal, semi structured interview, social aspect, teaching hospital, Focus Groups, Hospitals, Teaching, Humans, Interviews as Topic, Iran, Medical Order Entry Systems, Medical Staff, Hospital, Medication Errors, Physicians
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 18 Apr 2015 05:16
Last Modified: 01 Mar 2017 08:31
URI: http://eprints.goums.ac.ir/id/eprint/2292

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