The Development and Evaluation of an Integrated Electronic Prescribing and Drug Management System for Primary Care基层医疗电子处方与药品管理一体化系统的开发与评价.pdfVIP

148 TAMBLYN ET AL., e-Rx and Integrated Drug Management in Primary Care Application of Information Technology j The Development and Evaluation of an Integrated Electronic Prescribing and Drug Management System for Primary Care ROBYN TAMBLYN , PHD, ALLEN HUANG , MDCM, YUKO KAWASUMI , MSC, GILLIAN BARTLETT , PHD, ´ ROLAND GRAD, MDCM, ANDRE JACQUES , MD, MARTIN DAWES , MD, MICHAL ABRAHAMOWICZ , PHD, ROBERT PERREAULT , MD, LAUREL TAYLOR , PHD, NANCY WINSLADE, PHARMD, LISE POISSANT, PHD, ALAIN PINSONNEAULT, PHD A b s t r a c t Objective: To develop and evaluate the acceptability and use of an integrated electronic prescribing and drug management system (MOXXI) for primary care physicians. Design: A 20-month follow-up study of MOXXI (Medical Office of the XXIst Century) implementation in 28 primary care physicians and 13,515 consenting patients. Measurement: MOXXI was developed to enhance patient safety by integrating patient demographics, retrieving active drugs from pharmacy systems, generating an automated problem list, and providing electronic prescription, stop order, automated prescribing problem alerts, and compliance monitoring functions. Evaluation of technical performance, acceptability, and use was conducted using audit trails, questionnaires, standardized tasks, and information from comprehensive health insurance databases. Results: Perceived improvements in continuity of care and professional autonomy were associated with physicians’ expected use of MOXXI. Physician speed in using MOXXI improved substantially in the first three months; however, only the represcribing function was faster using MOXXI than by handwritten prescription. Physicians wrote electronic prescriptions in 36.9 per 100 visits and reviewed the