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Short Communication International Journal of
Pharmacy Practice International Journal of Pharmacy Practice 2014, 22, pp. 440–444
A qualitative study of community pharmacy perceptions of the Electronic Prescriptions Service in England Jasmine Harveya, Anthony J. Averyb and Nick Barberc a
Division of Primary Care, School of Medicine, University of Nottingham, bDivision of Primary Care, School of Medicine, Queens Medical Centre,
Nottingham and cDepartment of Practice and Policy, School of Pharmacy, University College London, London, UK
Keywords community pharmacy; electronic prescription service; healthcare IT; perception Correspondence Dr Jasmine Harvey, Division of Primary Care, University of Nottingham, Nottingham NG7 2UH, UK. E-mail: [email protected] Received May 1, 2013 Accepted January 18, 2014 doi: 10.1111/ijpp.12107
Abstract Objectives To explore attitudes and perceptions of early adopters of the Electronic Prescription Service (release two) in England (EPS2). EPS2 is information technology that allows community pharmacies to download and dispense electronically written prescriptions from general practices. When the prescriber writes a prescription electronically, it is sent and stored on a national central database, commonly called the Spine. The community pharmacy that the patient nominates is then able to download the prescription and dispense to the patient. Method In-depth interviews were conducted with professionals from eight early adopter community pharmacies in the midlands and north of England, and 56 hours of non-participant observations were recorded as field notes. Each interview transcript was coded using a line-by-line approach. Overall, 37 200 words were analysed from 10 transcripts using a ‘bottom up’ approach to identify key perceptions. Field notes from the observation were analysed thematically and were used to verify interview findings. Key findings Findings follow a narrative which shows that (a) early adopter pharmacies had to cope with challenges such as missing EPS2 prescriptions, (b) despite this, they perceived EPS2 as helpful in streamlining pharmacy workflow and (c) were therefore keen to retain EPS2. Conclusions Initial user perception of EPS2 provides a key message on the likelihood of the system being adopted beyond these eight pharmacies. Our findings provide key information for other pharmacies in the adoption process, and policymakers on the potential of EPS2 to achieve its goals and become sustainable in terms of its value to community pharmacies.
Introduction The Electronic Prescription Service in England enables prescriptions to be generated and stored on a national central database, called the Spine. Community pharmacies are then able to download and dispense these prescriptions to patients.[1–3] In this article, we explore the following: (a) What were community pharmacist initial perceptions of the advanced version of the Electronic Prescriptions Service: EPS2? (b) Whether pharmacists would wish to retain the service?
ducted in midland and northern regions of England. Fifty six hours of non-participant observations were also conducted to complement the interviews. Data were collected between February and September 2011. Table 1 has further details of the study methods. At the time of data collection, the sites were dispensing from 10% to 40% EPS2 prescriptions (Table 2), and ranged between 9 and 18 months into their period of adoption. We focussed on common themes running through the eight pharmacies.
Method
Results
In-depth interviews with pharmacy professionals in the eight first adopter community pharmacies for EPS2 were con-
Our findings showed a narrative which begins with pharmacists contending with challenges such as missing electronic
© 2014 Royal Pharmaceutical Society
International Journal of Pharmacy Practice 2014, 22, pp. 440–444
Jasmine Harvey et al.
Table 1
441
Details of methods used in the study
Methodology Framework
The methodological framework was developed from ‘user-perception’ literature reviews on technology adoption, and listed benefits of EPS2 according to Connecting for Health (CfH).[4–8] We adopted a constructivist (qualitative) approach by using flexible themes based on user-perception study models such as positive and negative experiences, and perceived benefits of the system. This approach allowed us to delve deeper, beyond standardised variables, into extracting candid perceptions from users.
Permissions and sampling strategy Permissions Permissions were sought from approval bodies for each site including, Primary Care Trusts, research governance teams, benefit realisation teams and informatics leads. The study protocol was submitted to the Cambridgeshire Research Ethics Committee who classed the study as a service evaluation. Sampling We obtained a list of pharmacies classified as first adopters from CfH and selected pharmacies that were ‘live’ and dispensing above 5% electronic prescriptions, all of which were located in the midland and northern regions of England. Sites with different pharmacy manager systems were chosen to get divergent perspectives. Data collection Interviews Interviews were conducted with pharmacy professionals at the sites. Questions focussed on initial user experiences and perspectives such as what issues they had with EPS2, which issues were persistent, what they liked and disliked about it, how they felt EPS2 had affected their workflow and workloads, and how they would feel if the system was discontinued. Due to the busy nature of pharmacy work, it was challenging to audio-record all interviews. However, we audio-recorded interviews with pharmacists in all eight sites, in addition to one accredited checking technician and one dispenser. The interviews lasted between 30 min and 1 h, and were typed into transcripts averaging 3700 words each. Notes were taken from other participants who could not give audio-recorded interviews. Observations These were used to explore a range of practice perspectives such as how EPS2 prescriptions were dispensed, whether electronic prescriptions were printed out and how often EPS2 prescriptions were downloaded. Observations were recorded as field notes. See Fig. 1 for the fieldwork schedule (observation and interview). Analysis Interviews Each interview transcript was manually coded using line-by-line approach and bottom up analysis to identify key perceptions. Figure 2 shows a short example of a coding sheet. Overall, 37 200 words were analysed. Observations Field notes were analysed thematically. Results were compared with interview findings. For example if an interviewee said, ‘we download EPS2 five times a day’, we used the observations to verify this. Reflections on the data collection process and researchers’ positionality were taken into account in the analysis, and consideration was given to elements of ‘reactivity’.
Table 2 Site 1 2 3 4 5 6 7 8
Study site descriptors Proportion of EPS2 dispensed at the time of study 20% 35% 18% Information not supplied but proportion noted to be greater than 10% 40% 10% 10% 16%
EPS2 live since 07.2009 12.2009 09.2010 06.2011 08.2010 08.2010 07.2010 05.2010
Due to the small number of first adopters at the time of the study, providing detailed descriptions of sites will breech confidentiality and commercial sensitivity agreements.
prescriptions, but perceiving EPS2 as helpful in streamlining pharmacy workflow, and ending with accounts of why would like to retain EPS2. There were several examples of problems with missing prescriptions and download problems from the Spine. Missing prescriptions were a particular challenge as they took time to © 2014 Royal Pharmaceutical Society
chase up as, once the prescription was sent, it was impossible for the general practitioner (GP) or the pharmacist to establish whether it was on the Spine. In some cases, the patient might arrive in the pharmacy asking for their prescription only 2 or 3 minute after leaving the surgery. Under these circumstances, pharmacists had to repeatedly check whether the prescription had arrived on the Spine. Pharmacists thought this issue created tensions between the pharmacy and the GP practice, and between the pharmacy and the patient, and, on occasions, left pharmacists feeling starved of information. ‘We’ve had issues where prescriptions have gone missing, where the doctor’s surgery have said that they have sent a number of prescriptions and we are saying that we haven’t received the prescriptions . . . and so they [patients] end up playing ping pong between the doctor’s and the pharmacy, and we seem to be the guilty party because they [doctor’s] have sent it.’ (Site 8, Pharmacist). There were different reasons for this issue including GPs forgetting to sign the prescriptions electronically, the system automatically generating expiry dates and the Spine being too International Journal of Pharmacy Practice 2014, 22, pp. 440–444
442
Community pharmacy perceptions of EPS
Figure 1
Fieldwork guide (template).
Figure 2
Interview coding sheet sample.
© 2014 Royal Pharmaceutical Society
International Journal of Pharmacy Practice 2014, 22, pp. 440–444
Jasmine Harvey et al.
slow to process the prescription (especially for acute prescriptions). The pharmacists however thought that these issues could be solved, and classified them as ‘teething’ problems; they went on to discuss how EPS2 had improved their workflow. ‘It’s helped with running day to day of the business, because whereas before we used to get a lot of peaks and troughs and used to get a lot of people in at [one] time and then nobody. Now, we’ve got less people coming in and waiting, they come in and they get their prescriptions and they go. It’s been much better for our waiting times throughout the day’ (Site 6, Pharmacist). It has been suggested that EPS2 has potential to aid repeat dispensing.[9] We found that it was also useful for processing bulk repeat prescriptions: something that was not included in early piloting of the EPS system.[10] This function worked well because pharmacists could download repeat prescriptions in one go and dispense during quieter times, thereby smoothing their workflow and helping their workload. The fluidity in the workflow was also related, at least by some interviewees, to reduction in workload. Some felt it helped them to organise their dispensing activities, and it was a bit quicker to dispense items using the system; others felt it was faster still if a token was scanned, rather than waiting for an item to come through the Spine electronically. Ordering of drugs was also improved as pharmacists had advanced notice of what was required. These experiences were associated with positive attitudes towards EPS2 and its sustainability. All respondents said that they would like to keep the EPS2 system. For many, this was because it had made their lives easier; others argued for keeping it, and working on improving it, on the basis that otherwise it would have been a significant waste of money. The following quotes illustrate the views of respondents when asked about the possibility of EPS2 being discontinued. ‘I would cry. Don’t get me wrong, when I first had it, I was sceptical about it. I was very much, I want to print tokens and it was just paper again. But now I’ve got it, now I really would actually cry if I got it taken away.’ (Site 5, Pharmacist). ‘We’ve invested quite a lot of effort and energy into this. I would get a bit frustrated at the fact that having gone through this that they then decided that it isn’t functioning very well and it all needs to be put aside.’ (Site 8, Pharmacist).
443
Despite this, the pharmacists perceived EPS2 to be beneficial in enabling smoother workflow, and were supportive of it being retained and improved upon. These perceptions show that while there are still issues to be addressed, the system is becoming a useful part of practice in terms of its specified goals.[8] While user perspectives studies in clinical settings are often seen as anecdotal and lacking generalisability, they can provide evidence on the acceptability of new systems to real users.[5] Nevertheless these are only preliminary findings from first adopter sites, and we suggest further studies to establish how the system operates when more mature.
Conclusion The EPS2 implementation has been challenging for community pharmacists. Missing prescriptions was especially problematic. Initial views were however supportive of the system being retained and improved upon.
Declarations Conflict of interest The Authors declare that they have no conflicts of interest to disclose.
Funding This report is independent research commissioned by the National Institute of Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
Acknowledgements We thank all the pharmacies that took part of the study despite having a lot to grapple with. We also thank the individuals from Connecting for Health and the informatics leads from the Primary Care Trusts who allowed us access to these early adopter sites. We thank the wider project team for their feedback in the analysis and interpretation of the results, and the writing of this article. Finally, we thank colleagues from Department of Social Sciences, Loughborough University, for their helpful commentary on the paper.
Authors’ contributions
Discussion Early adopters of EPS2 have identified both barriers and benefits for community pharmacies. In terms of barriers, pharmacists found missing prescriptions especially challenging. © 2014 Royal Pharmaceutical Society
Dr Jasmine Harvey (JH) is a social scientist working with Professor Avery at the School of Medicine, Division of Primary Care, University of Nottingham. JH previously worked at the Department of Social Sciences, Loughborough University, International Journal of Pharmacy Practice 2014, 22, pp. 440–444
444
Community pharmacy perceptions of EPS
and International Digital Laboratory at the University of Warwick. JH facilitated the refinement of the research design, and was the primary data collector of the study. JH conducted analysis and interpretation of the data together with AA and NB and other members of the team, and lead the writing of this article. Professor Antony Avery (AA) is professor of Primary Health Care, and director of Research at the School of Medicine, Division of Primary Care, University of Nottingham. Among other interests, he specialises in patient safety and the use of information technology to aid clinical practice, and has an extensive portfolio of academic papers for both quantitative and qualitative research in this field. AA is also an active
References 1. Department of Health. Delivering 21st Century IT Support for the NHS. [online] London, UK: Department of Health, 2002. http://webarchive .nationalarchives.gov.uk/20130107105 354/http://www.dh.gov.uk/en/ Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/ DH_4008227 (accessed 5 March 2014 ). 2. Connecting for Health. The national programme for IT implementation guide: guidance to support trusts when implementing National Programme products and services. 2007. NHS Connecting for Health. 3. Rai N. EPS put simply. Tomorrows Pharmacist [online] 2008; 56. http:// www.pjonline.com/news/eps_put _simply (accessed 28 December 2012).
© 2014 Royal Pharmaceutical Society
general practitioner in the city of Nottingham. AA co-authored and edited all the case studies from the study, extensively contributed to the analysis and the interpretation and of the data, and provided commentary on the writing up process. Professor Nick Barber (NB) is professor of the Practice of Pharmacy at the Department of Practice and Policy,University College London School of Pharmacy, University of London. NB gave a critical insight throughout the research write up and critically edited this article. NB is also visiting professor of Medication Safety at Harvard Medical School and is a practising pharmacist.All Authors state that they had complete access to the study data that support the publication.
4. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q 1989; 13: 319–340. 5. Heathfield H et al. Evaluating information technology in health care: barriers and challenges. BMJ 1998; 316: 1959– 1961. 6. Pare G, Elam JJ. Physicians’ acceptance of clinical information systems: an empirical look at attitudes expectations and skills. Int J Healthc Tech Mnag 1999; 1: 46–61. 7. Schuring RW, Spil TAM. Explaining stranded diffusion by combing the user-IT-success factors (USIT) and adopter categories: the case of electronic prescription systems for general practitioners. Int J Healthc Tech Manag 2002; 4: 303–318.
8. Connecting for Health, Electronic Prescription Service for Dispensers. [online] http://www.connectingfor health.nhs.uk/systemsandservices/eps/ dispensing (accessed 14 November 2012). 9. Cowley C. NPfIT product – the electronic prescription service release benefits. NHS Connecting for Health. 19.01.2009, Draft/Version/0.1. Document record key: NPFIT-ETP-BUS0025.01. 10. Sugden B, Wilson R. Integrated care and electronic transmission of prescriptions: experience of the evaluation of ETP pilots. Health Inf J 2004; 10: 277–290.
International Journal of Pharmacy Practice 2014, 22, pp. 440–444
Short Communication International Journal of
Pharmacy Practice International Journal of Pharmacy Practice 2014, 22, pp. 440–444
A qualitative study of community pharmacy perceptions of the Electronic Prescriptions Service in England Jasmine Harveya, Anthony J. Averyb and Nick Barberc a
Division of Primary Care, School of Medicine, University of Nottingham, bDivision of Primary Care, School of Medicine, Queens Medical Centre,
Nottingham and cDepartment of Practice and Policy, School of Pharmacy, University College London, London, UK
Keywords community pharmacy; electronic prescription service; healthcare IT; perception Correspondence Dr Jasmine Harvey, Division of Primary Care, University of Nottingham, Nottingham NG7 2UH, UK. E-mail: [email protected] Received May 1, 2013 Accepted January 18, 2014 doi: 10.1111/ijpp.12107
Abstract Objectives To explore attitudes and perceptions of early adopters of the Electronic Prescription Service (release two) in England (EPS2). EPS2 is information technology that allows community pharmacies to download and dispense electronically written prescriptions from general practices. When the prescriber writes a prescription electronically, it is sent and stored on a national central database, commonly called the Spine. The community pharmacy that the patient nominates is then able to download the prescription and dispense to the patient. Method In-depth interviews were conducted with professionals from eight early adopter community pharmacies in the midlands and north of England, and 56 hours of non-participant observations were recorded as field notes. Each interview transcript was coded using a line-by-line approach. Overall, 37 200 words were analysed from 10 transcripts using a ‘bottom up’ approach to identify key perceptions. Field notes from the observation were analysed thematically and were used to verify interview findings. Key findings Findings follow a narrative which shows that (a) early adopter pharmacies had to cope with challenges such as missing EPS2 prescriptions, (b) despite this, they perceived EPS2 as helpful in streamlining pharmacy workflow and (c) were therefore keen to retain EPS2. Conclusions Initial user perception of EPS2 provides a key message on the likelihood of the system being adopted beyond these eight pharmacies. Our findings provide key information for other pharmacies in the adoption process, and policymakers on the potential of EPS2 to achieve its goals and become sustainable in terms of its value to community pharmacies.
Introduction The Electronic Prescription Service in England enables prescriptions to be generated and stored on a national central database, called the Spine. Community pharmacies are then able to download and dispense these prescriptions to patients.[1–3] In this article, we explore the following: (a) What were community pharmacist initial perceptions of the advanced version of the Electronic Prescriptions Service: EPS2? (b) Whether pharmacists would wish to retain the service?
ducted in midland and northern regions of England. Fifty six hours of non-participant observations were also conducted to complement the interviews. Data were collected between February and September 2011. Table 1 has further details of the study methods. At the time of data collection, the sites were dispensing from 10% to 40% EPS2 prescriptions (Table 2), and ranged between 9 and 18 months into their period of adoption. We focussed on common themes running through the eight pharmacies.
Method
Results
In-depth interviews with pharmacy professionals in the eight first adopter community pharmacies for EPS2 were con-
Our findings showed a narrative which begins with pharmacists contending with challenges such as missing electronic
© 2014 Royal Pharmaceutical Society
International Journal of Pharmacy Practice 2014, 22, pp. 440–444
Jasmine Harvey et al.
Table 1
441
Details of methods used in the study
Methodology Framework
The methodological framework was developed from ‘user-perception’ literature reviews on technology adoption, and listed benefits of EPS2 according to Connecting for Health (CfH).[4–8] We adopted a constructivist (qualitative) approach by using flexible themes based on user-perception study models such as positive and negative experiences, and perceived benefits of the system. This approach allowed us to delve deeper, beyond standardised variables, into extracting candid perceptions from users.
Permissions and sampling strategy Permissions Permissions were sought from approval bodies for each site including, Primary Care Trusts, research governance teams, benefit realisation teams and informatics leads. The study protocol was submitted to the Cambridgeshire Research Ethics Committee who classed the study as a service evaluation. Sampling We obtained a list of pharmacies classified as first adopters from CfH and selected pharmacies that were ‘live’ and dispensing above 5% electronic prescriptions, all of which were located in the midland and northern regions of England. Sites with different pharmacy manager systems were chosen to get divergent perspectives. Data collection Interviews Interviews were conducted with pharmacy professionals at the sites. Questions focussed on initial user experiences and perspectives such as what issues they had with EPS2, which issues were persistent, what they liked and disliked about it, how they felt EPS2 had affected their workflow and workloads, and how they would feel if the system was discontinued. Due to the busy nature of pharmacy work, it was challenging to audio-record all interviews. However, we audio-recorded interviews with pharmacists in all eight sites, in addition to one accredited checking technician and one dispenser. The interviews lasted between 30 min and 1 h, and were typed into transcripts averaging 3700 words each. Notes were taken from other participants who could not give audio-recorded interviews. Observations These were used to explore a range of practice perspectives such as how EPS2 prescriptions were dispensed, whether electronic prescriptions were printed out and how often EPS2 prescriptions were downloaded. Observations were recorded as field notes. See Fig. 1 for the fieldwork schedule (observation and interview). Analysis Interviews Each interview transcript was manually coded using line-by-line approach and bottom up analysis to identify key perceptions. Figure 2 shows a short example of a coding sheet. Overall, 37 200 words were analysed. Observations Field notes were analysed thematically. Results were compared with interview findings. For example if an interviewee said, ‘we download EPS2 five times a day’, we used the observations to verify this. Reflections on the data collection process and researchers’ positionality were taken into account in the analysis, and consideration was given to elements of ‘reactivity’.
Table 2 Site 1 2 3 4 5 6 7 8
Study site descriptors Proportion of EPS2 dispensed at the time of study 20% 35% 18% Information not supplied but proportion noted to be greater than 10% 40% 10% 10% 16%
EPS2 live since 07.2009 12.2009 09.2010 06.2011 08.2010 08.2010 07.2010 05.2010
Due to the small number of first adopters at the time of the study, providing detailed descriptions of sites will breech confidentiality and commercial sensitivity agreements.
prescriptions, but perceiving EPS2 as helpful in streamlining pharmacy workflow, and ending with accounts of why would like to retain EPS2. There were several examples of problems with missing prescriptions and download problems from the Spine. Missing prescriptions were a particular challenge as they took time to © 2014 Royal Pharmaceutical Society
chase up as, once the prescription was sent, it was impossible for the general practitioner (GP) or the pharmacist to establish whether it was on the Spine. In some cases, the patient might arrive in the pharmacy asking for their prescription only 2 or 3 minute after leaving the surgery. Under these circumstances, pharmacists had to repeatedly check whether the prescription had arrived on the Spine. Pharmacists thought this issue created tensions between the pharmacy and the GP practice, and between the pharmacy and the patient, and, on occasions, left pharmacists feeling starved of information. ‘We’ve had issues where prescriptions have gone missing, where the doctor’s surgery have said that they have sent a number of prescriptions and we are saying that we haven’t received the prescriptions . . . and so they [patients] end up playing ping pong between the doctor’s and the pharmacy, and we seem to be the guilty party because they [doctor’s] have sent it.’ (Site 8, Pharmacist). There were different reasons for this issue including GPs forgetting to sign the prescriptions electronically, the system automatically generating expiry dates and the Spine being too International Journal of Pharmacy Practice 2014, 22, pp. 440–444
442
Community pharmacy perceptions of EPS
Figure 1
Fieldwork guide (template).
Figure 2
Interview coding sheet sample.
© 2014 Royal Pharmaceutical Society
International Journal of Pharmacy Practice 2014, 22, pp. 440–444
Jasmine Harvey et al.
slow to process the prescription (especially for acute prescriptions). The pharmacists however thought that these issues could be solved, and classified them as ‘teething’ problems; they went on to discuss how EPS2 had improved their workflow. ‘It’s helped with running day to day of the business, because whereas before we used to get a lot of peaks and troughs and used to get a lot of people in at [one] time and then nobody. Now, we’ve got less people coming in and waiting, they come in and they get their prescriptions and they go. It’s been much better for our waiting times throughout the day’ (Site 6, Pharmacist). It has been suggested that EPS2 has potential to aid repeat dispensing.[9] We found that it was also useful for processing bulk repeat prescriptions: something that was not included in early piloting of the EPS system.[10] This function worked well because pharmacists could download repeat prescriptions in one go and dispense during quieter times, thereby smoothing their workflow and helping their workload. The fluidity in the workflow was also related, at least by some interviewees, to reduction in workload. Some felt it helped them to organise their dispensing activities, and it was a bit quicker to dispense items using the system; others felt it was faster still if a token was scanned, rather than waiting for an item to come through the Spine electronically. Ordering of drugs was also improved as pharmacists had advanced notice of what was required. These experiences were associated with positive attitudes towards EPS2 and its sustainability. All respondents said that they would like to keep the EPS2 system. For many, this was because it had made their lives easier; others argued for keeping it, and working on improving it, on the basis that otherwise it would have been a significant waste of money. The following quotes illustrate the views of respondents when asked about the possibility of EPS2 being discontinued. ‘I would cry. Don’t get me wrong, when I first had it, I was sceptical about it. I was very much, I want to print tokens and it was just paper again. But now I’ve got it, now I really would actually cry if I got it taken away.’ (Site 5, Pharmacist). ‘We’ve invested quite a lot of effort and energy into this. I would get a bit frustrated at the fact that having gone through this that they then decided that it isn’t functioning very well and it all needs to be put aside.’ (Site 8, Pharmacist).
443
Despite this, the pharmacists perceived EPS2 to be beneficial in enabling smoother workflow, and were supportive of it being retained and improved upon. These perceptions show that while there are still issues to be addressed, the system is becoming a useful part of practice in terms of its specified goals.[8] While user perspectives studies in clinical settings are often seen as anecdotal and lacking generalisability, they can provide evidence on the acceptability of new systems to real users.[5] Nevertheless these are only preliminary findings from first adopter sites, and we suggest further studies to establish how the system operates when more mature.
Conclusion The EPS2 implementation has been challenging for community pharmacists. Missing prescriptions was especially problematic. Initial views were however supportive of the system being retained and improved upon.
Declarations Conflict of interest The Authors declare that they have no conflicts of interest to disclose.
Funding This report is independent research commissioned by the National Institute of Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
Acknowledgements We thank all the pharmacies that took part of the study despite having a lot to grapple with. We also thank the individuals from Connecting for Health and the informatics leads from the Primary Care Trusts who allowed us access to these early adopter sites. We thank the wider project team for their feedback in the analysis and interpretation of the results, and the writing of this article. Finally, we thank colleagues from Department of Social Sciences, Loughborough University, for their helpful commentary on the paper.
Authors’ contributions
Discussion Early adopters of EPS2 have identified both barriers and benefits for community pharmacies. In terms of barriers, pharmacists found missing prescriptions especially challenging. © 2014 Royal Pharmaceutical Society
Dr Jasmine Harvey (JH) is a social scientist working with Professor Avery at the School of Medicine, Division of Primary Care, University of Nottingham. JH previously worked at the Department of Social Sciences, Loughborough University, International Journal of Pharmacy Practice 2014, 22, pp. 440–444
444
Community pharmacy perceptions of EPS
and International Digital Laboratory at the University of Warwick. JH facilitated the refinement of the research design, and was the primary data collector of the study. JH conducted analysis and interpretation of the data together with AA and NB and other members of the team, and lead the writing of this article. Professor Antony Avery (AA) is professor of Primary Health Care, and director of Research at the School of Medicine, Division of Primary Care, University of Nottingham. Among other interests, he specialises in patient safety and the use of information technology to aid clinical practice, and has an extensive portfolio of academic papers for both quantitative and qualitative research in this field. AA is also an active
References 1. Department of Health. Delivering 21st Century IT Support for the NHS. [online] London, UK: Department of Health, 2002. http://webarchive .nationalarchives.gov.uk/20130107105 354/http://www.dh.gov.uk/en/ Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/ DH_4008227 (accessed 5 March 2014 ). 2. Connecting for Health. The national programme for IT implementation guide: guidance to support trusts when implementing National Programme products and services. 2007. NHS Connecting for Health. 3. Rai N. EPS put simply. Tomorrows Pharmacist [online] 2008; 56. http:// www.pjonline.com/news/eps_put _simply (accessed 28 December 2012).
© 2014 Royal Pharmaceutical Society
general practitioner in the city of Nottingham. AA co-authored and edited all the case studies from the study, extensively contributed to the analysis and the interpretation and of the data, and provided commentary on the writing up process. Professor Nick Barber (NB) is professor of the Practice of Pharmacy at the Department of Practice and Policy,University College London School of Pharmacy, University of London. NB gave a critical insight throughout the research write up and critically edited this article. NB is also visiting professor of Medication Safety at Harvard Medical School and is a practising pharmacist.All Authors state that they had complete access to the study data that support the publication.
4. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q 1989; 13: 319–340. 5. Heathfield H et al. Evaluating information technology in health care: barriers and challenges. BMJ 1998; 316: 1959– 1961. 6. Pare G, Elam JJ. Physicians’ acceptance of clinical information systems: an empirical look at attitudes expectations and skills. Int J Healthc Tech Mnag 1999; 1: 46–61. 7. Schuring RW, Spil TAM. Explaining stranded diffusion by combing the user-IT-success factors (USIT) and adopter categories: the case of electronic prescription systems for general practitioners. Int J Healthc Tech Manag 2002; 4: 303–318.
8. Connecting for Health, Electronic Prescription Service for Dispensers. [online] http://www.connectingfor health.nhs.uk/systemsandservices/eps/ dispensing (accessed 14 November 2012). 9. Cowley C. NPfIT product – the electronic prescription service release benefits. NHS Connecting for Health. 19.01.2009, Draft/Version/0.1. Document record key: NPFIT-ETP-BUS0025.01. 10. Sugden B, Wilson R. Integrated care and electronic transmission of prescriptions: experience of the evaluation of ETP pilots. Health Inf J 2004; 10: 277–290.
International Journal of Pharmacy Practice 2014, 22, pp. 440–444
