Appl Clin Inform 2014; 05(02): 527-537
DOI: 10.4338/ACI-2014-04-RA-0032
Research Article – ehealth2014 special topic
Schattauer GmbH

Crucial Factors for the Acceptance of a Computerized National Medication List

Insights into Findings from the Evaluation of the Austrian e-Medikation Pilot
W.O. Hackl
1   Institute of Health Informatics, UMIT-University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
,
A. Hoerbst
2   Research Division for eHealth and Telemedicine, UMIT, Hall in Tirol, Austria
,
G. Duftschmid
3   Section for Medical Information Management and Imaging, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
,
W. Gall
3   Section for Medical Information Management and Imaging, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
,
S. Janzek-Hawlat
3   Section for Medical Information Management and Imaging, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
,
M. Jung
1   Institute of Health Informatics, UMIT-University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
,
K. Woertz
1   Institute of Health Informatics, UMIT-University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
,
W. Dorda
3   Section for Medical Information Management and Imaging, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
,
E. Ammenwerth
1   Institute of Health Informatics, UMIT-University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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Weitere Informationen

Correspondence to:

Dr. Werner O. Hackl
Institute of Health Informatics, UMIT-University of Health Sciences
Medical Informatics and Technology
Eduard Wallnöfer Zentrum 1
6060 Hall in Tirol
Austria

Publikationsverlauf

Received: 07. April 2014

Accepted: 30. April 2014

Publikationsdatum:
21. Dezember 2017 (online)

 

Summary

Objective: The objective of this paper is to present crucial factors among registered doctors and pharmacists for acceptance of the Austrian ’e-Medikation’ system which is aimed at providing, on a national level, complete and recent information on all the medication that were prescribed or dispensed to a patient.

Methods: As the accompanying formative evaluation study of the pilot project showed different overall acceptance rates among participating physicians and pharmacists, a decision tree analysis of 30 standardized survey items was performed to identify crucial acceptance factors.

Results: For the physicians’ group, only two items (fear of improper data use and satisfaction with software support) were crucial for overall e-Medikation acceptance. The analysis of the pharmacists’ data resulted in five crucial factors primarily focusing on functional aspects and the perceived benefits of e-Medikation.

Conclusion: The results indicate that the acceptance among physicians and pharmacists depends on quite different factors. This must be taken into account during the planned rollout of e-Medikation or of comparable products.


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Conflict of interest

The authors declare that they have no conflicts of interest in the research.

  • References

  • 1 Haux R. Gute Medizin erfordert gute Information. Informatik Biometrie und Epidemiologie in Medizin und Biologie 2002; 33 (Suppl. 04) 496.
  • 2 Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D. et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA 1995; 274 (Suppl. 01) 29-34.
  • 3 Commission of the European Communities.. Communication from the Commission to the European Parliament and the Council on patient safety, including the prevention and control of healthcare-associated infections 2008. Brussels. 2008 [cited 2013 Dec 24]; Available from: http://ec.europa.eu/health/ph_systems/docs/patient_com2008_en.pdf.
  • 4 Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Inform Assoc 2008; 15 (Suppl. 05) 585-600.
  • 5 Kuperman GJ, Bobb A, Payne TH, Avery AJ, Gandhi TK, Burns G. et al. Medication-related clinical decision support in computerized provider order entry systems: a review. J Am Med Inform Assoc 2007; 14 (Suppl. 01) 29-40.
  • 6 Herbek S, Eisl HA, Hurch M, Schator A, Sabutsch S, Rauchegger G. et al. The Electronic Health Record in Austria: a strong network between health care and patients. Eur Surg 2012; 44 (Suppl. 03) 155-163.
  • 7 Dorda W, Duftschmid G, Gerhold L, Gall W, Gambal J. Austria’s path toward nationwide electronic health records. Methods Inf Med 2008; 47 (Suppl. 02) 117-123.
  • 8 Ammenwerth E, Duftschmid G, Gall W, Hackl WO, Hoerbst A, Janzek-Hawlat S. et al. A nationwide computerized patient medication history: Evaluation of the Austrian Pilot Project “e-Medikation”. Submitted to International Journal of Medical Informatics 2013.
  • 9 Janzek-Hawlat S, Ammenwerth E, Dorda W, Duftschmid G, Hackl W, Horbst A. et al. The Austrian e-Medikation pilot evaluation: lessons learned from a national medication list. Stud Health Technol Inform 2013; 192: 347-351.
  • 10 Dorda W, Ammenwerth E, Hackl W, Duftschmid G, Hörbst A, Gall W. et al. Pilot project e-Medikation: Final evaluation report [in German]. 2012 [cited 2013 Dec 24]; Available from: http://www.elga.gv.at/fileadmin/user_upload/uploads/download_Papers/PR/Langfassung_Pilot_e-Med_Evaluierung.pdf.
  • 11 Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: toward a unified view. MIS Q 2003; 27 (Suppl. 03) 425-478.
  • 12 Delone WH, McLean ER. The DeLone and McLean Model of Information Systems Success: A Ten-Year Update. J Manage Inf Syst 2003; 19 (Suppl. 04) 9-30.
  • 13 Hellstrom L, Waern K, Montelius E, Astrand B, Rydberg T, Petersson G. Physicians’ attitudes towards ePrescribing--evaluation of a Swedish full-scale implementation. BMC Med Inform Decis Mak 2009: 9-37
  • 14 Tan WS, Phang JS, Tan LK. Evaluating user satisfaction with an electronic prescription system in a primary care group. Ann Acad Med Singapore 2009; 38 (Suppl. 06) 494-497.
  • 15 De’ath G, Fabricius KE. Classification and regression trees: a powerful yet simple technique for ecological data analysis. Ecology 2000; 81 (11) 3178-3192.
  • 16 Kohavi R. A Study of Cross-Validation and Bootstrap for Accuracy Estimation and Model Selection. In: Mellish CS, editor. IJCAI’95 –14th international joint conference on Artificial intelligence Montreal, Quebec, Canada: Morgan Kaufmann Publishers Inc.; 1995. p. 1137-1143
  • 17 Campion Jr TR, Ancker JS, Edwards AM, Patel VN, Kaushal R. Push and pull: physician usage of and satisfaction with health information exchange. AMIA Annu Symp Proc 2012; 2012: 77-84.
  • 18 Jung M, Hoerbst A, Hackl WO, Kirrane F, Borbolla D, Jaspers MW. et al. Attitude of physicians towards automatic alerting in computerized physician order entry systems. A comparative international survey. Methods Inf Med 2013; 52 (Suppl. 02) 99-108.
  • 19 Wright A, Soran C, Jenter CA, Volk LA, Bates DW, Simon SR. Physician attitudes toward health information exchange: results of a statewide survey. J Am Med Inform Assoc 2010; 17 (Suppl. 01) 66-70.
  • 20 Lee SI, Park H, Kim JW, Hwang H, Cho EY, Kim Y. et al. Physicians’ perceptions and use of a health information exchange: a pilot program in South Korea. Telemed J E Health 2012; 18 (Suppl. 08) 604-612.
  • 21 Fuji KT, Gait KA, Siracuse MV, Christoffersen JS. Electronic health record adoption and use by Nebraska pharmacists. Perspect Health Inf Manag 2011; 8: 1d.
  • 22 Hackl WO, Hoerbst A, Ammenwerth E. ,,Why the hell do we need electronic health records?“. EHR acceptance among physicians in private practice in Austria: a qualitative study. Methods Inf Med 2011; 50 (Suppl. 01) 53-61.
  • 23 Secginli S, Erdogan S, Monsen KA. Attitudes of health professionals towards electronic health records in primary health care settings: a questionnaire survey. Inform Health Soc Care 2014; 39 (Suppl. 01) 15-32.
  • 24 Warholak TL, Murcko A, McKee M, Urbine T. Results of the Arizona Medicaid health information technology pharmacy focus groups. Res Social Adm Pharm 2011; 7 (Suppl. 04) 438-443.
  • 25 Klapf G, Ammenwerth E. eHealth aus der Sicht von niedergelassenen Ärzten: Eine Studie zu EInflussgrößen auf das Nutzungsverhalten und die Akzeptanz von eHealth-Funktion. In: Ammenwerth E, Hörbst A, Hayn D, Schreier G, editors. eHealth2013 –Health Informatics meets eHealth Big Data: eHealth von der Datenanalyse bis zum Wissensmanagement 23. 24.5.2013 Vienna: OCG 2013 p. 161-6
  • 26 Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS quarterly 1989: 319-340.
  • 27 Gagnon MP, Ghandour EK, Talla PK, Simonyan D, Godin G, Labrecque M. et al. Electronic health record acceptance by physicians: Testing an integrated theoretical model. J Biomed Inform 2013 Oct 31.
  • 28 Hoerbst A, Ammenwerth E. Electronic health records. A systematic review on quality requirements. Methods Inf Med 2010; 49 (Suppl. 04) 320-336.

Correspondence to:

Dr. Werner O. Hackl
Institute of Health Informatics, UMIT-University of Health Sciences
Medical Informatics and Technology
Eduard Wallnöfer Zentrum 1
6060 Hall in Tirol
Austria

  • References

  • 1 Haux R. Gute Medizin erfordert gute Information. Informatik Biometrie und Epidemiologie in Medizin und Biologie 2002; 33 (Suppl. 04) 496.
  • 2 Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D. et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA 1995; 274 (Suppl. 01) 29-34.
  • 3 Commission of the European Communities.. Communication from the Commission to the European Parliament and the Council on patient safety, including the prevention and control of healthcare-associated infections 2008. Brussels. 2008 [cited 2013 Dec 24]; Available from: http://ec.europa.eu/health/ph_systems/docs/patient_com2008_en.pdf.
  • 4 Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Inform Assoc 2008; 15 (Suppl. 05) 585-600.
  • 5 Kuperman GJ, Bobb A, Payne TH, Avery AJ, Gandhi TK, Burns G. et al. Medication-related clinical decision support in computerized provider order entry systems: a review. J Am Med Inform Assoc 2007; 14 (Suppl. 01) 29-40.
  • 6 Herbek S, Eisl HA, Hurch M, Schator A, Sabutsch S, Rauchegger G. et al. The Electronic Health Record in Austria: a strong network between health care and patients. Eur Surg 2012; 44 (Suppl. 03) 155-163.
  • 7 Dorda W, Duftschmid G, Gerhold L, Gall W, Gambal J. Austria’s path toward nationwide electronic health records. Methods Inf Med 2008; 47 (Suppl. 02) 117-123.
  • 8 Ammenwerth E, Duftschmid G, Gall W, Hackl WO, Hoerbst A, Janzek-Hawlat S. et al. A nationwide computerized patient medication history: Evaluation of the Austrian Pilot Project “e-Medikation”. Submitted to International Journal of Medical Informatics 2013.
  • 9 Janzek-Hawlat S, Ammenwerth E, Dorda W, Duftschmid G, Hackl W, Horbst A. et al. The Austrian e-Medikation pilot evaluation: lessons learned from a national medication list. Stud Health Technol Inform 2013; 192: 347-351.
  • 10 Dorda W, Ammenwerth E, Hackl W, Duftschmid G, Hörbst A, Gall W. et al. Pilot project e-Medikation: Final evaluation report [in German]. 2012 [cited 2013 Dec 24]; Available from: http://www.elga.gv.at/fileadmin/user_upload/uploads/download_Papers/PR/Langfassung_Pilot_e-Med_Evaluierung.pdf.
  • 11 Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: toward a unified view. MIS Q 2003; 27 (Suppl. 03) 425-478.
  • 12 Delone WH, McLean ER. The DeLone and McLean Model of Information Systems Success: A Ten-Year Update. J Manage Inf Syst 2003; 19 (Suppl. 04) 9-30.
  • 13 Hellstrom L, Waern K, Montelius E, Astrand B, Rydberg T, Petersson G. Physicians’ attitudes towards ePrescribing--evaluation of a Swedish full-scale implementation. BMC Med Inform Decis Mak 2009: 9-37
  • 14 Tan WS, Phang JS, Tan LK. Evaluating user satisfaction with an electronic prescription system in a primary care group. Ann Acad Med Singapore 2009; 38 (Suppl. 06) 494-497.
  • 15 De’ath G, Fabricius KE. Classification and regression trees: a powerful yet simple technique for ecological data analysis. Ecology 2000; 81 (11) 3178-3192.
  • 16 Kohavi R. A Study of Cross-Validation and Bootstrap for Accuracy Estimation and Model Selection. In: Mellish CS, editor. IJCAI’95 –14th international joint conference on Artificial intelligence Montreal, Quebec, Canada: Morgan Kaufmann Publishers Inc.; 1995. p. 1137-1143
  • 17 Campion Jr TR, Ancker JS, Edwards AM, Patel VN, Kaushal R. Push and pull: physician usage of and satisfaction with health information exchange. AMIA Annu Symp Proc 2012; 2012: 77-84.
  • 18 Jung M, Hoerbst A, Hackl WO, Kirrane F, Borbolla D, Jaspers MW. et al. Attitude of physicians towards automatic alerting in computerized physician order entry systems. A comparative international survey. Methods Inf Med 2013; 52 (Suppl. 02) 99-108.
  • 19 Wright A, Soran C, Jenter CA, Volk LA, Bates DW, Simon SR. Physician attitudes toward health information exchange: results of a statewide survey. J Am Med Inform Assoc 2010; 17 (Suppl. 01) 66-70.
  • 20 Lee SI, Park H, Kim JW, Hwang H, Cho EY, Kim Y. et al. Physicians’ perceptions and use of a health information exchange: a pilot program in South Korea. Telemed J E Health 2012; 18 (Suppl. 08) 604-612.
  • 21 Fuji KT, Gait KA, Siracuse MV, Christoffersen JS. Electronic health record adoption and use by Nebraska pharmacists. Perspect Health Inf Manag 2011; 8: 1d.
  • 22 Hackl WO, Hoerbst A, Ammenwerth E. ,,Why the hell do we need electronic health records?“. EHR acceptance among physicians in private practice in Austria: a qualitative study. Methods Inf Med 2011; 50 (Suppl. 01) 53-61.
  • 23 Secginli S, Erdogan S, Monsen KA. Attitudes of health professionals towards electronic health records in primary health care settings: a questionnaire survey. Inform Health Soc Care 2014; 39 (Suppl. 01) 15-32.
  • 24 Warholak TL, Murcko A, McKee M, Urbine T. Results of the Arizona Medicaid health information technology pharmacy focus groups. Res Social Adm Pharm 2011; 7 (Suppl. 04) 438-443.
  • 25 Klapf G, Ammenwerth E. eHealth aus der Sicht von niedergelassenen Ärzten: Eine Studie zu EInflussgrößen auf das Nutzungsverhalten und die Akzeptanz von eHealth-Funktion. In: Ammenwerth E, Hörbst A, Hayn D, Schreier G, editors. eHealth2013 –Health Informatics meets eHealth Big Data: eHealth von der Datenanalyse bis zum Wissensmanagement 23. 24.5.2013 Vienna: OCG 2013 p. 161-6
  • 26 Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS quarterly 1989: 319-340.
  • 27 Gagnon MP, Ghandour EK, Talla PK, Simonyan D, Godin G, Labrecque M. et al. Electronic health record acceptance by physicians: Testing an integrated theoretical model. J Biomed Inform 2013 Oct 31.
  • 28 Hoerbst A, Ammenwerth E. Electronic health records. A systematic review on quality requirements. Methods Inf Med 2010; 49 (Suppl. 04) 320-336.