Ngo, Sacred Wai-man; (1994) Implications of computerised prescribing in hospitals in the UK. Masters thesis (M.Phil), UCL (University College London).

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Abstract

In a computerised prescribing system (CPS), doctors would prescribe on computer terminals on wards and outpatient departments. The prescribing information would be transmitted electronically to the pharmacy department. The introduction of CPS to hospitals in the UK will change the current practices of prescribing, dispensing, drug administration and the pharmacy profession significantly. This thesis looks at the potential advantages and disadvantages of CPS and how CPS may fit into the current health services information requirement. It describes observations made at four hospital pharmacy departments in the USA. It was found that prescribers' support was vital for the success of CPS. Structured face to face interviews were conducted with 39 doctors at two London hospitals to examine doctors' attitudes towards CPS. Most of the interviewees had not heard about CPS. Their main concerns were system reliability and the time that might take to prescribe on computer terminals. Computers are used in hospital pharmacies for labelling individual patient medication. Since the labelling process requires similar information to that of a prescribing system, the time taken to produce a label for dispensing gives an idea of prescribing time for a text-input prescribing system. Labelling time was measured by direct observation at four combinations of London hospitals and computer systems. The time to produce 2167 labels was measured and 59 operators were observed. There were significant differences in the average labelling time between the studied hospitals/systems (16.6 to 39.3 seconds); with a general trend that labelling time decreased with increasing operator experience. This would have an important training implication on CPS, especially for locums and junior doctors. The thesis concluded that CPS could potentially offer many advantages to its users. However its success will depend critically on the software design and the method of system implementation and pharmacists must evaluate and develop their roles in CPS.

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