A Qualitative Study Exploring the Acceptability and Usability of the e-Prescribing Risk and Safety Evaluation (ePRaSE) Assessment Within English Hospitals.

Abstract

Objectives: The e-prescribing risk and safety evaluation (ePRaSE) tool was developed to support the evaluation of hospital e-prescribing (EP) systems. The tool uses fictitious patients alongside previously validated prescribing scenarios to detect whether these systems provide appropriate prescribing advice to users. We sought to evaluate the usability and acceptability of ePRaSE across different EP systems in England.

Materials and methods: NHS hospitals in England with live EP systems were invited to participate. A combination of observations and semi-structured interviews were used to explore participants' perspectives on the acceptability and usability of ePRaSE throughout all stages of the tool development. The data were transcribed verbatim, coded, and analyzed using the Framework Approach.

Results: The study was conducted over 2 periods: April-December 2019 and September 2022-January 2023. Thirty-two health care professionals across 22 different NHS hospitals participated in semi-structured interviews (n=25) and 13 observations (n=20) involving 11 different EP systems in total. The ePRaSE assessment was completed in 2 to 3 hours and participants described the tool as easy to use with clinically relevant prescribing tasks. However, some participants experienced difficulties inputting clinical data, such as laboratory results, due to restricted access to different parts of the electronic health record. Many participants suggested areas for further improvement such as capturing a broader range of implemented clinical decision support and requested more detailed feedback on the performance of their systems.

Conclusions: EP system users found ePRaSE to be a useful and acceptable tool. Further refinement is desirable, particularly in recording EP system responses and providing detailed results to optimize EP systems for safety benefits.