Building an Implementation Toolset for E-Prescribing - 2010

Target Population: General

Summary: This project is developing and testing complementary toolsets for implementing e-prescribing across various ambulatory care settings and pharmacies. The toolsets, one for health care providers and one for pharmacies, provide comprehensive guidance on activities that contribute to successful implementation, addressing technology requirements, workflow analysis tools, and governance agreement templates. The project includes: 1) an environmental scan of current national and international e-prescribing implementation programs; 2) detailed analysis of successful e-prescribing implementations in several organizational configurations, including large and small practices and safety net settings; 3) development of an implementation toolset based on these findings; and 4) pilot testing of toolsets. The toolsets will be evaluated on usability and usefulness for implementing e-prescribing in a broad range of practices. The goal is to develop toolsets to guide community and organizational decisionmaking about and implementation of e-prescribing.

To inform toolset development, several e-prescribing initiatives were analyzed to assess the contribution of key practices and features to successful implementation. The research team examined governance agreements, organizational characteristics, individual attitudes and motivations, prescription-related work processes, use of specific e-prescribing technologies and standards, distinctive implementation practices, and estimated costs (versus savings) for each participating organization. The findings from the analysis provide guidance and customizable aids to help organizations adopt practices and characteristics that contribute to successful implementation. The guidance includes goal-setting, timelines, workflow patterns, feasible work process transitions, and direction on other key organizational factors including leadership, organizational culture, employee involvement, training, performance evaluation, and incentives

Project Objective:

• Catalogue publicly-announced, ongoing e-prescribing initiatives. (Achieved)
• Assess contributors to successful implementation of e-prescribing initiatives. (Achieved)
• Create two draft e-prescribing implementation toolsets. (Achieved)
• Evaluate the draft toolset’s usability and usefulness in helping provider organizations implement e-prescribing. (Ongoing)
• Create a final e-prescribing implementation toolset based on findings from the pilot evaluation. (Ongoing)

2010 Activities: Pilot testing of the toolsets began among prescribers and pharmacies that are adopting e-prescription functionality. Field researchers visited each practice before and after the e-prescribing draft toolsets are piloted to conduct semi-structured interviews and observations of work processes. The research team has modified the toolkits based on pilot testing and is working to create a final product that organizations and communities can use when considering e-prescribing. The toolsets will be evaluated in 2011 on usability and usefulness in helping implement e-prescribing in a broad range of practices.

The toolsets will be publicly available in late summer 2011. The project team is making draft versions of the toolsets available for extended pilot testing to Regional Extension Centers through the Health Information Technology Resource Center’s Communities of Practice.

Preliminary Impact and Findings: Findings will be made available upon completion of the project’s final report.

Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to improve the quality and safety of medication management via the integration and utilization of medication management systems and technologies.

Business Goal: Implementation and Use