全科诊所和社区药房共享电子健康记录的混合方法评估

IF 3.2 4区 医学 Q2 PHARMACOLOGY & PHARMACY
J Fynn, M Lamptey, G Coote, M J Twigg, J Newman, S Lingard, M Cooper, H Nazar
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引用次数: 0

摘要

导言:通过数字基础设施将社区药房纳入初级保健,对于加强保健的连续性、协调性和安全性至关重要。从历史上看,社区药房没有全面访问全科医疗电子健康记录(EHRs),限制了它们提供知情干预的能力。引入共享的、可互操作的电子病历有可能解决这一限制,并重新定义社区药剂师的临床角色。目的:本研究旨在评估在英格兰东部选定地点向社区药房授予共享EHR系统(SystmOne)读写权限的可行性、可接受性和影响。方法:采用解释顺序和收敛方法进行为期12个月的混合方法试点(2023年1 - 12月)。通过活动日志、调查和半结构化访谈,从35家社区药店和31家全科诊所收集数据。描述性统计用于分析定量数据,专题编码用于分析定性数据。然后整合数据来评估服务交付、沟通和用户体验。结果:13家社区药房积极使用电子病历,记录了超过19,000次预约和16,000次临床记录。使用情况各不相同,障碍包括工作量、技术复杂性和重复的文档需求。然而,用户报告了患者安全、专业间沟通和服务效率的改善。预约和任务共享功能促进了协作工作,而实时临床信息的访问支持了临床决策。培训支持、部门之间的信任和政策一致性被确定为系统采用的关键推动因素。结论:为社区药房提供共享电子病历的读写访问是可行的,有助于更安全、更综合的患者护理。药剂师和全科医生之间沟通、临床文件和任务授权的改善代表了数字协作的重大转变。然而,成功的扩展需要在互操作性、国家IT基础设施一致性和简化的报销流程方面进行投资,以防止重复工作。这些发现支持社区药剂师不断发展的临床角色,并建议集成数字系统对于实现现代NHS社区药房的全部潜力以改善患者护理至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A mixed methods evaluation of a shared electronic health record between general practice and community pharmacy.

Introduction: Integrating community pharmacies into primary care via digital infrastructure is crucial to enhancing continuity, coordination, and safety of care. Historically, community pharmacies have not had full access to general practice electronic health records (EHRs), limiting their ability to provide informed interventions. The introduction of shared, interoperable EHRs has the potential to address this limitation and redefine the clinical role of community pharmacists.

Aim: This study aimed to evaluate the feasibility, acceptability, and impact of granting community pharmacies read-and-write access to a shared EHR system (SystmOne) across selected sites in the East of England.

Method: A 12-month mixed-methods pilot (Jan-Dec 2023) was conducted using an explanatory sequential and convergent approach. Data were collected from 35 community pharmacies and 31 general practices via activity logs, surveys, and semi-structured interviews. Descriptive statistics was used to analyse quantitative data and thematic coding used for analysing qualitative data. Data was then integrated to evaluate service delivery, communication, and user experience.

Results: Thirteen community pharmacies actively used the EHR, documenting over 19,000 appointments and 16,000 clinical entries. Usage varied, with barriers including workload, technical complexity, and duplicated documentation requirements. However, users reported improvements in patient safety, interprofessional communication, and service efficiency. Appointment booking and task-sharing functions fostered collaborative working, while access to real-time clinical information supported clinical decision-making. Training support, trust between sectors, and policy alignment were identified as critical enablers for system uptake.

Conclusion: Providing community pharmacies with read-and-write access to a shared EHR is feasible and contributes to safer, more integrated patient care. Improved communication, clinical documentation, and task delegation between pharmacists and general practice staff represent a major shift in digital collaboration. However, successful scale-up requires investment in interoperability, national IT infrastructure alignment, and streamlined reimbursement processes to prevent duplication of effort. These findings support the evolving clinical role of community pharmacists and suggest that integrated digital systems are essential to realising the full potential of community pharmacy in the modern NHS to improve patient care.

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来源期刊
CiteScore
4.10
自引率
8.30%
发文量
131
审稿时长
4-8 weeks
期刊介绍: The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences. IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy. IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor. International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy . Until 2010 the journal was called Pharmacy World & Science.
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