Electronic-Prescribing-System Protocol Development for Government Sector Outpatients and Private Drug Stores: Case Study in Kalasin Province, Thailand
Keywords:
Electronic prescribing system, reducing overcrowding policy, Kalasin provinceAbstract
Introduction: Thai hospitals are overcrowded, with patients spending half of their time waiting for medicines, resulting in increasing patient unhappiness and strain on staff, which leads to medication errors. So, a policy was implemented to minimize congestion by using an E-prescribing system (EPS) that allows patients to obtain medicines at drug store. However, the existing EPS does not give adequate operational assistance since the system does not cover all areas, there is insufficient financial support, and the EPS does not facilitate information sharing.
Objective: to develop an EPS protocol that allows for interoperability between a drug store and outpatients in a government hospital
Method: this research was a design and development research separated into four stages: review of Thailand's EPS, stakeholder analysis, system analysis and design, and system evaluation.
Results: The results indicated from 17 key stakeholders at 1 secondary hospital, 1 primary hospital, and 2 drug stores in Kalasin province. The new EPS protocol allows patients to choose from a variety of health settings (all-tier hospitals, Suksala, and drug stores) to obtain lab tests or refill medications anywhere and at any time based on their condition by making or changing an appointment through the Line official account named "Morprom."
Conclusions: The goal of this research was to develop an EPS protocol utilizing a case study in Kalasin province. To build an EPS protocol applicable in Thailand, this protocol must be deployed in real-world settings in a variety of areas.
References
Moore L. Hospital overcrowding: A complex but solvable problem. Available from: https://www.3mhisinsideangle.com/blog-post/hospital-overcrowding-a-complex-but-solvable-problem/, accessed 3 June, 2021.
Ministry of Public Health, Department of Health, Thailand. Work manual of “solving overcrowding in healthcare settings of National Health Security Office” project. Ministry of Public Health; 2019.
Hostetter M, Klein S. In Focus: Improving Patient Flow—In and Out of Hospitals and Beyond. Available from: https://www.commonwealthfund.org/publications/newsletter-article/focus-improving-patient-flow-and-out-hospitals-and-beyond, accessed 3 June, 2021.
Pharmaceutical system research and development foundation. Report of Performance indicator phase 1 for hospital pharmacy; 2007 [cited 2021 July 10]. Available from: https://www.hiso.or.th/hiso/picture/reportHealth/pro-8_chapter4(6).pdf.
Sare H, Yapa P, Kaewsuwan K. Report of Development of Outpatient Drug Delivery System to Reduce Patient Waiting Time in Thepha hospital; 2018 [cited 2021 July 10].
Narathkornrit N, Preampinijpong D. Report of Reducing waiting time for outpatient medicine at Saraburi hospital; 2018 [cited 2021 July 10].
Chinvarakorn C. Reduction of Drug Dispensing Time for Out-patients at Somdetphraphutthalertla Hospital. Journal of Health Science 2016; 25(4): 664-72. (In Thai)
Changeakwong P. Reducing waiting times for anti-tuberculosis drugs at the outpatient pharmacy of Nan Hospital. IJPS. 2021; 17(2): 15-25. (In Thai). DOI: 10.14456.ijps.2021.8
Sawangdee Y, Isornpakdee P, Malee Sunpuwan. Problems and suffering of people when using the service at a public health service. Nakhon Pathom: Institute for Population and Social Research of Mahidol University; 2000. (In Thai)
Sun J, Lin Q, Zhao P, Zhang Q, Xu K, Chen H, et al. Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study. BMC Public Health. 2017;17. DOI: 10.1186/s12889-017-4667-z.
Tewthanom K, Thananonniwat S. Medication error and Prevention guide for patient’s safety. Veridian E – Journal, Silpakorn University. 2009; 2(1): 195-217. (In Thai)
Vajira Hospital. Report of A study of OPD medication errror in Petcharat Building at Vajira Hospital. 2018.
Glintborg B, Poulsen HE, Dalhoff KP. The use of nationwide on-line prescription records improves the drug history in hospitalized patients. Br J Clin Pharmacol. 2008; 65(2): 265-9. DOI: 10.1111/j.1365-2125.2007.03017.x.
Goundrey-Smith S. The Connected Community Pharmacy: Benefits for Healthcare and Implications for Health Policy. Front Pharmacol. 2018; 9: 1352. DOI: 10.3389/fphar.2018.01352.
Spiro S, Quach D. Interoperability: Plugging Community Pharmacy into the Clinical Data Superhighway. Pharmacy Times Oncology Edition. 2015; 2(3).
Zadeh PM, Tremblay MC. A review of the literature and proposed classification on e-prescribing: Functions, assimilation stages, benefits, concerns, and risks. Res Social Adm Pharm. 2016; 12(1): 1-19. DOI: 10.1016.j.sapharm.2015.03.001
Samadbeik M, Ahmadi M, Asanjan S. A theorectical approach to electronic prescription system: lesson learned from literature review. Iranian Red Crescent Medical Journal. 2013; 15(10): e846. DOI: 10.5812/ircmj.8436
The Australian Digital Health Agency. Electronic prescriptions. Available from: https://www.digitalhealth.gov.au/initiatives-and-programs/electronic-prescriptions, accessed 15 July, 2021.
Motulsky A, Liang M, Moreault M, Borycki E, Kushniruk A, Sicotte C. Evaluation of a Nationwide e-Prescribing System. Stud Health Technol Inform. 2019; 264: 714-8. DOI: 10.3233/SHTI190316.
Aanestad M, Grisot M, Hanseth O, Vassilakopoulou P. Information Infrastructures within European Health Care Working with the Installed Base [Internet]. Cham: Springer; 2017. Information Infrastructures in Healthcare; [cited 2021 July 10]. Available from: https://link.springer.com/content/pdf/10.1007/978-3-319-51020-0.pdf.
National Health Security Office. The results of the reducing overcrowding policy in 2020. Available from: https://gnews.apps.go.th/news?news=67601, accessed 15 June, 2021.
National Health Security Office. The results of the reducing overcrowding policy in 2021. Available from: https://www.nhso.go.th/news/2984, accessed 15 June, 2021.
National statistical office. Number of Pharmaceutical Licences, by Type, Region, and Province: 2010 – 2019; 2019 [cited 2021 July 16].
National Health Security Office. The result from “picking medicine at near patient home ’s drug store” project. Available from: https://www.nhso.go.th/news/2865, accessed 3 June, 2021. (In Thai)
Chalongsuk R, Lochind-amnuay S, Suntimaleewolagun W. A Study of a Refill Prescription Service System Comparing a Hospital Pharmacy and an Accredited Pharmacy. Journal of Health Systems Research. 2007; 1(3-4): 249-61. (In Thai)
Lertsinudom S, Rintara W, Wanakamanee U, Thananithisak C, Anusornpanichakul P, Kaewketthong P. The synthesis of political suggestion for the development of Accredited Drugstore Co-working with Family Medicine Clinic [Internet]. 2020. [cited 2021 July 10]. Available from:https://kb.hsri.or.th/dspace/bitstream/handle/11228/5298/hs2621.pdf?sequence=1&isAllowed=y. (In Thai)
Connectia. What Does it Mean for Cloud Services to be HIPAA Compliant? (And are YOU actually compliant?). Available from: https://www.connectria.com/blog/what-does-it-mean-for-cloud-services-to-be-hipaa-compliant-and-are-you-actually-compliant/, accessed 11 July, 2021.
Health Insurance Portability and Accountability Act of 1996 (Office of the assistant secretary for planning and evaluation)
U.S. Department of Health & Human Services. Department of Health & Human Services. Guidance on HIPAA & Cloud Computing. Available from: https://www.hhs.gov/hipaa/for-professionals/special-topics/health-information-technology/cloud-computing/index.html, accessed 11 July, 2021.
Thailand’s Personal Data Protection Act 2019 (The Royal Thai Government)
Secure privacy. Thailand PDPA Summary: What Businesses Need to Know. Available from: https://secureprivacy.ai/blog/thailand-pdpa-summary-what-businesses-need-to-know, accessed 12 July, 2021.
The University of Sydney. What is PESTLE. Available from: https://libguides.library.usyd.edu.au/c.php?g=508107&p=5994242, accessed 20 July, 2021.
Fosher H. Understanding the Marketing and Management of trails using PESTEL Analysis [dissertation on the Internet]. Durham: University of New Hampshire; 2018. [cited 2021 July 20]. Available from: https://scholars.unh.edu/cgi/viewcontent.cgi?article=2182&context=thesis.
Sammut-Bonnici T, Galea D. SWOT Analysis [Internet]. Wiley Encyclopedia of Management; 2015. Available from: https://onlinelibrary.wiley.com/doi/10.1002/9781118785317.weom120103.
Division of Non Communicable Disease, the Ministry of Public Health. The number and mortality rate from NCD between 2017-2021. Available from: http://www.thaincd.com/2016/mission/documents-detail.php?id=14220&tid=32&gid=1-020; 2021 [cited 2021 June 21].
Kalasin Provincial Governor's Office. Kalasin province join in the reducing overcrowding policy. Available from: http://kalasin.go.th/t/index.php/en/features/1154-16.html, accessed June 20, 2022.
Sandelowski M. Whatever happened to qualitative description?. Research in Nursing & Health. 2000; 23(4): 334-40. DOI: 10.1002/1098-240x(200008)23:4<334:aid-nur9>3.0.co;2-g
Patton MQ. Qualitative research and evaluation methods. Thousand Oaks: Sage Publications; 2002.
Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001; 358(9280): 483-8. DOI: 10.1016/S0140-6736(01)05627-6
Waltz C, Strickland OL, Lenz E. Measurement in Nursing and Health Research. New York: Springer; 2010.
Graneheim UH, Lundman G. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004; 24(2): 105-12. DOI: 10.1016/j.nedt.2003.10.001.
Hsieh H, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005; 15(9): 1277-88. DOI: 10.1177/1049732305276687.
Im E, Chee W. An Online Forum As a Qualitative Research Method: Practical Issues. Nurs Res. 2006; 55(1): 267-73. DOI: 10.1097/00006199-200607000-00007.
Sandelowski M. Sample size in qualitative research. Res Nurs Health. 1995;18(2) 179-83. DOI: 10.1002/nur.4770180211.
Allen NJ, Meyer JP. Organizational Socialization Tactics: A Longitudinal Analysis of Links to Newcomers' Commitment and Role Orientation. The Academy of Management Journal. 1990; 33(4): 847-58. DOI.10.2307/256294
Loatrakul O. The Success of Near-home Medicine Pick-up Project According to New Normal Medical Service Measure in Nakhon Pathom Province. Region 4-5 Medical Journal. 2021; 40(2).
Kalasin Provincial Public Health Office. Hospital in Kalasin province. Available from: http://203.157.186.15/institute.php, accessed 15 April, 2022.
Piapengton S. Subdistrict health promoting hospital in Thailand in 2021. Available from: http://team.sko.moph.go.th/phi/report/view/?repid-link=40&cat-link=47&page=6&sort=level_service, accessed 2 February, 2022.
Khamooshi P. The benefits of using web-based applications. Available from: https://www.geeks.ltd.uk/insights/the-benefits-of-using-web-based-applications, accessed 5 May, 2021.
Kwon S, Reich MR. The Changing Process and Politics of Health Policy in Korea. J Health Polit Policy Law. 2005; 30(6): 1003–26. DOI: 10.1215/03616878-30-6-1003
Kijpan P. Separation of prescribing and dispensing. FDA Journal. 2017: 4-8
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