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Table 2 Views and opinions of the panelists on EHRs with embedded CDSSs

From: Merits, features, and desiderata to be considered when developing electronic health records with embedded clinical decision support systems in Palestinian hospitals: a consensus study

 

Item

n

%

Qualitative comments

Source of the xitem

 

Compared to paper-based handwritten patient records, EHRs with embedded CDSSs can:

Patient safety

1. Reduce medication errors

   

B

Strongly agree

53

69.7

EHRs might be associated with other types of errors like omissions and entry of inaccurate information

 

Agree

18

23.7

Neutral

3

3.9

Disagree

1

1.3

Strongly disagree

1

1.3

2. Reduce adverse reactions

   

B

Strongly agree

26

34.2

Evidence for reducing adverse medication reactions is mixed

 

Agree

33

43.4

 

Neutral

12

15.8

 

Disagree

3

3.9

 

Strongly disagree

2

2.6

 

3. Improve communication between healthcare providers

   

B

Strongly agree

27

35.5

In case of inaccurate information, more interactions are needed for corrective actions

 

Agree

41

53.9

 

Neutral

6

7.9

 

Disagree

1

1.3

 

Strongly disagree

1

1.3

 

4. Improve overall patient care experience

   

B

Strongly agree

36

47.4

Poor design of systems, drop-down menus, screen design, and automatic filling functions might increase likelihood of errors and may negatively impact the overall patient care experience

 

Agree

25

32.9

 

Neutral

12

15.8

 

Disagree

2

2.6

 

Strongly disagree

1

1.3

 

Cost

5. Improve prescriber’s ability to prescribe more cost-effective medications

   

I

Strongly agree

18

23.7

This might be dependent on the list of product options available in the system

 

Agree

34

44.7

 

Neutral

18

23.7

 

Disagree

4

5.3

 

Strongly disagree

2

2.6

 

6. Increase prescriber’s likelihood to discontinue unnecessary and/or ineffective medications

   

B

Strongly agree

14

18.4

Evidence for reducing ineffective medications is mixed

 

Agree

42

55.3

 

Neutral

15

19.7

 

Disagree

2

2.6

 

Strongly disagree

3

3.9

 

7. Decrease costs associated with adverse medication reactions and medication errors

   

I

Strongly agree

51

67.1

EHRs are associated with other types of errors

 

Agree

16

21.1

 

Neutral

6

7.9

 

Disagree

2

2.6

 

Strongly disagree

1

1.3

 

Record keeping

8. Improve storage of patient information and prescription records

   

L

Strongly agree

53

69.7

More efforts are needed to keep and maintain copies of these electronic copies

 

Agree

21

27.6

 

Neutral

2

2.6

 

Disagree

0

0

 

Strongly disagree

0

0

 

9. Improve prescriber’s ability to trace patient’s prescribing information

   

B

Strongly agree

50

65.8

More efforts are needed to improve search and retrieval activities

 

Agree

23

30.3

 

Neutral

3

3.9

 

Disagree

0

0

 

Strongly disagree

0

0

 

10. Improve prescriber’s ability to monitor medications and evaluate clinical outcomes

   

L

Strongly agree

31

40.8

More efforts are needed to improve reminders that should pop-up only when necessary to avoid prescriber’s desensitization

 

Agree

26

34.2

 

Neutral

15

19.7

 

Disagree

2

2.6

 

Strongly disagree

2

2.6

 

Workflow

11. Reduce wait times needed to call prescribers to clarify illegible or ambiguous medication orders

   

B

Strongly agree

38

50

In case of technology failures and system malfunctions, more wait times are needed

 

Agree

27

35.5

 

Neutral

9

11.8

 

Disagree

1

1.3

 

Strongly disagree

1

1.3

 

12. Improve workflow of prescribers and other healthcare team by enabling copying and editing of prescribing information

   

L

Strongly agree

14

18.4

Workflow challenges, more personnel, training, and maintenance efforts are needed

 

Agree

22

28.9

 

Neutral

17

22.4

 

Disagree

12

15.8

 

Strongly disagree

11

14.5

 
  1. B both (literature and interviews), EHRs electronic health records, CDSSs clinical decisions support systems, I interviews, L literature