Upgrading features of electronic health record systems to capture the impact of pharmacists in Palestinian healthcare facilities: a mixed method رسالة ماجستير

Abstract

Background: Many healthcare systems around the world have transitioned from paper-based patient record systems to more modern electronic health record systems (EHRs). Pharmacists are one of the most trusted and accessible healthcare providers. Today, pharmacists are increasingly involved in providing direct patient care services. Currently, little is known on how the currently used systems can be upgraded to allow documenting pharmaceutical services/pharmacist interventions. Additionally, little is known on how these documented pharmaceutical services/interventions can be used to evaluate performance of pharmacists, benchmark services, and improve patient health outcomes. This study was conducted to report on the use of EHRs by pharmacists in hospitalized patient settings, collect the view of the pharmacists on the features that they desire to be upgraded in the current EHR to capture their role in hospitalized patient settings. Methods: In phase 1, the databases: Medline/Pubmed, Cochrane, CINAHL/EBSCO, Embase, PsycINFO, and Scopus were systematically searched as late as April 10, 2021. Documents reporting on design/development of electronic health record systems to capture pharmaceutical services, use of electronic health record systems to improve/evaluate pharmaceutical care services/delivery, and/or measuring impact of pharmacists through EHRs were selected. In phase 2, in-depth semi-structured qualitative interviews were conducted with pharmacists, physicians, and IT/health informatics specialists. Results: A total of 741 documents were identified from the database searches. Additional 5 relevant documents were added to the search results. Upon initial screening, 653 documents were excluded. When the documents were screened against the inclusion and exclusion criteria, 73 documents were excluded and 20 documents were included in the systematic scoping review. Of the selected documents, 4 (20%) reported on use of EHRs by pharmacists, 7 (35%) reported on VII improvements to the pharmaceutical services brought by EHRs, 5 (25%) reported on using EHRs to capture impact of pharmacists, and 4 (20%) reported on the need to improve the design of EHRs. Semi-structured in-depth interviews were conducted with 17 participants. Of those, 9 (52.9%) were 40 years old and above, 9 (52.9%) were pharmacists, 15 (88.2%) were employed by a governmental hospital, and 10 (58.8%) had experience of 10 or more years. Qualitative analysis of the interviews allowed gaining insights into the importance of pharmacists as healthcare providers to hospitalized patients, perspectives of the participants on the EHR, and challenges and future outlooks. Conclusion: Findings of this thesis indicated that pharmacists were important healthcare providers that were neglected when EHRs were designed. Currently used EHRs allow limited capture of the role of pharmacists in caring for patients in hospitalized patient settings. Upgrading EHRs taking into consideration of the interviewees in this study might allow capturing the impact of pharmacists in caring for patients in hospitalized patient settings. Future studies are still needed to investigate if upgrading EHRs can improve healthcare delivery and health outcomes of patients in hospitalized settings