{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T09:17:03Z","timestamp":1780564623170,"version":"3.54.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001774","name":"the university of sydney","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001774","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hospitals across Australia are implementing Clinical Information Systems, e.g. Electronic Medication Management Systems (EMMS) at a rapid pace to moderate health services. The benefits of the EMMS depend on the acceptance of the system by the clinicians. The study hospital used a unique patient-centric implementation strategy that was based on the guiding principle of \u201cone patient, one chart\u201d to avoid a patient being on a\u00a0hybrid medication chart. This paper aims to study the factors facilitating or hindering the adoption of the EMMS as viewed by clinicians and the implementation team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four focus groups (FG), one each for (1) doctors, (2) nurses, (3) pharmacists, and (4) implementation team, were conducted. A guide for the FG was based on the Unified Theory of Acceptance and Use of Technology (UTAUT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 23 unique subthemes were identified and were grouped into five main themes (1) implementation strategy, (2) organisational outcome of EMMS, (3) individual impact of EMMS, (4) IT product, and (5) organisational culture. Clinicians reported improvement in their workflow efficiency post-EMMS implementation. They also reported some challenges in using the EMMS that centered around the area of infrastructure, technical and design issues. Additionally, the implementation team highlighted two crucial factors influencing the success of EMMS implementation, namely: (1) the patient-centric implementation strategy, and (2) the organisation readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall, this study outlines the implementation process of the EMMS in a large healthcare facility from the clinicians\u2019 and the implementation team\u2019s perspectives using UTAUT model. The result suggests that clinicians\u2019 acceptance of the EMMS was highly influenced by the unique implementation strategy (namely, patient-centric approach and clinical leadership in the implementation team). Whereas the level of adoption of EMMS by clinicians was determined by their level of perceived and realised benefits. On the other hand, a number of barriers to the adoption of EMMS were discovered, namely, general training instead of customised training based on local needs, technical and design issues and lack of availability of computer systems. It is suggested that promptly resolving these issues can improve the adoption of the EMMS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12911-021-01584-w","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T04:02:57Z","timestamp":1627358577000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0128-4757","authenticated-orcid":false,"given":"Milan Rasikbhai","family":"Vaghasiya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Penm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin K. Y.","family":"Kuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naren","family":"Gunja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiren","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eui Dong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neysa","family":"Petrina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Poon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"1584_CR1","unstructured":"Australian Digital Health Agency. Australia\u2019s National Digital Health Strategy. Canberra; 2018."},{"key":"1584_CR2","unstructured":"Porterfield A, Engelbert K, Coustasse A. Electronic prescribing: improving the efficiency and accuracy of prescribing in the ambulatory care setting. Perspect Heal Inf Manag. 2014;11 Spring:1g."},{"key":"1584_CR3","first-page":"693","volume":"180","author":"A Cufar","year":"2012","unstructured":"Cufar A, Droljc A, Orel A. Electronic medication ordering with integrated drug database and clinical decision support system. Stud Health Technol Inform. 2012;180:693\u20137.","journal-title":"Stud Health Technol Inform"},{"key":"1584_CR4","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1093\/intqhc\/mzv046","volume":"27","author":"JD Hron","year":"2015","unstructured":"Hron JD, Manzi S, Dionne R, Chiang VW, Brostoff M, Altavilla SA, et al. Electronic medication reconciliation and medication errors. Int J Qual Heal Care. 2015;27:314\u20139.","journal-title":"Int J Qual Heal Care"},{"key":"1584_CR5","doi-asserted-by":"publisher","first-page":"e1001164","DOI":"10.1371\/journal.pmed.1001164","volume":"9","author":"JI Westbrook","year":"2012","unstructured":"Westbrook JI, Reckmann M, Li L, Runciman WB, Burke R, Lo C, et al. Effects of two commercial electronic prescribing systems on prescribing error rates in hospital in-patients: a before and after study. PLoS Med. 2012;9:e1001164.","journal-title":"PLoS Med"},{"key":"1584_CR6","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1197\/aemj.9.11.1168","volume":"9","author":"KE Bizovi","year":"2002","unstructured":"Bizovi KE, Beckley BE, McDade MC, Adams AL, Lowe RA, Zechnich AD, et al. The effect of computer-assisted prescription writing on emergency department prescription errors. Acad Emerg Med. 2002;9:1168\u201375.","journal-title":"Acad Emerg Med"},{"key":"1584_CR7","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1111\/acem.12678","volume":"22","author":"U Sethuraman","year":"2015","unstructured":"Sethuraman U, Kannikeswaran N, Murray KP, Zidan MA, Chamberlain JM. Prescription errors before and after introduction of electronic medication alert system in a pediatric emergency department. Acad Emerg Med. 2015;22:714\u20139.","journal-title":"Acad Emerg Med"},{"key":"1584_CR8","doi-asserted-by":"publisher","first-page":"e8436","DOI":"10.5812\/ircmj.8436","volume":"15","author":"M Samadbeik","year":"2013","unstructured":"Samadbeik M, Ahmadi M, Hosseini Asanjan SM. A theoretical approach to electronic prescription system: lesson learned from literature review. Iran Red Crescent Med J. 2013;15:e8436.","journal-title":"Iran Red Crescent Med J"},{"key":"1584_CR9","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.jcrc.2013.10.016","volume":"29","author":"ER Armada","year":"2014","unstructured":"Armada ER, Villama\u00f1\u00e1n E, L\u00f3pez-de-S\u00e1 E, Rosillo S, Rey-Blas JR, Testillano ML, et al. Computerized physician order entry in the cardiac intensive care unit: effects on prescription errors and workflow conditions. J Crit Care. 2014;29:188\u201393.","journal-title":"J Crit Care"},{"key":"1584_CR10","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1016\/j.ijmedinf.2012.07.011","volume":"81","author":"RS Cartmill","year":"2012","unstructured":"Cartmill RS, Walker JM, Blosky MA, Brown RL, Djurkovic S, Dunham DB, et al. Impact of electronic order management on the timeliness of antibiotic administration in critical care patients. Int J Med Inform. 2012;81:782\u201391.","journal-title":"Int J Med Inform"},{"key":"1584_CR11","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1016\/j.ijmedinf.2007.10.008","volume":"77","author":"TR Cunningham","year":"2008","unstructured":"Cunningham TR, Geller ES, Clarke SW. Impact of electronic prescribing in a hospital setting: a process-focused evaluation. Int J Med Inform. 2008;77:546\u201354.","journal-title":"Int J Med Inform"},{"key":"1584_CR12","first-page":"12","volume":"48","author":"G Lau","year":"2019","unstructured":"Lau G, Ho J, Lin S, Yeoh K, Wan T, Hodgkinson M. Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: a qualitative study at a multisite Australian hospital network. Heal Inf Manag J. 2019;48:12\u201323.","journal-title":"Heal Inf Manag J"},{"key":"1584_CR13","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1136\/qshc.2006.019505","volume":"16","author":"N Barber","year":"2007","unstructured":"Barber N, Cornford T, Klecun E. Qualitative evaluation of an electronic prescribing and administration system. BMJ Qual Saf. 2007;16:271\u20138.","journal-title":"BMJ Qual Saf"},{"key":"1584_CR14","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1007\/s11096-013-9771-2","volume":"35","author":"E Villama\u00f1\u00e1n","year":"2013","unstructured":"Villama\u00f1\u00e1n E, Larrubia Y, Ruano M, V\u00e9lez M, Armada E, Herrero A, et al. Potential medication errors associated with computer prescriber order entry. Int J Clin Pharm. 2013;35:577\u201383.","journal-title":"Int J Clin Pharm"},{"key":"1584_CR15","doi-asserted-by":"crossref","unstructured":"Redwood S, Rajakumar A, Hodson J, et al. Does the implementation of an electronic prescribing system create unintended medication errors? A study of the sociotechnical context through the analysis of reported medication incidents. BMC Med Inform Decis Mak 2011;11(29):1\u201311.","DOI":"10.1186\/1472-6947-11-29"},{"key":"1584_CR16","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1177\/0193945914567359","volume":"37","author":"AA Abbott","year":"2015","unstructured":"Abbott AA, Fuji KT, Galt KA. A qualitative case study exploring nurse engagement with electronic health records and E-prescribing. West J Nurs Res. 2015;37:935\u201351.","journal-title":"West J Nurs Res"},{"key":"1584_CR17","unstructured":"Rizer MK, Kaufman B, Sieck CJ, Hefner JL, McAlearney AS. Top 10 lessons learned from electronic medical record implementation in a large academic medical center. Perspect Heal Inf Manag. 2015;12 Summer:1g."},{"key":"1584_CR18","unstructured":"Ash JS, Sittig DF, Campbell E, Guappone K, Dykstra RH. An unintended consequence of CPOE implementation: shifts in power, control, and autonomy. In: AMIA Annual Symposium Proceedings. American Medical Informatics Association; 2006. p. 11\u20135."},{"key":"1584_CR19","first-page":"140","volume":"46","author":"U Guo","year":"2017","unstructured":"Guo U, Chen L, Mehta PH. Electronic health record innovations: Helping physicians\u2014One less click at a time. Heal Inf Manag J. 2017;46:140\u20134.","journal-title":"Heal Inf Manag J"},{"key":"1584_CR20","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1287\/mnsc.46.2.186.11926","volume":"46","author":"V Venkatesh","year":"2000","unstructured":"Venkatesh V, Davis FD. A theoretical extension of the technology acceptance model: four longitudinal field studies. Manag Sci. 2000;46:186\u2013204.","journal-title":"Manag Sci"},{"key":"1584_CR21","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.ijmedinf.2008.06.006","volume":"78","author":"VP Aggelidis","year":"2009","unstructured":"Aggelidis VP, Chatzoglou PD. Using a modified technology acceptance model in hospitals. Int J Med Inform. 2009;78:115\u201326.","journal-title":"Int J Med Inform"},{"key":"1584_CR22","unstructured":"Schultz R, Ginzberg, MJ, Lucas Jr HC. A Structural Model of Implementation. NYU Working Paper. 1983;IS83-98, Available at SSRN: https:\/\/ssrn.com\/abstract=1290167."},{"key":"1584_CR23","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1136\/bmjqs-2017-006631","volume":"27","author":"SJ Puaar","year":"2018","unstructured":"Puaar SJ, Franklin BD. Impact of an inpatient electronic prescribing system on prescribing error causation: a qualitative evaluation in an English hospital. BMJ Qual Saf. 2018;27:529\u201338.","journal-title":"BMJ Qual Saf"},{"key":"1584_CR24","first-page":"33","volume":"24","author":"K Owens","year":"2008","unstructured":"Owens K. Defining the evolving role of the EMR implementation team. J Med Pract Manag. 2008;24:33\u20135.","journal-title":"J Med Pract Manag"},{"key":"1584_CR25","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1136\/amiajnl-2013-002203","volume":"21","author":"M-P Gagnon","year":"2014","unstructured":"Gagnon M-P, Nsangou \u00c9-R, Payne-Gagnon J, Grenier S, Sicotte C. Barriers and facilitators to implementing electronic prescription: a systematic review of user groups\u2019 perceptions. J Am Med Inf Assoc. 2014;21:535\u201341.","journal-title":"J Am Med Inf Assoc"},{"key":"1584_CR26","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1108\/14637150710752317","volume":"13","author":"S Shang","year":"2007","unstructured":"Shang S, Seddon PB. Managing process deficiencies with enterprise systems. Bus Process Manag J. 2007;13:405\u201316.","journal-title":"Bus Process Manag J"},{"key":"1584_CR27","first-page":"169","volume":"25","author":"N Gunja","year":"2018","unstructured":"Gunja N, Dunlop I, Vaghasiya M, Kuan K, Poon S. Patient-centric implementation of an electronic medication management system at a tertiary hospital in Western Sydney. J Innov Heal Inf. 2018;25:169\u201375.","journal-title":"J Innov Heal Inf"},{"key":"1584_CR28","first-page":"279","volume":"23","author":"K Owens","year":"2008","unstructured":"Owens K. EMR implementation: big bang or a phased approach? J Med Pract Manag. 2008;23:279\u201381.","journal-title":"J Med Pract Manag"},{"key":"1584_CR29","doi-asserted-by":"publisher","first-page":"425","DOI":"10.2307\/30036540","volume":"27","author":"M Venkatesh","year":"2003","unstructured":"Venkatesh M, Davis D. User acceptance of information technology: toward a unified view. Manag Inf Syst Q. 2003;27:425\u201378.","journal-title":"Manag Inf Syst Q"},{"key":"1584_CR30","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/978-3-642-69746-3_2","volume-title":"Action control","author":"I Ajzen","year":"1985","unstructured":"Ajzen I. From intentions to actions: a theory of planned behavior. In: Kuhl J, Beckmann J, editors. Action control. Berlin: Springer; 1985. p. 11\u201339."},{"key":"1584_CR31","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77\u2013101.","journal-title":"Qual Res Psychol"},{"key":"1584_CR32","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1136\/qshc.2006.019505","volume":"16","author":"N Barber","year":"2007","unstructured":"Barber N, Cornford T, Klecun E. Qualitative evaluation of an electronic prescribing and administration system. Qual Saf Health Care. 2007;16:271\u20138.","journal-title":"Qual Saf Health Care"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-021-01584-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12911-021-01584-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-021-01584-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T04:04:04Z","timestamp":1627358644000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedinformdecismak.biomedcentral.com\/articles\/10.1186\/s12911-021-01584-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,27]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1584"],"URL":"https:\/\/doi.org\/10.1186\/s12911-021-01584-w","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.2.11632\/v1","asserted-by":"object"}]},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,27]]},"assertion":[{"value":"4 March 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval for this study was obtained from the Western Sydney Local Health District Human Ethics Committee (Ref. No. AU RED LNR\/16\/WMEAD\/359). Participants\u2019 written and oral consents were obtained before the FG.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publications"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"226"}}