Design challenges for electronic medication administration record systems in residential aged care facilities: a...

Area of Science:

• Health Informatics
• Aged Care Technology
• Medication Safety

Background:

• Electronic medication administration record (eMAR) systems are proposed to improve medication safety in residential aged care facilities (RACFs).
• An in-practice evaluation was conducted on a pilot eMAR system in an Australian RACF prior to wider implementation.

Purpose of the Study:

• To evaluate an eMAR system in a real-world setting within an Australian RACF.
• To identify challenges and provide recommendations for improving the eMAR system's design and workflow integration.

Main Methods:

• Direct workflow observations (34 hours) in RACFs and community pharmacies.
• Semi-structured interviews (n=5) with RACF staff and pharmacists.
• Grounded theory analysis to identify eMAR design challenges.

Main Results:

• The current eMAR system is not fully integrated, with manual processes (paper, fax) still used for prescribing and pharmacy communication.
• Identified design challenges include limited interactivity, inadequate flexibility, poor information layout, lack of decision support, and maintenance issues.
• Recommendations focus on improving system design and optimizing workflows.

Conclusions:

• Immediate improvements in system interactivity, data entry consistency, and organizational support are crucial.
• Longer-term benefits require decision support features and established interoperability with stakeholders like community pharmacies.
• In-practice evaluations are vital for uncovering design flaws that hinder optimal eMAR system use.