Challenges and solutions in implementing electronic prescribing in Iran's health system: a qualitative study

Area of Science:

• Health Informatics
• Healthcare Management
• Information Systems in Medicine

Background:

• Electronic prescribing (e-prescribing) is a key strategy for enhancing healthcare delivery.
• Iran initiated nationwide e-prescribing system implementation in 2020, necessitating an evaluation of its progress in a developing country context.

Purpose of the Study:

• To explore the challenges encountered during the implementation of electronic prescribing systems in Iran.
• To identify potential solutions for overcoming these implementation barriers within the Iranian health system.

Main Methods:

• A qualitative study employing semi-structured interviews with physicians, pharmacy staff, and e-prescribing representatives.
• Purposive sampling was used, with data saturation guiding the number of participants (12 physicians, 15 representatives, 9 pharmacy staff).
• Inductive content analysis was performed using MAXQDA software, followed by expert panel sessions to formulate solutions.

Main Results:

• Key challenges were categorized into organizational (insurance, referrals, education, supervision) and systemic (infrastructure, user interface, database).
• Primary implementation barriers included system downtime, internet connectivity, and fragmented insurance systems.
• Proposed solutions focused on uniform software design, integrated referral systems, practical physician training, and electronic signatures.

Conclusions:

• Electronic prescribing in Iran is nascent and confronts significant challenges.
• Continuous monitoring and strategic interventions are crucial for addressing implementation issues.
• Recommendations include infrastructure enhancement, insurance system integration, standardized electronic signatures, and comprehensive training.