Economic impact of electronic prescribing in the hospital setting: A systematic review
File(s)Submitted paper 16 November 2015.pdf (1.79 MB)
Accepted version
Author(s)
Ahmed, Z
Barber, N
Jani, Y
Garfield, S
Franklin, BD
Type
Journal Article
Abstract
Objective
To examine evidence on the economic impact of electronic prescribing (EP) systems in the hospital setting.
Method
We conducted a systematic search of MEDLINE, EMBASE, PsycINFO, International Pharmaceutical Abstracts, the NHS Economic Evaluation Database, the European Network of Health Economic Evaluation Database and Web of Science from inception to October 2013. Full and partial economic evaluations of EP or computerized provider order entry were included. We excluded studies assessing prescribing packages for specific drugs, and monetary outcomes that were not related to medicines. A checklist was used to evaluate risk of bias and evidence quality.
Results
The search yielded 1160 articles of which three met the inclusion criteria. Two were full economic evaluations and one a partial economic evaluation. A meta-analysis was not appropriate as studies were heterogeneous in design, economic evaluation method, interventions and outcome measures. Two studies investigated the financial impact of reducing preventable adverse drug events. The third measured savings related to various aspects of the system including those related to medication. Two studies reported positive financial effects. However the overall quality of the economic evidence was low and key details often not reported.
Discussion
There seems to be some evidence of financial benefits of EP in the hospital setting. However, it is not clear if evidence is transferable to other settings. Research is scarce and limited in quality, and reported methods are not always transparent. Further robust, high quality research is required to establish if hospital EP is cost effective and thus inform policy makers’ decisions.
To examine evidence on the economic impact of electronic prescribing (EP) systems in the hospital setting.
Method
We conducted a systematic search of MEDLINE, EMBASE, PsycINFO, International Pharmaceutical Abstracts, the NHS Economic Evaluation Database, the European Network of Health Economic Evaluation Database and Web of Science from inception to October 2013. Full and partial economic evaluations of EP or computerized provider order entry were included. We excluded studies assessing prescribing packages for specific drugs, and monetary outcomes that were not related to medicines. A checklist was used to evaluate risk of bias and evidence quality.
Results
The search yielded 1160 articles of which three met the inclusion criteria. Two were full economic evaluations and one a partial economic evaluation. A meta-analysis was not appropriate as studies were heterogeneous in design, economic evaluation method, interventions and outcome measures. Two studies investigated the financial impact of reducing preventable adverse drug events. The third measured savings related to various aspects of the system including those related to medication. Two studies reported positive financial effects. However the overall quality of the economic evidence was low and key details often not reported.
Discussion
There seems to be some evidence of financial benefits of EP in the hospital setting. However, it is not clear if evidence is transferable to other settings. Research is scarce and limited in quality, and reported methods are not always transparent. Further robust, high quality research is required to establish if hospital EP is cost effective and thus inform policy makers’ decisions.
Date Issued
2015-12-03
Date Acceptance
2015-11-17
Citation
International Journal of Medical Informatics, 2015, 88, pp.1-7
ISSN
1872-8243
Publisher
Elsevier
Start Page
1
End Page
7
Journal / Book Title
International Journal of Medical Informatics
Volume
88
Copyright Statement
© 2015, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
National Institute for Health Research
Grant Number
HPRU-2012-10047
Subjects
Science & Technology
Technology
Life Sciences & Biomedicine
Computer Science, Information Systems
Health Care Sciences & Services
Medical Informatics
Computer Science
Health economics
Electronic prescribing
Computerized provider order entry
Systematic review
Hospital
PHYSICIAN ORDER-ENTRY
MEDICATION ERRORS
BENEFITS
CARE
COSTS
Publication Status
Published