Implementation of an Electronic Medication System in a large tertiary hospital: A case of qualitative inquiry

Abstract Introduction There is a growing interest in the use of technology in the health sector in Australia. Hospitals across Australia are implementing Clinical Information Systems (CIS) e.g. Electronic Medication Systems (EMS) at a rapid space to moderate health service delivery. The implementation of an EMS is crucial in a big hospital organisation. The benefits of the EMS depend on the acceptance of the system by the clinicians. The study hospital used a unique patient-centric implementation strategy. This paper aims to study the factors facilitating or hindering the adoption of EMS as viewed by clinicians and the implementation team. Method Four focus group, one each for 1) doctors, 2) nurses 3) pharmacists 4) implementation team were conducted. A guide for the focus group was created based on the Unified Theory of Acceptance and Use of Technology (UTAUT). Results A total of 23 unique codes were identified and were grouped into five main themes 1) Implementation strategy 2) Organisational outcome of EMS 3) Individual impact of EMS 4) IT product and 5) Organisational culture. Clinicians reported improvement in their workflow efficiency post-EMS implementation. They also reported some challenges in using the EMS that centered around the area of infrastructure, technical and design issues. Additionally, the implementation team highlighted two crucial factors influencing the success of EMS implementation, namely: 1) the patient-centric implementation strategy, and 2) the organisation readiness. Conclusion Overall, this study provides substantial evidence of the use of the behavior theory of UTAUT in explaining the implementation process of EMS in a large healthcare facility by using clinicians’ and the implementation team’s perspectives. A unique implementation strategy with the patient-centric approach and clinical leadership in the implementation team played a crucial role in clinicians’ acceptance of the EMS. Perceived and realised benefits helped clinicians to form a positive attitude in the adoption of EMS. On the other hand, general training instead of customised training based on local needs, technical and design issues and lack of availability of computer systems can act as a barrier to the adoption of the system. Promptly resolving these issues can improve the adoption of the EMS.