Optimising hospital electronic prescribing systems: A Systematic Scoping Review

Jac Williams, Stephen Malden, Catherine Heeney, Matt-Mouley Bouamrane, Mike Holder, Uditha Perera, David W Bates, Aziz Sheikh

Research output: Contribution to journalArticlepeer-review


Objectives: Considerable international investment in hospital electronic prescribing (ePrescribing) systems has been made, but despite this, it is proving difficult for most organisations to realise safety, quality and efficiency gains in prescribing. The objective of this work is to develop policy-relevant insights into the optimisation of hospital ePrescribing systems in order to maximise the benefits and minimise the risks of these expensive digital health infrastructures.

Methods: We undertook a systematic scoping review of the literature by searching Medline, Embase and CINAHL databases. We searched for primary studies reporting on ePrescribing optimisation strategies and independently screened and abstracted data until saturation was achieved. Findings were theoretically and thematically synthesised taking a medicines lifecycle perspective, incorporating consultative phases with domain experts.

Results: We identified 23,609 potentially eligible studies from which 1,367 satisfied our inclusion criteria. Thematic synthesis was conducted on a dataset of 76 studies, of which 48 were based in the United States (US). Key approaches to optimisation included: stakeholder engagement, system or process redesign, technological innovations, and education and training packages. Single-component interventions (n=26) described technological optimisation strategies focusing on a single, specific step in the prescribing process. Multi-component interventions (n=50), employed a combination of optimisation strategies, typically targeting multiple steps in the medicines management process.

Discussion: We identified numerous optimisation strategies for enhancing the performance of ePrescribing systems. Key considerations for ePrescribing optimisation include meaningful stakeholder engagement to re-conceptualise the service delivery model, and implementing technological innovations with supporting training packages to simultaneously impact on different facets of the medicines management process.
Original languageEnglish
JournalJournal of patient safety
Early online date14 May 2021
Publication statusPublished - 14 May 2021


  • Patient Safety
  • Quality of Health Care
  • Efficiency
  • ePrescribing
  • Health Information Systems
  • Medicines Management


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