Literature Review: Intensifying Primary Care with E-Pharmacy Practices

This document presents a literature review focusing on the adoption of e-pharmacy practices to enhance primary care, utilizing reasoning systems. It analyzes various research articles, including one focusing on e-prescribing in rural communities, highlighting the ERx tool's potential to reduce prescription errors and improve electronic health records (EHR). The review examines the process, advantages, and disadvantages of ERx implementation, emphasizing communication, internet accessibility, and confirmation processes. It also discusses the impact of web-based applications in healthcare, emphasizing benefits such as reduced human effort and improved patient history tracking, while also acknowledging challenges like training costs and potential limitations. The review evaluates the effectiveness and potential improvements for integrating technology into pharmacy and primary care, suggesting enhancements like incorporating rural pharmacist supply chains and mobile connectivity for patients. Desklib offers a wide array of study tools and resources, including similar assignments and past papers to aid students in their academic pursuits.

Literature Review (Secondary Research) Template
Student Name & CSU
ID
Project Topic Title Intensifying primary care perspective with adoption of e pharmacy practices using reasoning system
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Version 1.0 _ Week 1
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Reference in APA format Kooienga, S., & Singh, R. L. (2017). Pharmacy and primary care perspectives on e-prescribing in a
rural community: A focused ethnography. Research in Social and Administrative Pharmacy, 13(4),
820-830.
URL of the Reference Authors Names and Emails
and Level of Journal (Q1, Q2, …Qn)
Keywords in this Reference
https://www-sciencedirect-
com.ezproxy.csu.edu.au/science/
article/pii/S1551741116303291
Sarah Kooienga and Reshmi L. Singh.
Level of Journal “Q1”
Pharmacist, Rural population, Electronic prescribing,
Digital divide, Primary health care.
The Name of the Current Solution
(Technique/ Method/ Scheme/
Algorithm/ Model/ Tool/ Framework/
... etc )
The Goal (Purpose) of this Solution &
What is the Problem that needs to be
solved
What are the components of it?
Name of the current solution: ERx
tool for E-prescription
Techniques: Information technology
Tools: ERx
Applied Area: Rural and urban area to
develope pharmacy prescription
Problem: Errors in manual prescription
made by doctors, understandable writing,
lack of accuracy about a pharmaceutical
prescription for medical care. The author
has analysed this problem by analysing the
rural primary health care settings according
to which he has found that 14% of medical
practice cases are recorded in the EHR
(Electronic Health Records). It is the
current problem which is the reason behind
this to conduct a research on it.
Goal: To develop an easy, safe, fast and
List of components of ERx
 Information Technology
 Digital prescription
 Pharmacists
 Doctors and nursing practitioners
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errorless prescribing process to keep EHR
(Electronic Health Records).
The Process (Mechanism) of this Work; Means How the Problem has Solved & Advantage & Disadvantage of Each Step in This Process
Process Steps Advantage Disadvantage (Limitation)
1 Relationship-based activity This stage has effectively worked to
identify the possible problems to develop
an e-prescription.
It is based on the skills of a pharmacist
and primary care providers so it can be
affected by their knowledge and skills.
2 Accessibility of the internet It helps to the pharmacist and primary care
providers which are working in the rural
areas to be connected to share e-
prescription.
Rural areas have many challenges to be
connected with high data transmission
internet. The environment is another
factor which may be hindered in the
internet accessibility.
3 Communication in between patients and
primary care providers
In rural areas most probably a medical care
provider knows the patients personally so
it helps in an appropriate diagnosis of
disease and reason behind to be ill.
It is highly affected by the personal
relations who sometimes decrease the
significance of the case and diagnose the
case in an effective manner.
4 Confirmation of e-prescription It is effective for the patients to get an
availability confirmation notification about
their medicines as prescribed.
It takes a time to ready a set of medicine
by the pharmacist for patients so the late
notification can decrease the
effectiveness of medicines.
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Major Impact Factors in this Work
Dependent Variable Independent Variable
Communication is a dependent variable which is grounded in
the patient, primary medical care provider and pharmacist.
Patients, primary medical care and pharmacist are the dependent
variables which have developed a better role to design the process of
ERx to develop errorless processing of e-prescription.
E-prescription is generated by the primary medical service
providers in the rural areas after diagnosing the patient so e-
prescription is the dependent variable.
The context of rurality is independent elements which have a huge
impact on the e-prescription process.
Internet connectivity is a dependent variable which is
grounded in the context of rurality and environmental factors.
Natural disaster and environmental changes can be a cause of internet
access and connectivity which can develop a huge negative effect on
the ERx.
Input and Output A feature of This Solution Contribution & The Value of This Work
Input Output
Information
collected from
patients to analyse
their problems and
issues
An errorless and
appropriately
developed digital
prescription for
medicines for a
specific patient
It also impacts on the electronic health
records which can help to the medical
practitioners to review past history of the
cases. Currently, 14% medical cases are
electronically recorded which a challenge for
the healthcare service provider authorities to
improve the electronic records.
The author has developed a process of ERx
which supports to digitalize the process of the
medical prescription to eliminate the errors,
issues and doubts within pharmacists and
primary medical care provider.
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1. what in the method could have been
better?
2. what in the author analyses were
missed?
3. was there a technique that could have been
used or a question that could have been
asked, that the researchers did not use or
ask?
ERx with EHR is better to enhance the
validity of the e-prescription for the patients
to keep a record.
Rural pharmacist’s supply chain is not added
to the solution process which decreases the
effect of the solution on the goal.
Author has to synch this identified process with
the mobile number connection of the patient to
send e-prescription as a message.
4. were the conclusion justified and How? Analyse This Work By Critical Thinking The Tools That Assessed this Work
According to the author, The Ecological
Transactional Model is appropriate to
conduct primary and secondary research. As
the author has effectively done both types of
research it is justified. Author has explained
the relationship based transaction is effective
to develop a better collaboration between the
healthcare practitioners and pharmacist.
1. The author has developed ERx for rural
areas mainly because they are having a huge
need for medical care benefits. It helps them
to decrease the travelling possibilities for
medical care.
2. The author has identified the ERx as a
better tool to develop an errorless prescription
but it is also effective to use a hard copy of
the medical prescription to remind about
medicines for the patients. Most of the
patients get confused while taking medicines
about the time to take it so the hard copy is
effective to recognize the medicine.
The author has used the patients to take their
feedback about the process which justified that
ERx is effective for them to get a better medical
service.
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Diagram/Flowchart
Figure 1: An adaptation of the ecological transactional systemic map of primary care
Figure 2: Contextual understandings and dimensions impacting
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Reference in APA format Zadeh, P. E., & Tremblay, M. C. (2016). A review of the literature and proposed classification on e-
prescribing: Functions, assimilation stages, benefits, concerns, and risks. Research in Social and
Administrative Pharmacy, 12(1), 1-19.
URL of the Reference Authors Names and Emails
and Level of Journal (Q1, Q2, …Qn)
Keywords in this Reference
https://ac-els-cdn-
com.ezproxy.csu.edu.au/
S1551741115000431/1-s2.0-
S1551741115000431-main.pdf?
_tid=aa0eec9c-4eaa-45ac-a89d-
7accb3e985bd&acdnat=1520062002_3
89869aaa93f14a33ad1612c1acccf60
Pouyan Esmaeil Zadeh, Monica Chiarini
Tremblay,
E-Prescribing; Prescribers ;E-Prescription; Benefits;
Pharmacies; Risks; Medication errors; Assimilation
stages
The Name of the Current Solution
(Technique/ Method/ Scheme/
Algorithm/ Model/ Tool/ Framework/
... etc )
The Goal (Purpose) of this Solution &
What is the Problem that need to be
solved
What are the components of it?
The name of the solution is to Develop
updated online applications for entering
the prescription
Tools: latest web-based applications
Applied Area: Providing medication to
the patients
Problem: entering incorrect prescription
results in providing wrong treatments and
increase medication costs
Goal: Develop the interface which reduces
error while entering the prescription by
using web-based applications.
 Pharmacists
 Pharmacy
 Physicians
 Nurses and clinical staff
 Multidisciplinary team (clinicians, pharmacists
and researchers)
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The Process (Mechanism) of this Work; Means How the Problem has Solved & Advantage & Disadvantage of Each Step in This Process
Process Steps Advantage Disadvantage (Limitation)
1 Develop the online system Patients will be able to order medicines
online
The prescription is entered manually
which may result in entering incorrect
prescription
2 Use of web-based application to enter details Patient history can be tracked easily and
medicines can be prescribed accordingly
Lack of knowledge of using the software
may create errors
3 Developing Training programmes Efficiency in operation and patients
records can be viewed online which
enables the doctors to accurately provide
the treatment
Additional costs for training the staff
and nurses
4 Difference between using paper and e-
prescription
Minimising the human effort since all the
details of the patients are entered by using
the application
A complete online system is still being
developed
Major Impact Factors in this Work
Dependent Variable Independent Variable
Web-based infrastructures such as online platforms and use of Providing prescription to the patients and providing patient care
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the internet services
Communication between physicians and hospital staff for
implementing the web-based platform
Maintaining the complete records of the patient by hospital staff and
providing the information to the physicians as and when required
The interaction between physicians and pharmacists for
providing e-prescription
Providing the medicines required to the patients as per the
prescription provided by the physicians.
Providing patient information by using Clinical Decision
Support (CDS) and monograph in order to ascertain the dose
calculation and drug allergies
Checking the medical condition of the patient before prescribing the
medication which includes the side-effects of the prescribed
medication in order to ascertain the level of improvement in the
health of patients
Input and Output Feature of This Solution Contribution & The Value of This Work
Input Output
Use of web-based
application for
recording patient
details
Improved medical
services provided to
the patients
Use of web-based application reduces the
human efforts to record and maintain the
prescription. Complete patient history,
including medication type and current
medical conditions, can be easily ascertained
by the physicians.
The physicians will be able to ascertain the
progress of the patients online and hence,
treatment facilities provided to the patients can
be improved
1. what in the method could have been
better?
2. what in the author analyses were
missed?
3. was there a technique that could have been
used, or a question that could have been
asked, that the researchers did not use or
ask?
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The ratio analysis could have been done to
ascertain the success of using the web-based
application. The other benefits to the staff and
Nurses such as enhanced knowledge of
internet and their career prospects can also be
added to support the use of web-based
applications in hospitals.
The number of patients who can be benefited
by using the web-based applications can be
further analysed. Also, the benefits of web-
based applications to the pharmacists and
clinical staff can be elaborated since the
reduction of human effort with regard to
patient service has been evaluated
The questions related to the use of the internet
can be asked to the hospital staff in order to
ascertain the actual knowledge possessed by
them. The practical application of the technique
where the e-prescription is sent to pharmacists
can be done to check the viability of this
approach.
4. were the conclusion justified and
How?
Analyse This Work By Critical Thinking The Tools That Assessed this Work
The conclusion provided a detailed analysis
regarding the use of latest technologies in
hospitals and pharmacy. The advantages and
disadvantages were clearly stated along with
the ways in which the patient care services
can be improved.
The analyses of the problems and issues
related to the use of latest web-based
applications in health care services are clearly
stated. The views of the hospital and clinical
staff were recorded before drawing the
conclusion. However, the current knowledge
of hospital staff and patients could have been
included to understand the needs and
preferences of the patients.
Interviews were conducted to analyse the
possibilities of utilizing the web-based
applications to maintain the records of patients.
The interview was conducted by pharmacists,
physicians, nurses and clinical staff
Diagram/Flowchart
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Figure 3: Selection strategy for the review
Figure 4: The 3Ps model
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