Top

International Journal of Clinical Pharmacy

Open Access 04-01-2025 | Review Article

Investigating digital determinants shaping pharmacists’ preparedness for interoperability and health informatics practice evolution: a systematic review

Authors: Sabrina Ait Gacem, Hasniza Zaman Huri, Izyan A. Wahab, Abduelmula R. Abduelkarem

Published in: International Journal of Clinical Pharmacy

Abstract

Background

Fragmented healthcare systems hinder pharmacists’ access to comprehensive patient data, limiting their clinical role and posing health risks. Enhancing system interoperability and evaluating factors influencing pharmacists' readiness for technology-driven practice change is a crucial step.

Aim

This systematic review aimed to investigate the digital determinants of pharmacists’ readiness for technology-oriented practice change and interoperability.

Method

A systematic search of PubMed, Scopus, and Cochrane Library was conducted on August 7, 2023, with registration number INPLASY202380071. Search method was developed, and quality was assessed using the Boynton and Greenhalgh Quality Checklist (BGQC) and Critical Appraisal Skills Programme (CASP).

Results

The review included 13 studies, of which 7 (53.8%) included the study’s setting. Of the seven studies, most discussed the community pharmacy setting (n = 3, 23.1%), followed by hospital pharmacy (n = 1, 7.6%), and both settings (n = 3, 23.1%). The studies included several countries: the United Kingdom (UK), Canada, the United States of America (USA), Australia, India, Sweden, and Saudi Arabia. The studies discussed several medical health informatic technologies such as electronic health records and e-prescribing. The three most reported technology-related influencing factors were related to digital literacy and technology-oriented tailored training (n = 9, 69.2%), followed by technical system features (n = 6, 46.2%) and technology operations (n = 5, 38.5%). The overall readiness level for technology-related practice change was intermediate (n = 7, 53.8%), high (n = 3, 23.1%), and low (n = 3, 23.1%).

Conclusion

Digital literacy, tailored training, and system features are crucial for enhancing pharmacists’ readiness for technology adoption, highlighting the need for improved digital infrastructure and interoperability in clinical practice.

Available only for authorised users

Olaronke I, Soriyan A, Gambo I, et al. Interoperability in healthcare: benefits, challenges and resolutions. Int J Innov Appl Stud. 2013;3:2028–9324.

Motulsky A, Couture I, Weir D, et al. Incorporating pharmacy dispensing records into medical records: usability challenges. Stud Health Technol Inform. 2016;221:126.PubMed

Li E, Clarke J, Ashrafian H, et al. The impact of electronic health record interoperability on safety and quality of care in high-income countries: systematic review. J Med Internet Res. 2022;24(9): e38144. https://doi.org/10.2196/38144.CrossRefPubMedPubMedCentral

Goldstein LH, Elias M, Ron-Avraham G, et al. Consumption of herbal remedies and dietary supplements amongst patients hospitalized in medical wards. Br J Clin Pharmacol. 2007;64(3):373–80. https://doi.org/10.1111/j.1365-2125.2007.02878.x.CrossRefPubMedPubMedCentral

Ben-Sasson M, Levy I, Ben-Arye E, et al. Dietary and herbal supplements use among patients hospitalized in internal medicine departments. Complement Ther Med. 2020;50:102345. https://doi.org/10.1016/j.ctim.2020.102345.CrossRefPubMed

Goundrey-Smith S. The connected community pharmacy: benefits for healthcare and implications for health policy. Front Pharmacol. 2018;9:1352. https://doi.org/10.3389/fphar.2018.01352.CrossRefPubMedPubMedCentral

Rezaei R, Chiew TK, Lee SP, et al. Interoperability evaluation models: a systematic review. Comput Ind. 2014;65(1):1–23. https://doi.org/10.1016/j.compind.2013.09.001.CrossRef

McManus R, Nemec EC, Ferer DS, et al. Suggested definitions for informatics terms: Interfacing, integration, and interoperability. Am J Health Syst Pharm. 2012;69(13):1163–5. https://doi.org/10.2146/ajhp110612.CrossRef

Sadek MM, Elnour AA, Al Kalbani NM, et al. Community pharmacy and the extended community pharmacist practice roles: The UAE experiences. Saudi Pharm J. 2016;24(5):563–70. https://doi.org/10.1016/j.jsps.2015.03.023.CrossRefPubMed

10.

Franklin B, Reynolds M, Hibberd R, et al. Community pharmacists’ interventions with electronic prescriptions in England: an exploratory study. Int J Clin Pharm. 2013;35:1030–5. https://doi.org/10.1007/s11096-013-9853-1.CrossRefPubMedPubMedCentral

11.

Tait L-A, Cassidy N, Jamieson D, et al. Medication supply at hospital discharge via community pharmacy: a quality improvement study. Int J Clin Pharm. 2023;45(6):1309–16. https://doi.org/10.1007/s11096-023-01635-4.CrossRefPubMed

12.

Tetzlaff L, Purohit AM, Spallek J, et al. Evaluating interoperability in German critical incident reporting systems. Stud Health Technol Inform. 2023;307:249–57. https://doi.org/10.3233/shti230722.CrossRefPubMed

13.

Wilson K, Khansa L. Migrating to electronic health record systems: a comparative study between the United States and the United Kingdom. Health Policy. 2018;122(11):1232–9. https://doi.org/10.1016/j.healthpol.2018.08.013.CrossRefPubMed

14.

Hogg A, Scott M, Fleming G, et al. The medicines optimisation innovation centre: a dedicated centre driving innovation in medicines optimisation-impact and sustainability. Int J Clin Pharm. 2024;46(5):1001–9. https://doi.org/10.1007/s11096-024-01775-1.CrossRefPubMedPubMedCentral

15.

Stoll JT, Böhmdorfer-McNair B, Jeske M, et al. Development and validation of a national clinical pharmacy competency framework for hospital pharmacists in Austria: a multi-method study. Int J Clin Pharm. 2024. https://doi.org/10.1007/s11096-024-01781-3.CrossRefPubMedPubMedCentral

16.

Sebugwaawo I. Unified health file system for all UAE hospitals by 2022. Khaleej Times; 2020. https://www.khaleejtimes.com/uae/unified-health-file-system-for-all-uae-hospitals-by-2022. Accessed 25 Sep 2024.

17.

Abdulrahman M, El-Hassan O, Redha MAA, et al. Adoption of electronic medical records in healthcare facilities in the emirate of Dubai. Healthc Inform Res. 2024;30(2):154–61. https://doi.org/10.4258/hir.2024.30.2.154.CrossRefPubMedPubMedCentral

18.

World Health Organization. Global Strategy on Digital Health 2020–2025; 2021. https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf. Accessed 4 Sep 2023.

19.

Hamdan AB, Manaf RA, Mahmud A. Challenges in the use electronic medical records in middle eastern countries: a narrative review. Malays J Med Health Sci. 2023;19(3):334–40. https://doi.org/10.47836/mjmhs18.5.43.CrossRef

20.

Alrahbi DA, Khan M, Gupta S, et al. Challenges for developing health-care knowledge in the digital age. J Knowl Manag. 2022;26(4):824–53. https://doi.org/10.1108/JKM-03-2020-0224.CrossRef

21.

Dahabreh F. Northumbria University. The continued usage of artificial intelligence in the United Arab Emirates public sector organisations: An extended information system success model. [Thesis (Doctoral)]: Northumbria University; 2023. https://nrl.northumbria.ac.uk/id/eprint/51629/ Accessed 25 Sep 2024.

22.

Fejzic J, Barker M. ‘The readiness is all.’—Australian pharmacists and pharmacy students concur with Shakespeare on work readiness. Pharm Educ. 2015;15:76–82.

23.

Martin LT, Nelson C, Yeung D, et al. The issues of interoperability and data connectedness for public health. Big Data. 2022;10(S1):S19–24. https://doi.org/10.1089/big.2022.0207.CrossRefPubMedPubMedCentral

24.

Sweet LE, Moulaison HL. Electronic health records data and metadata: challenges for big data in the United States. Big Data. 2013;1(4):245–51. https://doi.org/10.1089/big.2013.0023.CrossRefPubMed

25.

Matthew JP, Joanne EM, Patrick MB, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372: n71. https://doi.org/10.1136/bmj.n71.CrossRef

26.

Nazar Z, Naseralallah LM, Stewart D, et al. Application of behavioural theories, models, and frameworks in pharmacy practice research based on published evidence: a scoping review. Int J Clin Pharm. 2024;46(3):559–73. https://doi.org/10.1007/s11096-023-01674-x.CrossRefPubMedPubMedCentral

27.

Izudi J, Semakula D, Sennono R, et al. Protocol for systematic review and meta-analysis of treatment success rate among adult patients with tuberculosis in sub-Saharan Africa. BMJ Open. 2018;8(12): e024559. https://doi.org/10.1136/bmjopen-2018-024559.CrossRefPubMedPubMedCentral

28.

McGowan J, Sampson M, Salzwedel DM, et al. PRESS peer review of electronic search strategies: 2015 guideline statement. J Clin Epidemiol. 2016;75:40–6. https://doi.org/10.1016/j.jclinepi.2016.01.021.CrossRefPubMed

29.

Harrison R, Chauhan A, Le-Dao H, et al. Achieving change readiness for health service innovations. Nurs Forum. 2022;57(4):603–7. https://doi.org/10.1111/nuf.12713.CrossRefPubMedPubMedCentral

30.

Rafferty AE, Jimmieson NL, Armenakis AA. Change readiness: a multilevel review. J Manag. 2013;39(1):110–35.

31.

Armenakis AA, Harris SG, Mossholder KW. Creating readiness for organizational change. Human relations. 1993;46(6):681–703.CrossRef

32.

Eshet-Alkalai Y. Digital literacy: a conceptual framework for survival skills in the digital era. J Educ Multimed Hypermedia. 2004;13:93–106.

33.

Osterman MD. Digital literacy: definition, theoretical framework, and competencies. In: Plakhotnik MS, Nielsen SM, Pane DM, editors. Proceedings of the 11th Annual College of Education & GSN Research Conference, Florida; 2012. pp. 135–141. http://education.fiu.edu/research_conference/. Accessed 24 Sep 2024.

34.

von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9. https://doi.org/10.1016/j.jclinepi.2007.11.008.CrossRef

35.

Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019;13(Suppl 1):S31–4. https://doi.org/10.4103/sja.SJA_543_18.CrossRefPubMedPubMedCentral

36.

Weir NM, Newham R, Bennie M, et al. A systematic review of barriers and facilitators to national implementation strategies within community pharmacy. PROSPERO CRD42016038876, 2016.

37.

Boynton P, Greenhalgh T. Hands-on guide to questionnaire research: selecting, designing, and developing your questionnaire. BMJ (Clin Res Ed). 2004;328:1312–5. https://doi.org/10.1136/bmj.328.7451.1312.CrossRef

38.

Programme CAS. Critical Appraisal Checklists. Skills Programme. CASP Qualitative Checklist; 2024. https://creativecommons.org/licenses/by-nc-sa/4.0/. Accessed 26 Oct 2024.

39.

Programme CAS. CASP (Qualitative Studies Checklist); 2023. https://casp-uk.net/casp-tools-checklists/. Accessed 26 Oct 2024.

40.

Cresswell KM, Worth A, Sheikh A. Comparative case study investigating sociotechnical processes of change in the context of a national electronic health record implementation. Health Informatics J. 2012;18(4):251–70. https://doi.org/10.1177/1460458212445399.CrossRefPubMed

41.

McGinn CA, Gagnon M-P, Shaw N, et al. Users’ perspectives of key factors to implementing electronic health records in Canada: a Delphi study. BMC Med Inform Decis Mak. 2012;12(1):105. https://doi.org/10.1186/1472-6947-12-105.CrossRefPubMedPubMedCentral

42.

Grossman JM, Cross DA, Boukus ER, et al. Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies. J Am Med Inform Assoc. 2012;19(3):353–9. https://doi.org/10.1136/amiajnl-2011-000515.CrossRefPubMed

43.

Thomas P, Rutter P. A computer literacy skills profile of pharmacists residing in two counties of England. Health Info Libr J. 2009;25:288–94. https://doi.org/10.1111/j.1471-1842.2008.00767.x.CrossRef

44.

Balen RM, Jewesson PJ. Pharmacist computer skills and needs assessment survey. J Med Internet Res. 2004;6(1): e11. https://doi.org/10.2196/jmir.6.1.e11.CrossRefPubMedPubMedCentral

45.

Gosling AS, Westbrook JI. Allied health professionals’ use of online evidence: a survey of 790 staff working in the Australian public hospital system. Int J Med Inform. 2004;73(4):391–401. https://doi.org/10.1016/j.ijmedinf.2003.12.017.CrossRefPubMed

46.

Gour N, Srivastava D. Knowledge of computer among healthcare professionals of India: a key toward e-health. Telemed J E Health. 2010;16(9):957–62. https://doi.org/10.1089/tmj.2010.0049.CrossRefPubMed

47.

Clauson KA, Alkhateeb FM, Lugo KD, et al. E-prescribing: attitudes and perceptions of community pharmacists in Puerto Rico. Int J Electron Healthc. 2011;6(1):34–46. https://doi.org/10.1504/ijeh.2011.039057.CrossRefPubMed

48.

Rahimi B, Timpka T. Pharmacists’ views on integrated electronic prescribing systems: associations between usefulness, pharmacological safety, and barriers to technology use. Eur J Clin Pharmacol. 2011;67(2):179–84. https://doi.org/10.1007/s00228-010-0936-9.CrossRefPubMed

49.

Weir NM, Newham R, Dunlop E, et al. Factors influencing national implementation of innovations within community pharmacy: a systematic review applying the Consolidated Framework for Implementation Research. Implement Sci. 2019; 14, 21. https://doi.org/10.1186/s13012-019-0867-5.CrossRefPubMedPubMedCentral

50.

Lee G, Caton E, Ding A. Evaluating digital competencies for pharmacists. Res Social Adm Pharm. 2023;19(5):753–7. https://doi.org/10.1016/j.sapharm.2023.01.012.CrossRefPubMed

51.

MacLure K, Stewart D. Self-reported digital literacy of the pharmacy workforce in north east Scotland. Pharmacy. 2015. https://doi.org/10.3390/pharmacy3040182.CrossRefPubMedPubMedCentral

52.

MacLure K, Stewart D. A qualitative case study of ehealth and digital literacy experiences of pharmacy staff. Res Social Adm Pharm. 2018;14(6):555–63. https://doi.org/10.1016/j.sapharm.2017.07.001.CrossRefPubMed

53.

Alghamdi KS, Petzold M, Alsugoor MH, et al. Community pharmacists’ perspectives towards automated pharmacy systems and extended community pharmacy services: an online cross-sectional study. Explor Res Clin Soc Pharm. 2023;12:100363. https://doi.org/10.1016/j.rcsop.2023.100363.CrossRefPubMedPubMedCentral

54.

Lam MK, Nguyen M, Lowe R, et al. “I can do it”: Does confidence and perceived ability in learning new ICT skills predict pre-service health professionals’ attitude towards engaging in e-healthcare? HIC. 2014;204:60–6. https://doi.org/10.3233/978-1-61499-427-5-60.CrossRef

55.

Hovenga EJ. Health workforce competencies needed for a digital world. Health Inf Gov Digital Environ. 2013;141:68.

56.

Kreps G, Wright K, Burke-Garcia A. The use of digital communication channels to enhance environmental health literacy. Cham: Springer International Publishing; 2019. p. 265–83.CrossRef

57.

Ramachandran HJ, Oh JL, Cheong YK, et al. Barriers and facilitators to the adoption of digital health interventions for COPD management: a scoping review. Heart Lung. 2023;59:117–27. https://doi.org/10.1016/j.hrtlng.2023.02.004.CrossRefPubMed

58.

Alpert JM, Hampton CN, Markham MJ, et al. Clinicians’ attitudes and behaviors towards communicating electronically with patients: a grounded practical theory approach. J Health Commun. 2022;27(2):103–14. https://doi.org/10.1080/10810730.2022.2059723.CrossRefPubMed

59.

Akhlaq A, Sheikh A, Pagliari C. Health information exchange as a complex and adaptive construct: scoping review. J Innov Health Inform. 2017;23(4):889. https://doi.org/10.14236/jhi.v23i4.889.CrossRefPubMed

60.

Takian A, Sheikh A, Barber N. Organizational learning in the implementation and adoption of national electronic health records: case studies of two hospitals participating in the National Programme for Information Technology in England. Health Informatics J. 2014;20(3):199–212. https://doi.org/10.1177/1460458213493196.CrossRefPubMed

61.

Paré G, Trudel MC. Knowledge barriers to PACS adoption and implementation in hospitals. Int J Med Inform. 2007;76(1):22–33. https://doi.org/10.1016/j.ijmedinf.2006.01.004.CrossRefPubMed

62.

Ndlovu K, Scott RE, Mars M. Interoperability opportunities and challenges in linking mhealth applications and eRecord systems: Botswana as an exemplar. BMC Med Inform Decis Mak. 2021;21(1):246. https://doi.org/10.1186/s12911-021-01606-7.CrossRefPubMedPubMedCentral

63.

Thompson MJ, Reilly JD, Valdez RS. Work system barriers to patient, provider, and caregiver use of personal health records: a systematic review. Appl Ergon. 2016;54:218–42. https://doi.org/10.1016/j.apergo.2015.10.010.CrossRefPubMed

64.

Watkinson F, Dharmayat KI, Mastellos N. A mixed-method service evaluation of health information exchange in England: technology acceptance and barriers and facilitators to adoption. BMC Health Serv Res. 2021;21(1):737. https://doi.org/10.1186/s12913-021-06771-z.CrossRefPubMedPubMedCentral

65.

Niazkhani Z, Toni E, Cheshmekaboodi M, et al. Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review. BMC Med Inform Decis Mak. 2020;20(1):153. https://doi.org/10.1186/s12911-020-01159-1.CrossRefPubMedPubMedCentral

66.

Odendaal WA, AnsteyWatkins J, Leon N, et al. Health workers’ perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2020;3(3):Cd011942. https://doi.org/10.1002/14651858.CD011942.pub2.CrossRefPubMed

67.

Stoumpos AI, Kitsios F, Talias MA. Digital transformation in healthcare: technology acceptance and its applications. Int J Environ Res Public Health. 2023;20(4):3107. https://doi.org/10.3390/ijerph20043407.CrossRef

68.

Holland RW, Nimmo CM. Transitions in pharmacy practice, part 3: effecting change–the three-ring circus. Am J Health Syst Pharm. 1999;56(21):2235–41. https://doi.org/10.1093/ajhp/56.21.2235.CrossRefPubMed

69.

MacLure K, Stewart D. Digital literacy knowledge and needs of pharmacy staff: a systematic review. J Innov Health Inform. 2016;23(3):840. https://doi.org/10.14236/jhi.v23i3.840.CrossRefPubMed

70.

Flückiger L, Zaugg C, Fiumefreddo R. Impact of pharmacist-evaluated clinical decision support system alerts on potentially missing or inappropriately prescribed proton pump inhibitors at hospital discharge: a retrospective cross-sectional study. Int J Clin Pharm. 2024;46(5):1143–51. https://doi.org/10.1007/s11096-024-01746-6.CrossRefPubMedPubMedCentral

Title: Investigating digital determinants shaping pharmacists’ preparedness for interoperability and health informatics practice evolution: a systematic review
Authors: Sabrina Ait Gacem
Hasniza Zaman Huri
Izyan A. Wahab
Abduelmula R. Abduelkarem
Publication date: 04-01-2025
Publisher: Springer International Publishing
Published in: International Journal of Clinical Pharmacy
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI: https://doi.org/10.1007/s11096-024-01851-6

Keynote webinar | Spotlight on menopause

Menopause
Video Series

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the broader systemic effects of menopause, so you can help patients in your clinics through the transition.

Prof. Martha Hickey

Dr. Claudia Barth

Dr. Samar El Khoudary

Developed by: Springer Medicine

Watch now

Keynote webinar | Spotlight on adolescent vaping

Live
Webinar | 29-01-2025 | 18:00 (CET)

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Watch it live: Wednesday 29th January, 18:00-19:30 CET

Prof. Ann McNeill

Dr. Debbie Robson

Benji Horwell

Developed by: Springer Medicine

Join the webinar

Keynote webinar | Spotlight on modern management of frailty

Frailty in Geriatric Patients
On-demand webinar

Frailty has a significant impact on health and wellbeing, especially in older adults. Our experts explain the factors that contribute to the development of frailty and how you can manage the condition and reduce the risk of disability, dependency, and mortality in your patients.

Prof. Alfonso Cruz-Jentoft

Prof. Barbara C. van Munster

Prof. Mirko Petrovic

Developed by: Springer Medicine

Watch now

A quick guide to ECGs

Electrocardiography
Training Course

Improve your ECG interpretation skills with this comprehensive, rapid, interactive course. Expert advice provides detailed feedback as you work through 50 ECGs covering the most common cardiac presentations to ensure your practice stays up to date.

PD Dr. Carsten W. Israel

Developed by: Springer Medizin

Start the cases

At a glance: The STEP trials

Obesity
Clinical Trial Summary

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on adolescent vaping

Springer Medicine

Abstract

Background

Aim

Method

Results

Conclusion

Please log in to get access to this content

Keynote webinar | Spotlight on menopause

Keynote webinar | Spotlight on adolescent vaping

Keynote webinar | Spotlight on modern management of frailty

A quick guide to ECGs

At a glance: The STEP trials