A Conceptual Framework for Evaluating Outpatient Electronic Prescribing Systems Based on Their Functional Capabilities

Electronic prescribing (e-prescribing) may substantially improve health care quality and efficiency, but the available systems are complex and their heterogeneity makes comparing and evaluating them a challenge. Analyses of two commercial e-prescribing systems are presented as examples of applying the conceptual framework for anticipating the effects of alternative designs for outpatient e-prescribing systems. The proposed framework evaluated 14 e-prescribing functional capabilities within the medical management model. Evidence is identified to support eight specific effects for six of the functional capabilities. Applying the framework involves identifying an e-prescribing system's functional capabilities within the process model and then assessing the effects that could be expected from each capability in the proposed clinical environment. The proposed conceptual framework supports the integration of available evidence in considering the full range of effects from e-prescribing design alternatives. More research is needed into the effects of specific e-prescribing functional alternatives. Until more is known, e-prescribing initiatives should include provisions to monitor for unintended hazards.