Background: The Clinical Oncology Society of Australia guidelines recommend cancer therapy to be prescribed electronically to improve patient centred care and reduce medication related problems. Electronic chemotherapy prescribing systems (ECPS) replace paper-based chemotherapy charts and manual prescribing and so require substantial changes in the way pharmacists organise their work and perform their role.
Aim: To determine the impact of an electronic chemotherapy prescribing system on pharmacist time and workflows.
Methods: An observational time and motion study was conducted using the Work Observation Method by Activity Timing (WOMBAT) software. An observer followed 14 pharmacists in both inpatient and outpatient settings of a hospital for a total of 118 hours over the working hours of 9am – 5pm Monday to Friday. Observations occurred both before and after the implementation of an ECPS. Descriptive statistics were used to determine the proportion of total observed time spent in tasks.
Results: Pharmacists spent the highest proportion of their time communicating with health professionals both pre and post ECPS implementation (32.6% and 26.8%). This communication occurred with their pharmacist colleagues, doctors and nurses. Pharmacists spent a larger proportion of their time verifying chemotherapy protocols in the post period (10.1%) compared to the pre period (7.5%). The way pharmacists verified chemotherapy protocols changed with a decrease in the proportion of time spent reviewing paper records from 10.1% in the pre period to 2% in the post period.
Conclusion: This study provides new data on how pharmacists workflows are impacted after the implementation of electronic chemotherapy prescribing system. The results provide data to help us understand workflows in a new ECPS environment and will be critical in workforce planning.