Design challenges for electronic medication administration record systems in residential aged care facilities: A formative evaluation

Tariq, A., Lehnbom, E., Oliver, K., Georgiou, A., Rowe, C., Osmond, T., & Westbrook, J. (2014) Design challenges for electronic medication administration record systems in residential aged care facilities: A formative evaluation. Applied Clinical Informatics, 5(4), pp. 971-987.

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Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements.


A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system.


The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues.We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows.


Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.

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ID Code: 92969
Item Type: Journal Article
Refereed: Yes
Keywords: Electronic medication administration records, Formative evaluation, Medication administration, Residential aged care facilities, System design
DOI: 10.4338/ACI-2014-08-RA-0062
ISSN: 1869-0327
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Deposited On: 17 Feb 2016 04:34
Last Modified: 22 Feb 2016 02:02

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