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首页> 外文期刊>BMJ Open >Qualitative analysis of vendor discussions on the procurement of Computerised Physician Order Entry and Clinical Decision Support systems in hospitals
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Qualitative analysis of vendor discussions on the procurement of Computerised Physician Order Entry and Clinical Decision Support systems in hospitals

机译：对医院计算机医师订单输入和临床决策支持系统的采购商讨论的定性分析

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Objectives We studied vendor perspectives about potentially transferable lessons for implementing organisations and national strategies surrounding the procurement of Computerised Physician Order Entry (CPOE)/Clinical Decision Support (CDS) systems in English hospitals. Setting Data were collected from digitally audio-recorded discussions from a series of CPOE/CDS vendor round-table discussions held in September 2014 in the UK. Participants Nine participants, representing 6 key vendors operating in the UK, attended. The discussions were transcribed verbatim and thematically analysed. Results Vendors reported a range of challenges surrounding the procurement and contracting processes of CPOE/CDS systems, including hospitals’ inability to adequately assess their own needs and then select a suitable product, rushed procurement and implementation processes that resulted in difficulties in meaningfully engaging with vendors, as well as challenges relating to contracting leading to ambiguities in implementation roles. Consequently, relationships between system vendors and hospitals were often strained, the vendors attributing this to a lack of hospital management's appreciation of the complexities associated with implementation efforts. Future anticipated challenges included issues surrounding the standardisation of data to enable their aggregation across systems for effective secondary uses, and implementation of data exchange with providers outside the hospital. Conclusions Our results indicate that there are significant issues surrounding capacity to procure and optimise CPOE/CDS systems among UK hospitals. There is an urgent need to encourage more synergistic and collaborative working between providers and vendors and for a more centralised support for National Health Service hospitals, which draws on a wider body of experience, including a formalised procurement framework with value-based product specifications.
机译：目标我们研究了供应商关于实施组织的潜在可转让课程的观点以及围绕英国医院的计算机医师订单录入（CPOE）/临床决策支持（CDS）系统的采购的国家策略。设置数据是从2014年9月在英国举行的一系列CPOE / CDS供应商圆桌讨论中通过数字录音讨论收集的。与会人员代表英国6家主要供应商的9名与会人员参加了会议。讨论被逐字记录并进行了主题分析。结果供应商报告了CPOE / CDS系统的采购和签约流程方面的一系列挑战，包括医院无法充分评估自己的需求然后选择合适的产品，匆忙的采购和实施流程，导致难以与供应商进行有意义的互动，以及与合同相关的挑战，导致实施角色不明确。因此，系统供应商与医院之间的关系通常很紧张，供应商将其归因于医院管理层对实施工作相关的复杂性缺乏了解。未来可能遇到的挑战包括围绕数据标准化以实现跨系统聚合以实现有效的二次使用的问题，以及与医院外部提供者进行数据交换的问题。结论我们的结果表明，在英国医院中，围绕采购和优化CPOE / CDS系统的能力存在重大问题。迫切需要鼓励提供者和供应商之间进行更多的协同合作，并为国家卫生局的医院提供更集中的支持，这需要更广泛的经验，包括具有基于价值的产品规格的正式采购框架。

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