Table S1.
The full list of themes, subthemes and representative quotes from the thematic analysis of the data
| Theme number | Themes and subthemes | Representative quotes |
|---|---|---|
| 1 | Uptake of e-DALs | |
| Uptake in secondary care | “If it could be rolled out onto more wards overtime then it would be much better for us and much better for the patient.” (A6) | |
| “I can just see so much potential if it got rolled out properly.” (A17) | ||
| “The wards that are using it, are they using it to its full advantage?” (A7) | ||
| Registering patients on the application | “We have a very big amount of blister pack [multi-compartment compliance aid] patients so we kind of know [sic] those who go in and out of hospital so we registered them.” (A17) | |
| “We did when it first came out [register]. We thought yes but it is really [sic] difficult because you’re also saying ‘I know you’re perfectly healthy but when you do eventually’ it is a really [sic] delicate subject” (A16) | ||
| 2 | Information in e-DAL vs. DAL | |
| Completeness | “There is no chance of any sort of errors happening on the discharge [sic] because we are getting the exact information, the right dosages, we can look at it, print it out which is much easier (than the DAL).” (A6) | |
| “I think [the e-DAL] is much better than what we use to have (DAL) because not only do you get the list of medication, you get what has stopped, what has changed, what has started so I’m very happy with the quality of the e-DAL.” (A15) | ||
| Presentation | “Again it’s so much clearer on the electronic version than it was on the paper version, having to go through all the pages, it’s all there on one page.” (A13) | |
| “You’re [sic] avoiding having to try and read doctor’s handwriting.” (A3) | ||
| “We can look at it, print it out which is much more easier than trying to get hold of the DAL from patients.” (A6) | ||
| 3 | Usability of the CPA | |
| Training | “I had a small training session with the people from the health board and after that I didn’t need to refer to the manual. I didn’t need to call them up for any assistance with anything; it was fairly self-explanatory once you got in and starting using it.” (A4) | |
| System | “Since they’ve updated (the software), its quite straightforward to get onto (the application).” (A5) | |
| “Over the last couple of months or even longer I haven’t had any problems at all with crashing or losing information so no it’s been fine.” (A2) | ||
| “Well with the ease of it, it’s very straightforward as well.” (A13) | ||
| Time | “…some of the procedures involved are very laborious. I find that when I’m doing a choose pharmacy consultation with the patient I have to spend too much time concentrating on ticking these boxes on the computer system and not enough time with the patient.” (A10) | |
| 4 | Patient confidentiality | |
| Logging in and logging out | “I like the fact that if you do forget to sign off, it does automatically sign you off.” (A15) | |
| Password | “I think it has high security level and it won’t let us, we have to re-input our password every time and we have to change the password on a frequent basis and it has to be a strong password.” (A10) | |
| “We’ve got individual passwords so there’s only myself and the other pharmacist who could access it, so nobody could get into it accidentally.” (A5) | ||
| Patient consent | “It’s fine, it’s well um, we get patients to sign application form and patients are well aware of what they are signing up for so as far as we are concerned it’s really confidential.” (A6) | |
| Location | “We always [access the application] in a secure place.” (A8) | |
| 5 | Impact of e-DMR service | |
| Link to e-DAL | “It’s just so much quicker with the e-DAL because you don’t need to write in the medicines because it sort of does it itself and also it sort of like reduces human error.” (A17) | |
| Patient safety | “Patient safety (important service) because we do see quite a lot of errors or quite a lot of drugs that have been missed from, dosages that we can pick up so easily which obviously makes continuity of care for the patient seamless. Yes, so it’s one of the most valuable services, simply because we want to stop people going back into hospital at the end of the day.” (A2) | |
| Audit | “Um, what don’t like I’m not sure if you can see it somehow but I like to see how many discharge reviews we’ve done so far.” (A1) | |
| Records | “You can’t go back into it and check what you’ve done. If somebody comes to see you in 2 months, you’ve submitted your claim for that DMR and I can’t access it so you’ve got to have a paper copy and again the system doesn’t print so you can’t make a copy from that system.” (A12) | |
| “It claims it automatically so you don’t have to do it all on paper and then put it into NECAF so that saves a lot of time.” (A2) | ||
| 6 | Communication | |
| Patient | “You know I think it’s much better if people are educated to bring their DAL into the pharmacy.” (A12) | |
| Hospital | “No nothing has changed at all [communication]. I mean every single week we’ve had someone that [sic] have realized they only have 3 or 5 days’ supply from hospital and they haven’t made that arrangement. They don’t know, it is not explained to them.” (A16) | |
| “ …the hospital will identify them as somebody who has a tray from us they’ll always contact us prior to discharge to say ‘you’ve got a tray patient coming out with, there’s been X change to their medication’. They’re only patients they will notify us of.” (A4) | ||
| “We haven’t been getting the e-DALs through but certainly the communication, like I was saying from the hospital to us has certainly improved since these trials.” (A5) | ||
| GP surgery | “We don’t have to go out to the surgery and pull the discharges in, um, even though luckily they do, they play ball with us no problem.” (A2) | |
| “We rarely see the patient actually bring in the discharge sheets in themselves. It’s normally sent from the GPs and some of the GPs themselves are reluctant to give the information out. (A6) | ||
| 7 | Expanding the CPA | |
| “If you see a pattern and the GP or practice nurse can see a pattern, they can ask the question of has this patient been referred for a sexual health check, as the information will be there (on the portal).” (A13) | ||
| “I can’t see why [the EHC service] can’t be on the system as well so the GPs are aware of how often our patients are using things like the EHC.” (A13) | ||
| “The more services we can get by the function [CPA] where we can do it straight away there the better.” (A10) | ||
| “I’d like it [services] all through one system, Why make it more complicated?” (A14) | ||
| “I’m quite happy the way that other services are recorded at the moment.” (A1) | ||
Abbreviations: CPA, Choose Pharmacy application; DAL, Discharge Advice Letter; e-DALs, DALs; e-DMR, electronic Discharge Medicines Review; EHC, emergency hormonal contraception; GP, general practitioner; NECAF, National Electronic Claim and Audit Forms.