Table 4.

Emergent Themes and Exemplar Quotes on Use of Narrative Electronic Prescribing Instructions (NEPI) from Key Stakeholder Survey

Prior NEPI Use	Dosing information	“…to extract daily dosing frequency and number of units per dose”
	NEPI quality	“Assessing the Sig text sent in e-prescriptions for incidences of quality issues as defined by text strings which are incomplete, unclear, difficult to read, indecipherable, truncated, or contradictory/nonsensical”
	Treatment patterns	“…investigating treatment patterns; whether a patient maintains a medication, switches, discontinues or adds another”
Opportunities for Use	Intent of prescription	“If widely available, narrative prescribing instructions would greatly increase the rigor of research by providing actual information of physician intent that are typically inferred from administrative data”
	Dosing information	“…the sig contains a lot of information about how things should be administered, and for some medications is the only place with accurate details regarding this”
	Treatment patterns	“More accurate descriptions of treatment patterns, as common end-points such as treatment discontinuation tend to rely on defining prescription periods”
	Treatment-related outcomes	“Better/clearer understanding of treatment overlap and/or discontinuation in relation adverse outcomes”
Barriers to Use	Data access	“Access to these data, across numerous providers/systems/clinical practice settings”
	NEPI quality	“…narrative prescribing data are incredibly messy and inconsistent”
	Standardization	“EPI is not standardized and can vary greatly between providers, regions, and institutions”
	Information technology (IT) infrastructure	“[My institution] does not provide IT infrastructure to allow the creation of machine learning models that predict the intention of an Rx narrative on a continual basis”