Effectiveness of IPD Paperless Implementation in Samutsakhon hospital

Abstract

The World Health Organization draft four-year global digital health strategy aims to “improve health for everyone, everywhere by accelerating the adoption of appropriate digital health”. Samutsakhon hospital, under the Ministry of Public Health, has therefore implemented this strategy by adopting an IPD paperless system for inpatient medical records to enhance treatment efficiency. The aims of this research is to study the medication errors, waiting time for medications and systems satisfaction after IPD paperless implementation. The researcher conducted a retrospective descriptive study after the implementation of the IPD paperless system in Samutsakhon hospital, which began on February 6, 2023, and expanded to cover the entire inpatient wards by February 7, 2024. Subsequently, the researcher collected data between March 1, 2024, and August 31, 2024. The study gathered data on medication prescribing errors and medication transcribing errors from medication incident reports, and collected waiting times for stat medications and home medications using systematic random sampling of 400 cases, comparing these with data from March 1, 2023, to August 31, 2023 before IPD paperless implementation. Additionally, system satisfaction data was collected through questionnaires from 223 relevant medical staff. Statistical analyses were done by Mann-Whitney U Test and descriptive statistics. The results showed that after implementing the IPD paperless system, there were 9 events (0.09 errors/1000 patient days) of prescribing errors and 99 events (1.03 errors/1000 patient days) of transcribing errors. The waiting time for stat medications decreased from a median of 68 minutes to 58.5 minutes (p<0.001) However, the waiting time for home medications increased from a median of 113 minutes to 118 minutes (p=0.047) Regarding system satisfaction among relevant medical staff, the average satisfaction score for the IPD paperless system was 3.78 points (75.6%). The highest satisfaction score of 4.01 points (80.2%) was for the system's ability to reduce waiting time for medical records and improve accessibility to patient information. The lowest satisfaction score was 3.36 points (67.2%) for the system's ability to reduce waiting times for medications. In conclusion, the IPD paperless system reduced medication prescribing and transcribing errors, reduced waiting times for stat medications and allow physicians to access patient medical records anywhere and anytime, somewhat reduced paperwork burden. As a result, the IPD paperless enhance patient safety and improve quality of care.