Using Think Aloud Protocols to Assess E-Prescribing in Community Pharmacies.

INTRODUCTION Think aloud protocol has rarely been used as a method of data collection in community pharmacies. PURPOSE The aim of the report is to describe how think aloud protocols were used to identify issues that arise when using e-prescribing technology in pharmacies. In this paper, we report on the benefits and challenges of using think aloud protocols in pharmacies to examine the use of e-prescribing systems. METHODS Sixteen pharmacists and pharmacy technicians were recruited from seven community pharmacies in Wisconsin. Data were collected using direct observation alongside think aloud protocol. Direct observations and think aloud protocols took place between January-February, 2011. Participants were asked to verbalize their thoughts as they process electronic prescriptions. RESULTS Participants identify weaknesses in e-prescribing that they had previously not conceived. This created heightened awareness for vigilance when processing e-prescriptions. The main challenge with using think aloud protocols were interruptions in the pharmacy. Some participants found it difficult to remember to continue verbalizing during think aloud sessions. CONCLUSION The use of think aloud protocols as method of data collection is a new way for understanding the issues related to technology use in community pharmacy practice. Think aloud protocol was beneficial in providing objective information on e-prescribing not based on pharmacist's or technician's opinion of the technology. This method provided detailed information and also a wide variety of real time challenges with e-prescribing technology in community pharmacies. Using this data collection method can help identify potential patient safety issues when using e-prescribing and suggestions for redesign.