Comparative Barriers to Electronic Prescribing Across Healthcare Settings: A Systematic Review / Perbandingan Hambatan Implementasi Resep Elektronik di Berbagai Fasilitas Pelayanan Kesehatan: Sebuah Tinjauan Sistematis

Background: Electronic prescribing (e-prescribing) is increasingly implemented to improve patient safety and healthcare efficiency. However, its implementation across different healthcare settings continues to face complex and varied barriers. Aim: This systematic review aims to identify barriers to e-prescribing implementation, compare variations in barriers across healthcare facility types, and develop evidence-based recommendations. Methods: A systematic literature search was conducted in Scopus, PubMed, and ScienceDirect following PRISMA guidelines, supplemented by manual reference screening and grey literature searches. Eligible studies included English-language qualitative and mixed-methods research focusing on implementation barriers. Data were analyzed using thematic synthesis, while methodological quality was assessed using the Joanna Briggs Institute (JBI) tools and the Mixed Methods Appraisal Tool (MMAT). Results: Ten studies met the inclusion criteria, covering hospitals, primary care clinics, community pharmacies, and residential aged care facilities. Four major categories of barriers were identified: technical and system challenges, workflow barriers, human and behavioral factors, and organizational and regulatory constraints. Barrier patterns varied significantly across facility types, with technical barriers being most dominant in hospitals, transitional barriers in primary clinics, operational pressures in pharmacies, and low user motivation in residential aged care facilities. Conclusion: Successful e-prescribing implementation requires an integrated approach addressing technical, organizational, and human factors. Implementation strategies must be tailored to the specific characteristics of each healthcare setting to support patient safety and sustainable healthcare quality.

Latar Belakang: Resep elektronik (e-prescribing) semakin luas diimplementasikan untuk meningkatkan keselamatan pasien dan efisiensi pelayanan kesehatan. Namun, implementasinya di berbagai fasilitas kesehatan masih menghadapi hambatan yang kompleks dan bervariasi. Tujuan: Tinjauan sistematis ini bertujuan untuk mengidentifikasi hambatan implementasi resep elektronik, membandingkan variasi hambatan antar tipe fasilitas pelayanan kesehatan, serta menyusun rekomendasi berbasis bukti. Metode: Pencarian literatur dilakukan pada basis data Scopus, PubMed, dan ScienceDirect sesuai panduan PRISMA, dilengkapi dengan penelusuran manual referensi dan literatur abu-abu. Kriteria inklusi mencakup studi kualitatif dan mixed-methods berbahasa Inggris yang berfokus pada hambatan implementasi. Analisis data menggunakan sintesis tematik, sedangkan penilaian kualitas metodologis menggunakan Joanna Briggs Institute (JBI) tools dan Mixed Methods Appraisal Tool (MMAT). Hasil: Sebanyak sepuluh studi memenuhi kriteria inklusi, mencakup rumah sakit, klinik layanan primer, apotek komunitas, dan fasilitas perawatan lansia. Empat kategori hambatan utama diidentifikasi: tantangan teknis dan sistem, hambatan alur kerja, faktor manusia dan perilaku, serta kendala organisasi dan regulasi. Pola hambatan menunjukkan variasi signifikan antar tipe fasilitas, dengan hambatan teknis paling dominan di rumah sakit, hambatan transisi di klinik primer, tekanan operasional di apotek, serta rendahnya motivasi pengguna di fasilitas perawatan lansia. Kesimpulan: Implementasi resep elektronik yang berhasil memerlukan pendekatan terintegrasi yang mencakup aspek teknis, organisasi, dan sumber daya manusia. Strategi implementasi harus disesuaikan dengan karakteristik spesifik masing-masing fasilitas kesehatan untuk mendukung keselamatan pasien dan kualitas layanan kesehatan secara berkelanjutan.