Closing the Loop for Controlled Substances Surveillance: A Field Study of the Usability and User Experience of an Integrated Electronic Narcotic Consumption

The distribution and handling of controlled substances (CSs), i.e., narcotics, is strictly regulated to decrease the risk of abuse and drug diversion. In Finland, hospital pharmacies are mandated to keep records of CS distribution and consumption in healthcare through a labor-intensive paper-based process. After implementing a new electronic health record (EHR) system, a large university hospital started to streamline the process by transferring the CS documentation process from paper to digital format. Although the benefits of digital archiving, surveillance, and consumption monitoring are self-evident from the hospital pharmacy's perspective the advantages at wards remain less explored. Therefore, our goal was to explore the usability and user experience (UX) of the recently implemented electronic narcotic consumption card (eNCC) solution built into the EHR system, and the related workflows of nurses, pharmacists, and physicians. The field study consisted of two parts and was conducted using observation, interviews, and survey methods in two wards. Our findings suggest that the digitalized process enables reliable real-time documentation of CSs and improves process efficiency, particularly for oral tablets and capsules. Considering diverse end-users' perspectives is crucial when assessing the practical benefits of newly implemented digital solutions targeted at several healthcare professional groups. This approach enables a broader understanding of UX; supports development efforts, including usability improvements; and facilitates broader implementation. More research is needed to analyze the long-term impacts of the digital CSs' consumption documentation workflow and surveillance at different healthcare units.