Background: When the Swedish pharmacy market was re-regulated in 2009, Sweden moved from one
state-owned pharmacy chain to several private pharmacy companies, and four new dispensing systems
emerged to replace the one system that had previously been used at all Swedish pharmacies for more than
20 years.
Objectives: The aim of this case study was to explore the implementation of the new information systems
for dispensing at pharmacies.
Methods: The vendors of the four dispensing systems in Sweden were interviewed, and a questionnaire was
sent to the managers of the pharmacy companies. In addition, a questionnaire was sent to 350 pharmacists
who used the systems for dispensing prescriptions.
Results: The implementation of four new dispensing systems followed a strict time frame set by political
decisions, involved actors completely new to the market, lacked clear regulation and standards for
functionality and quality assurance, was complex and resulted in variations in quality. More than half of
the pharmacists (58%) perceived their current dispensing system as supporting safe dispensing of
medications, 26% were neutral and 15% did not perceive it to support a safe dispensing. Most pharmacists
(80%) had experienced problems with their dispensing system during the previous month. The pharmacists
experienced problems included reliability issues, usability issues, and missing functionality.
Conclusion: In this case study exploring the implementation of new information systems for dispensing
prescriptions at pharmacies in Sweden, weaknesses related to reliability, functionality and usability were
identified and could affect patient safety. The weaknesses of the systems seem to result from the limited
time for the development and implementation, the lack of comprehensive and evidence-based requirements
for dispensing systems, and the unclear distribution of quality assurance responsibilities among involved
stakeholders.