Friday, March 01, 2013

Interesting To See How Electronic Medication Ordering Can Reduce Errors. Seems It Really Works.

This appeared a little while ago.

Researchers: CPOE averted 17.4 million medication errors in one year

February 22, 2013 | By Gienna Shaw
Electronic prescribing through computerized physician order entry averted 17.4 million medication errors in the U.S. in a single year, according to researchers publishing in the Journal American Medical Informatics Association.
The authors analyzed data from 2006 to 2008, including the American Hospital Association's 2008 electronic health record adoption database to estimate the reduction in medication errors that they said could be attributed to CPOE.
"Processing a prescription drug order through a CPOE system decreases the likelihood of error on that order by 48 percent," the authors wrote. "Given this effect size, and the degree of CPOE adoption and use in hospitals in 2008, we estimate a 12.5% reduction in medication errors, or 17.4 million medication errors averted."
Putting a hard number on the results of any health information technology on quality improvement is a challenge--and research on the effects of HIT are often ripe  for debate.  
For example, data transfer between health IT systems can threaten patient safety perspective, according to an analysis of health IT-related safety events by the ECRI Institute Patient Safety Organization, FierceHealthIT reported earlier this month.
A breakdown of the events found that 53 percent were associated with medication management systems. Of the systems identified in such events, computerized physician order entry systems were mentioned the most (25 percent of the time).
More with links here:
A useful one for the evidence files.


InformaticsMD said...

It is hard to know for sure what is going on, but the data plays both ways.

A summary of the new ECRI Institute PSO "Deep Dive" study is in the American Medical News by Kevin O'Reilly: "Ways EHRs can lead to unintended safety problems" - .

Key points:

- 9 week study only, The PSO Deep Dive analysis consisted of 171 health IT-related events submitted by 36 healthcare facilities, primarily hospitals, over 9 weeks.

- Volunteer data asked for, specifically on EHR-related medical mishaps

- Eight of the incidents reported involved patient harm, and three may have contributed to patient deaths

Extrapolate *that* out to ~ 5,724 U.S. hospitals (AHA figures) over a full year, accounting for the fact that these reports were a time when novice organizations are buying into EHRs rapidly...and you see where I'm going. And this doesn't even include private docs.

InformaticsMD said...

Making things even more complex. From the JAMIA abstract:

Materials and methods We conducted a systematic literature review and applied random-effects meta-analytic techniques to derive a summary estimate of the effect of CPOE on medication errors. This pooled estimate was combined with data from the 2006 American Society of Health-System Pharmacists Annual Survey, the 2007 American Hospital Association Annual Survey, and the latter's 2008 Electronic Health Record Adoption Database supplement to estimate the percentage and absolute reduction in medication errors attributable to CPOE.

I note the ECRI PSO study was not of literature, but of actual PSO member solicited reports.

Anonymous said...

Sounds like an estimate times an estimate times an estimate = a big rubbery figure.
--- Tim C