August 21, 2014
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Hospitals in Florida that implemented the medical management measures required by Meaningful Use reported significant drops in adverse drug events (ADEs), according to a new study funded by the Agency for Healthcare Research and Quality (AHRQ).
Stage 1 of the Meaningful Use program has five core measures relating to medication management, such as using computerized physician order entry (CPOE), maintaining an active medication list and implementing clinical decision support to check for drug/drug and drug/allergy interactions.
The study used the Florida state inpatient database, American Hospital Association IT supplement and Hospital Compare to review 2010 hospital data. Researchers found that hospitals reporting medication elements among their top Meaningful Use challenges reduced ADEs by 69% when using the five core measures. Hospitals that didn't flag medication management as a top Meaningful Use challenge still reduced their ADEs by 54%.
Even hospitals that reported cost as their main barrier to Meaningful Use reduced ADEs by 35%.
However, hospitals that encountered physician resistance to Meaningful Use actually experienced a 14% increase of ADEs. Hospitals with no such resistance enjoyed a 52% ADE reduction.
In a related Health IT Buzz blog post, Judy Murphy—chief nursing officer and director of the office of clinical quality for the Office of the National Coordinator for Health IT—and John White—director of health IT at AHRQ—said that the "rising tide of Meaningful Use payments to hospitals ... has pushed more hospitals to adoption of medication management measures.
"What's less certain is whether increased adoption of [electronic health records] has significantly lowered adverse drug rates in hospitals and addressed the strong effects of physician resistance," Murphy and White said. "Answers to these questions are critical to ongoing EHR buy-in and continued improvements in hospital patient safety."
At least one other state has found that EHRs can reduce medication and other errors and improve patient safety. Improving outcomes is one of the main tenets of the Meaningful Use program; ONC and other agencies are working to create a safety center to better manage EHR-related patient care.
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