Evidence Lacking to Support Health IT
Anecdotes about patients receiving inappropriate treatment from lack of access to vital medical information has lead to the belief that widespread use of electronic medical records would reduce the incidence of medical errors. However, a report published last year in the Annals of Internal Medicine found few rigorous and generalizable studies of the effects of health information technology (IT). In support of IT, a frequently cited study conducted by the Brigham and Women’s Hospital in the late 1990s showed a 55% decrease in serious medical errors after implementing a computerized physician order entry (CPOE) system.
This is a significant reduction because medication errors comprise the largest category of medical errors. CPOE systems can help prevent errors by:
- “Eliminating issues surrounding eligible handwriting and incomplete prescriptions.
- Warning clinicians about potentially harmful interactions with other drugs that the patient is taking.
- Validating dosages; and
- Suggesting drugs suitable for a patient with a given diagnosis.”
Bar coding has resulted in a substantial decrease in medication errors. The Department of Veterans Affairs implemented this technology in the late 1990s and has found dramatic results. At the Martinsburg West Virgina VA Medical Center, five years after installing bar coding technology, medication errors decreased to one-third of their pre-implementation level.
In contrast, studies have shown that in certain instances health IT has increased medical errors. Some software for CPOE and other functions can cause errors, especially if the software is inadequate or implemented poorly. Many of these issues can be avoided, by developing health IT systems collaboratively with users. Higher quality systems will be created and deployment will generally be more successful.
Related entries:
February 22, 2007 Related topics: Quality, Safety, Errors, Pharmaceuticals, IT & software