Meaningful use of health information technology and declines in in-hospital adverse drug events | Journal of the American Medical Informatics Association | Oxford Academic

Meaningful use of health information technology and declines in in-hospital adverse drug events | Journal of the American Medical Informatics Association | Oxford Academic

Decline in Adverse Drug Events Linked to Use of Health Information Technology

Adverse drug events fell by 67,000 between 2010 and 2013 as the result of the federal “meaningful use” program that offered financial incentives to hospitals for using certified electronic health records, according to a new AHRQ study. Adverse drug events are harms experienced by a patient as a result of exposure to a medication. They affect nearly 5 percent of hospitalized patients and can be deadly. To minimize such harms, the Centers for Medicare & Medicaid Services initiated the meaningful use program in 2010, awarding financial incentives to hospitals and physicians who adopted specific information technology (IT) capabilities, such as computerized prescriber order entry. The new AHRQ study in Journal of the American Informatics Association found that the growth in meaningful use-related IT explained 22 percent of the observed reduction in adverse drug events in the first three years of the program. Access the abstract.

Meaningful use of health information technology and declines in in-hospital adverse drug events

Michael F Furukawa

William D Spector

M Rhona Limcangco

William E Encinosa

J Am Med Inform Assoc ocw183.

DOI:

https://doi.org/10.1093/jamia/ocw183

Published:

16 February 2017

Article history

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Objective: Nationwide initiatives have promoted greater adoption of health information technology as a means to reduce adverse drug events (ADEs). Hospital adoption of electronic health records with Meaningful Use (MU) capabilities expected to improve medication safety has grown rapidly. However, evidence that MU capabilities are associated with declines in in-hospital ADEs is lacking.

Methods: Data came from the 2010–2013 Medicare Patient Safety Monitoring System and the 2008–2013 Healthcare Information and Management Systems Society (HIMSS) Analytics Database. Two-level random intercept logistic regression was used to estimate the association of MU capabilities and occurrence of ADEs, adjusting for patient characteristics, hospital characteristics, and year of observation.

Results: Rates of in-hospital ADEs declined by 22% from 2010 to 2013. Adoption of MU capabilities was associated with 11% lower odds of an ADE (95% confidence interval [CI], 0.84–0.96). Interoperability capability was associated with 19% lower odds of an ADE (95% CI, 0.67- 0.98). Adoption of MU capabilities explained 22% of the observed reduction in ADEs, or 67,000 fewer ADEs averted by MU.

Discussion: Concurrent with the rapid uptake of MU and interoperability, occurrence of in-hospital ADEs declined significantly from 2010 to 2013. MU capabilities and interoperability were associated with lower occurrence of ADEs, but the effects did not vary by experience with MU. About one-fifth of the decline in ADEs from 2010 to 2013 was attributable to MU capabilities.

Conclusion: Findings support the contention that adoption of MU capabilities and interoperability spurred by the Health Information Technology for Economic and Clinical Health Act contributed in part to the recent decline in ADEs.

electronic health records, interoperability, adverse drug events, patient safety, hospitals

Issue Section:

 Research and applications