Studies Examine Impact of Electronic Health Records, Computerized Prescription Order Entry Systems
The adoption of electronic health records by the Veterans Affairs Health System is helping the agency "do a better job of treating patients," according to a study funded by VA, the Robert Wood Johnson Foundation and other sources, the AP/Washington Times reports. The study, published in Tuesday's Annals of Internal Medicine, studied 26 medical conditions in 1,588 men older than age 35. Some of the participants received care through VA, while others received care in non-VA facilities and some had health insurance and some did not.
According to the study, patients in the VA system, which offers doctors nationwide electronic access to medical records, received 67% of recommended treatments, while patients in non-VA outlets received 51% of recommended treatments. Most non-VA hospitals, physician offices, HMOs, clinics and other facilities "trail the agency in the use of electronic access to patient histories," the study says, the AP/Times reports (AP/Washington Times, 12/21).
As "more hospitals have implemented automated systems for administering drugs, the number of errors associated with them has risen," according to a separate study by U.S. Pharmacopeia, the Washington Post reports. USP has collected data from hospitals on a voluntary basis for five years. In 2003, 570 hospitals and other health facilities reported 235,159 errors in prescribing medication. Roughly 43,000 of those, or about 20%, involved some kind of automated drug administration system. Hospitals and other facilities reported errors, including entering of incorrect or incomplete information such as patient names, medication doses and lab test results.
The Post reports that medication errors as a result of automated systems tend to be "about half as likely to harm patients" as other types of errors. Although data on automated-medication errors from previous years were not available, there appears to be a trend of such errors increasing, Diane Cousins, vice president of USP's Center for the Advancement of Patient Safety, said. The study also noted that many errors occur because the user of the automated system is distracted or interrupted, and it suggested that the system be placed in an area where the user can concentrate (Stein, Washington Post, 12/21).
John Daigh of the VA Office of Inspector General said that EHRs "[make] all the difference in the world when you sit down to talk to someone and you dial up their records and you can see their history for the last five or six years. It's much easier to deliver quality care." Steven Asch, a VA researcher in Los Angeles, said VA's "information superhighway" offers "lessons for the rest of the country's health care system" (Washington Times, 12/21).
However, Kenneth Kizer, who heads the National Quality Forum, said, "Technology offers great opportunity to reduce errors, but it's not a panacea." He added, "You can't just throw a computerized system in and expect that everything's fixed." Cousins said, "It would seem logical that applying computer technology to the medication-use process would have a significant positive impact in preventing medication errors. Yet, depending on the computer's design or user competence, new points of potential errors can emerge" (Washington Post, 12/21). The VA study is available on the online. The USP study also is available online.