Computerized medication order-entry systems have the potential to dramatically reduce adverse drug events and save hospitals half a million dollars per year on average, but the technology is not often used by healthcare facilities.
From 28% to 95% of adverse drug events could be eliminated if hospitals used computerized monitoring systems, according to a report released last week by HHS' Agency for Healthcare Research and Quality. Computerized systems also could save hospitals up to $500,000 in direct costs, the report said.
Yet only about 13% of hospitals have the capability to allow physicians to enter and monitor prescriptions electronically and just 5% of all hospitals use the technology, according to a 1999 survey conducted by the nonprofit Institute for Safe Medication Practices.
"We have a long way to go to fully implement these systems," said Michael Cohen, president of the Huntingdon Valley, Pa.-based ISMP. Cohen said hospitals with the technology often still have difficulty getting physicians to use it.
Reasons for the industry's slow adoption are the cost-new vendor-bought systems cost about $5 million-and the lack of industry standards for the systems.
American Hospital Association spokeswoman Anne Berdahl called the AHRQ report "exactly the kind of research our members are looking for to make prudent and wise investments." Berdahl said hospitals have been frustrated because information systems vendors haven't come forward to set standards for the application.
Despite the high cost, the AHRQ and industry leaders said investing in drug-order technology pays off. Brigham and Women's Hospital in Boston, which began implementing its physician computerized medication order-entry system in 1993, finds that the technology saves the institution an estimated $5 million to $10 million annually because of more efficient use of medication and fewer negative patient outcomes associated with adverse drug effects.
"We find it to be an extraordinarily valuable application," said David Bates, M.D., chief of general internal medicine at 694-bed Brigham and Women's. Bates said the hospital spent $1.4 million to develop the system and spends about $500,000 annually to maintain it.
The AHRQ study found that patients who experienced adverse drug events were hospitalized an average of eight to 12 days longer than patients who did not.