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Published on: August 30, 2018
Meaningful Use IT reduces hospital-caused adverse drug events even at challenged hospitals
William E Encinosa1, Jaeyong Bae2
1Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, United States; Georgetown University, United States.
Background:
many Meaningful Use (MU) requirements involve medication management. Little is known about what impact these will have on adverse drug events (ADEs) at challenged hospitals.
Methods:
we use the Florida State Inpatient Database (HCUP, AHRQ), the AHA IT Supplement, and Hospital Compare. Controlling for non-response selection bias, we use multi-level GLLAMM regression analysis to examine the impact of the 5 core MU medication elements on hospital-caused ADEs.
Results:
adopting all 5 core MU elements was associated with a reduction in ADEs. Hospitals reporting costs as the main barrier to MU reduced their ADE rates by 35%; low quality hospitals reduced ADEs by 29%, compared to 27% at high quality hospitals. Among hospitals reporting these medication elements among their top MU challenges, ADEs were reduced by 69%, compared to 45% for hospitals with no drug functions as their top MU challenges. However, ADEs increased by 14% at hospitals with physician resistance to MU, compared to a 52% ADE reduction without physician resistance.
Conclusions:
the bundling all five medication functions in MU is associated with large reductions in ADEs.
Implications:
without physician buy-in at the hospital, MU will have no impact on ADEs.
Insights
Implementing Meaningful Use (MU) medication management criteria significantly reduced adverse drug events (ADEs). Physician buy-in is crucial for MU success in reducing ADEs.
Area of Science:
- Health Informatics
- Health Services Research
- Patient Safety
Background:
- Meaningful Use (MU) program requirements heavily emphasize medication management.
- The impact of MU on adverse drug events (ADEs) in challenged hospitals remains understudied.
Purpose of the Study:
- To investigate the association between core MU medication elements and hospital-caused ADEs.
- To analyze how different hospital characteristics and barriers influence this association.
Main Methods:
- Utilized the Florida State Inpatient Database, AHA IT Supplement, and Hospital Compare data.
- Employed multi-level GLLAMM regression analysis to control for selection bias.
- Examined the impact of five core MU medication elements on ADE rates.
Main Results:
- Adoption of all five core MU medication elements correlated with reduced ADEs.
- Hospitals citing cost as a barrier saw a 35% ADE reduction; low-quality hospitals saw 29%.
- Physician resistance to MU was associated with a 14% ADE increase, contrasting with a 52% reduction without resistance.
Conclusions:
- Bundling the five medication functions within MU is linked to substantial ADE reductions.
- Physician engagement is a critical factor for MU to effectively impact ADEs.
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