Annotated Bibliography
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Thesis
The health care industry each years spends millions in medication errors that could be prevented. By implementing a data entry system that would allow access by medical professionals and pharmacies to collaborate and reduce the chance of medication errors dramatically. The data systems are pricy but when compared to the cost of medication errors and loss of lives it saves most medical establishments money.
Annotated Bibliography
The need for data entry systems to reduce medical errors
Rinda, J. (2012). integration helps clinicians reduce medication errors. Health
Management Technology , 33 (10), 12-13.
With the risks of medication errors endangering lives, the technology has been gearing towards linking smart infusion pumps with health information platforms. Electronic health records have already been developed and are currently being used in some areas. This can lead to reductions in health care costs and increase in workflow. The medication errors could result in 400,000 preventable injuries each year. 1.5 million errors occur in the U.S. each year, resulting in $77 billion in cost annually. The iv integration system which is a form of the medication entry system, resulted in no iv related medication errors within the first 90 days used at Lancaster General Hospital. With the right implementation any healthcare would be able to implement this iv system and improve patient care, efficiency and cost.
This article was great at giving numbers and explaining the fast turn around the date entry system had. This article also showed the money involved in medication errors. The article also linked in other systems that are already being used in the health care field.
Rogoski, R. R. (2006). Banking on Safety. Health Management Technology , 27 (11).
Thomas Malone of Detroit Medical Center mentioned that the facility took a leap of faith in purchasing the order entry system. DMC believed this investment would be a great move at increasing competition and improving patient safety. DMC diverted their capital from other projects to this project for two years. DMC thought that this would help close the gap n the medication administration.
Before order entry systems, the orders for medications were written on papers and faxed to the pharmacy. The pharmacy would then have to enter the information on their system. Lab order would also be handled the same way. Now the entry order system provides alerts for any adverse drug or food interactions. Medications are now scanned when they are being dispensed.
In order for the systems to work, the system must be able to work from each site. You can also set the access to different levels for nurses and physicians. DMC stated that their switch to this new system was painless. The biggest fear is that the system would go down and they would not have access to patient files.
In recent research, the physician computer order entry was decreased the rate of medication errors by more than half. Estimates also imply that 1.3 million injuries occur in the U.S. each year. (Bates, et al., 1998). The adverse drug events account for 19% of hospitalization patient injuries and are the most common cause of injury. Adverse drug events cost “$2 billion per year, not including malpractice costs or the costs of injuries to patients. Hospitalizations initiated by ADEs appear to be at least as expenses”.
Morrissey, J. (2003). Modern Healthcare. Center for information Technology
Leadership , 33 (7).
By installing an order entry system, it would eliminate millions of injuries a year. In order to enjoy the benefits of having this system an office would need to invest in expensive systems. Per the modern healthcare, by using the order entry systems in health care facilities it eliminates more than 2 million injuries and 190,000 hospitalizations that are due to medication errors.
If the entry systems could be used with all physicians through ordering tests and drugs, it would save the U.S. industry 44 billion a year. The systems could pay for themselves. It is estimated that it would take 2 years for a hospital to pay itself for a order entry system. For small offices it would never pay for itself. The order system was built for the inpatient setting.
For the basic system for order entry, it costs 4500 for the first year and 11,000 over fives year no matter what the size of the office is. The more advance systems provide use of medication assistance. John Morrissey suggests,” order entry systems can save $27 billion in medication costs to all healthcare stakeholders if adopted nationally but only about 3 billion would go directly to the providers.”
Laura, W. (2012, December 04). Australia Digital Economy E Heal Personally
Controlled Electronic Health Records. PressWire .
Dublin announced that they are added the PCEHR also known as Australia Digital Economy E-Health personally controlled electronic health records to their system. The federal government managed to budget $466 million for this project between 2010-2011. The government also added an additional $233.7 million to it in May 2012. The purpose is to give every Australian citizen a PCEHR. The citizen can also deny this if they wish. Sign up for this device is planned to begin July 2012.
The government is wishing to implement this personal electronic health record as a secure system that will allow health practitioners to view medical history. This will provide faster diagnosis of illnesses and reduce medication errors.
Garner, S. (2012). Medicines Administration: avoiding the pitfalls. Practice Nurse , 42
(15).
In 2009, of the 100 medication incidents reported, 41% were due to drug administration errors. The other 61% were involving injectable medicine. Medication errors should not be made but they do happen. Even flu shot errors were reported through the department of health and medical defense union.
The way that we report errors needs to be managed and reported accurately. The NHS was created for this purpose to review and report patient safety incidents. For the specific area of medication errors NPSA is to specialize in. The government is still working on delegating and reviewing the clinical reports for medication errors.
DeArment, A. (2012, April 23). Finding new benefits to e-prescribing. Drug Store News .
The data entry system is now being used within pharmacies such as Walgreens and Duane Read stores. The stores are going to allow electronic records and immunization forms to be shared with public health agencies and primary care providers. This will allow people to receive vaccinations at their pharmacy and provide their primary doctors to be aware of it as soon has it happens. This could help decrease reminders sent out by primary doctors offices. This will be extremely beneficial as more and more pharmacies are offering vaccinations. If primary doctors offices would also jump on board with the e-prescribing, then the patients health records would all be in the system for the pharmacies giving the vaccinations. This would allow the pharmacy to see any drug reactions or allergies the patient may have had in the past.
Sheehan, P. (2012). Transitioning to an eMAR system. Long Term Living: For the
continuing care Professional , 61 (9), 10.
The transition from paper to eMar electronic medication administration records present benefits. These systems will not only be used in hospitals but also long term care facilities. The obvious benefits include the reduction of medication errors, improved quality care, and reduce the costs of administration and paperwork. The Assisted Living Federation of America’s National conference reported a 90% reduction in annual medication errors since switching to eMARs.
The issues that arise with the new system is how each electronic medication administration system is different and it needs to be compatible with other systems if information is going to be shared among healthcare providers. Other choices that arise is how the system is set up if cloud based or locally hosted. The other question is if the current computer systems can manage the program, or if they will also need to be upgraded. The ongoing support of a security system is also something that needs to be set up.
Bar code tech for hospitals. (2010). industrial Engineer , 42 (7), 15.
The barcode technology has improved the administration has improved medication errors by providing the right medication to the right patient at the right time. Communication between nurses and pharmacies are sent electronically. Alerts are sent notifying of when refills are due. The patient’s wristband bar code and medication bar code are to match or the drugs cannot be administrated. Research has shown that there was a 27% reduction wrong time drug administration. The research was gathered from Brigham Women’s Hospital in Boston. There was a 51% of drug related adverse effects reduced. Non-timing administration errors were reduced by 41 percent.
Hoisington, A. (2012). Medication reconciliation drives readmission reduction strategy.
Managed Healthcare Executive , 12-12.
Rather than using a data entry system some medical facilities are watching medication reconciliation to try and cut cost. The implementation of this has been difficult. By having a model for medication reconciliation before discharging a patient, this decreased the adverse drug effect, medication errors, and costs. This process involves calling family members, pharmacies, and primary doctors. This is also extremely difficult to keep track of with in home nurses not being authorized to prescribe medication reconciliation in the home.
To be able to make these changes affective McNeill believes five core attributes must be a part of this model. The five attributes include accountability, teamwork, medication reconciliation, direct engagement, and follow up. McNeill believes that most clinicians do not have enough time to complete the requirements for medication reconciliation.
Escobar-Rodriguez, T., Monge-Lozano, P., & Romero-Alonso, M. M. (2012).
Acceptance of e-prescriptions and automated medication management systems in
hospitals. Journal of Information Systems , 77-96.
This article uses the TAM system, the technology acceptance model, to study the external variables. The variables include perceived compatibility, training, perceived risks, and perceived usefulness to enhance control systems. With issuing the eprescriptions the hospital believes they would need to improve the compatibility of the systems by health care personnel through training in order to enhance job performance. The article welcomes automated control mechanisms.
The article recommended that training is a key issue and that top managers should design training to enhance acceptance of technology. The ongoing communication would need to be between the controls systems and the nurses. Further research is needing done to ensure the reduction of medication errors based upon national differences, hospital technology team, and individual experience.
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