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

• Published in: Journal of the American Medical Informatics Association : JAMIA Vol. 24; no. 4; pp. 729 - 736
• Main Authors: Furukawa, Michael F, Spector, William D, Rhona Limcangco, M, Encinosa, William E
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-07-2017
• Subjects: Adult; Aged; Drug-Related Side Effects and Adverse Reactions - epidemiology; Electronic Health Records - legislation & jurisprudence; Electronic Health Records - statistics & numerical data; Female; Health Information Interoperability; Hospitals - statistics & numerical data; Humans; Male; Meaningful Use - legislation & jurisprudence; Medical Informatics - legislation & jurisprudence; Medicare; Medication Errors - prevention & control; Medication Errors - trends; Middle Aged; Research and Applications; United States - epidemiology; adverse drug events; hospitals; patient safety; interoperability; electronic health records
• ISSN: 1067-5027; 1527-974X
• DOI: 10.1093/jamia/ocw183

Abstract
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.