Using Health IT to Prevent Adverse Events - AHRQ National ...

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Summary: Impact on Serious Medication ErrorsMDMed OrderingOrderingErrors (49%)Order Entry &decision support-55% reductionPharmacydecision support-TranscriptionTranscriptionErrors (11%)eMAR-100% reductionPharmacistDispensingDispensingErrors (14%)PharmacyBarcoding-67% reductionMedicationAdmin RecordMedication onWards-eMAR/barcodingat bedside- 51% reductionRNAdministrationErrors (26%)AdministrationPatient
Implementation Factors• Software developed by Partner’sHealthcare Information Systems analysts– Customized to BWH medicationadministration with ability to provide real timeenhancements– Networked with existing CPOE and Pharmacysystems– 10 year project
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National Web-Based Teleconference o
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Meaningful Use Incentives
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Benefits of EHR data• symptoms, s
Page 7 and 8:
Framework
Page 9 and 10: Target errors• Explicit voluntary
Page 11 and 12: Terminology challenges• Terminolo
Page 13 and 14: Deep Natural Language Processing“
Page 15 and 16: Demography of CXRs• 10 years; 889
Page 17 and 18: Falls• Calibrate database to lite
Page 19 and 20: Conflicts in the EHR
Page 21 and 22: Conflicts in the EHR: ―Digital cl
Page 23 and 24: Self reporting in the EHR
Page 25 and 26: Self reporting in the EHR• Accide
Page 27 and 28: Self reporting in the EHR: PPVMista
Page 29 and 30: Large scale event reporting
Page 31 and 32: Event reporting• Use NLP and 45 r
Page 33 and 34: Next-generation detection
Page 35 and 36: Data quality• All medical record
Page 37 and 38: Learning from the DataDeviation by
Page 39 and 40: 345New Information ToolsGlucose0.45
Page 41 and 42: Conclusions
Page 43 and 44: Thank You!
Page 45 and 46: Medication Safety• The typical ho
Page 47 and 48: MDMed OrdersOrderingErrors (49%)Tra
Page 49 and 50: Barcode/eMAR at the Bedside • Ord
Page 51 and 52: Real Time Alerts to Nurse
Page 53 and 54: Evaluating the Impact of Barcode-eM
Page 55 and 56: Impact on Potential Adverse Drug Ev
Page 57 and 58: Admin and Transcription Error Study
Page 59: Impact on Nurse Workflow• 232 2-h
Page 63 and 64: Implementation• 45 Enhancements t
Page 65 and 66: Information System Analyst• Troub
Page 67 and 68: Scanners•Need scanning flexibilit
Page 69 and 70: Bar Coding Inconsistencies• Where
Page 71 and 72: Physician Workflow• Inability toq
Page 73 and 74: Over Reliance• Technology driving
Page 75 and 76: Continued Feedback
Page 77 and 78: In Summary• Barcode technology si
Page 79 and 80: Kevin B. Johnson, MD, MSProfessor B
Page 81 and 82: • Adverse events are often mitiga
Page 83: • Single site study using interna
Page 87 and 88: Funded by AHRQ R 18 HSO17216
Page 89 and 90: • Mismatches between formulationr
Page 91 and 92: Goal - to improve the safety andusa
Page 93 and 94: • Discovered 115 medications to r
Page 95 and 96: • Many allow dosing in0.1 ml incr
Page 98 and 99: UsersE-PrescribingSystem ServerSTEP
Page 100 and 101: •Medication Name•Medication Enc
Page 102 and 103: For each known frequency…PatientW
Page 104 and 105: RecognizedMedication InSTEPSToolsKn
Page 106 and 107: For each dose range…PossibleDoseG
Page 108 and 109: • If the age of the patient is le
Page 110 and 111:
• Implementation in two vendor sy
Page 112 and 113:
Thank You!
Page 114 and 115:
Coming Soon!Our Next EventA webinar
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