Infection Control Today - 04/2003: IC BUSINESS

Surveys Reveal Strong Support for Technologies to Improve Patient Safety

VALLEY FORGE, Penn. -- Twenty-three percent of Americans -- or nearly one in four -- say they or a family member have received the wrong medication at some point from a healthcare professional, according to the latest AmerisourceBergen Index released recently. The quarterly telephone survey was conducted January 23-26, 2003 by Opinion Research Corporation on behalf of AmerisourceBergen, a pharmaceutical services company.

The survey of 1,033 adults nationwide explored a variety of issues related to patient safety, including the best ways to prevent medication errors, safety hazards in hospitals and the priority hospitals place on patient safety.

Reducing medication errors was a key topic addressed by the AmerisourceBergen Index. One way to reduce these errors is through barcode scanning systems, which scan medications and patient identification bracelets at hospital bedsides to verify patients are receiving the correct medications.

Seventy-five percent of respondents said they favored the use of barcode technologies as a way to reduce medication errors. This technology garnered even more support from 18 to 34-year-olds, with 82 percent in this age group saying the government should require drug manufacturers and companies that repackage drugs to put barcodes on all prescription medications.

In a related question, barcode scanning of medications came in second out of a list of five ways to increase medication-dispensing accuracy. Twenty-four percent of all respondents selected this choice. Interest was even higher among 45-to-54-year-olds, with 32 percent of these respondents choosing this option.

First place went to requiring doctors to use computers to issue prescriptions instead of writing them by hand. This was selected by 32 percent of all respondents. Greater use of automated technologies to count pills and check prescriptions before they are dispensed placed third, with 17 percent of respondents picking this. At the bottom of the list were "more pharmacists" (11 percent) and "more pharmacy technicians" (8 percent).

However, when respondents were asked whether the government should provide low-interest loans to pharmacy students to address the current pharmacist shortage and encourage more people to enter the field, 83 percent of those surveyed said yes. Only 15 percent said no.

Despite concerns about patient safety, 93 percent of respondents said they believed hospitals placed a priority on reducing medication errors and medical mistakes, although they expressed this opinion to varying degrees. Thirty-three percent said they thought hospitals viewed this as "a top priority," while 41 percent said it was important, but not a top priority. Eighteen percent said hospitals considered this "somewhat important." However, only 5 percent said hospitals did not consider it important to reduce medical or medication errors.

With regard to other solutions for ensuring greater patient safety, 80 percent of respondents said they thought the healthcare industry would benefit from the adoption of uniform safety protocols prior to administering medication or performing a medical procedure, such as a checklist or other measures. When asked why they thought uniform safety procedures had not yet been adopted, 47 percent cited cost. Twenty-one percent said it was disagreement over how to accomplish this goal, while 15 percent attributed it to a resistance to change. Only 10 percent selected physician independence as the reason.

The current nursing shortage was perceived to be the most serious safety hazard facing hospital patients today, according to 32 percent of those surveyed. This was followed by residents and interns who work long hours without sleep (27 percent), the risk of getting an infection while hospitalized (22 percent), and the risk of a medical mistake or medication error (15 percent).

Patient safety tops the list of concerns of healthcare information technology (IT) executives, according to the 14th annual Health Information Management Systems Society (HIMSS) Leadership Survey, sponsored by Superior Consultant Company, Inc.

More than half (52 percent) of the nearly 300 healthcare IT executives who participated in the survey said implementing technology to reduce medical errors and promote patient safety was a top IT priority at their facility today, 59 percent reported it would be a top priority in the next two years and 63 percent indicated they believe it is one of the top five business issues that will have the most impact on healthcare in the next two years.

"Since the Institute of Medicine (IOM) reports came out revealing the high prevalence of medical errors, healthcare organizations have been searching for ways to address the problem," says Richard E. Duncan, chair of the HIMSS board of directors. "Research has shown IT technologies may be an important part of the solution."

Survey respondents have shown high interest in two of the technologies that have been proven to reduce medical errors: computer-based practitioner order entry (CPOE) and bar coded medication management. Asked to identify the healthcare applications areas they considered most important to their facility over the next two years, among the top three were CPOE (64 percent) and bar coded medication management (46 percent). Clinical information systems (53 percent) also topped the list.

Although concerns about issues related to the Health Insurance Portability and Accountability Act (HIPAA) fell to second place behind patient safety, HIPAA was top concern in the survey. Forty-seven percent of respondents reported their facility currently is upgrading security on their systems and 46 percent indicated that they currently are implementing privacy modifications. Upgrading security on IT systems to meet HIPAA requirements was indicated by 43 percent of respondents as a top IT priority during the next two years.

For the first time in three years, the number of facilities using computer-based patient records (CPR) has increased. Nearly 20 percent of respondents indicated they have a fully operational CPR system. That number is up significantly from 13 percent in both 2002 and 2001 surveys. Only 20 percent of respondents indicated they haven't begun to plan for the use of a CPR, down almost 10 percentage points from last year.

Other survey results include:

  • 23 percent identified lack of adequate financial support for IT as the most significant barrier to successfully implementing IT at their facility
  • Some 68 percent of healthcare IT executives project an increase in their IT budgets in the next 12 months,
  • Fifty-six percent of the respondents expect to increase their staff in the next 12 months
  • Reported use of wireless information systems showed a significant increase: 72 percent compared to 50 percent in 2002.

"There is a definite correlation between the respondents' stated priorities and those recently identified in the proposed 2004 budgets for the Department of Health and Human Services and the Centers for Medicare and Medicaid Services, which earmark significant funding for patient safety initiatives, HIPAA enforcement, healthcare information technology and electronic medical records, among other things," says Charles O. Bracken, executive vice president of Superior Consultant Co. "By all indications, the healthcare community will continue taking the necessary actions to ensure the safety and privacy of our patient population, with 68 percent of the respondents projecting IT budget increases over the next 12 months."

Data were collected via a self-administered, Web-based questionnaire over a six-week period beginning in mid December. Approximately 1,500 chief information officers (CIOs) from healthcare organizations were invited to participate. Nearly 20 percent (287) completed the survey.

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