Infection Control Today - 04/2003: IC BUSINESS

Surveys Reveal Strong Support for Technologies to ImprovePatient Safety

VALLEY FORGE, Penn. -- Twenty-three percent of Americans -- or nearly one infour -- say they or a family member have received the wrong medication at somepoint from a healthcare professional, according to the latest AmerisourceBergenIndex released recently. The quarterly telephone survey was conducted January23-26, 2003 by Opinion Research Corporation on behalf of AmerisourceBergen, apharmaceutical services company.

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

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

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

In a related question, barcode scanning of medications came in second out ofa list of five ways to increase medication-dispensing accuracy. Twenty-fourpercent of all respondents selected this choice. Interest was even higher among45-to-54-year-olds, with 32 percent of these respondents choosing this option.

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

However, when respondents were asked whether the government should providelow-interest loans to pharmacy students to address the current pharmacistshortage and encourage more people to enter the field, 83 percent of thosesurveyed said yes. Only 15 percent said no.

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

With regard to other solutions for ensuring greater patient safety, 80percent of respondents said they thought the healthcare industry would benefitfrom the adoption of uniform safety protocols prior to administering medicationor performing a medical procedure, such as a checklist or other measures. Whenasked why they thought uniform safety procedures had not yet been adopted, 47percent cited cost. Twenty-one percent said it was disagreement over how toaccomplish 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 safetyhazard facing hospital patients today, according to 32 percent of thosesurveyed. This was followed by residents and interns who work long hours withoutsleep (27 percent), the risk of getting an infection while hospitalized (22percent), 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 ManagementSystems Society (HIMSS) Leadership Survey, sponsored by Superior ConsultantCompany, Inc.

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

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

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

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

For the first time in three years, the number of facilities usingcomputer-based patient records (CPR) has increased. Nearly 20 percent ofrespondents indicated they have a fully operational CPR system. That number isup significantly from 13 percent in both 2002 and 2001 surveys. Only 20 percentof respondents indicated they haven't begun to plan for the use of a CPR, downalmost 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' statedpriorities and those recently identified in the proposed 2004 budgets for theDepartment of Health and Human Services and the Centers for Medicare andMedicaid Services, which earmark significant funding for patient safetyinitiatives, HIPAA enforcement, healthcare information technology and electronicmedical records, among other things," says Charles O. Bracken, executivevice president of Superior Consultant Co. "By all indications, thehealthcare community will continue taking the necessary actions to ensure thesafety and privacy of our patient population, with 68 percent of the respondentsprojecting IT budget increases over the next 12 months."

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