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Sometimes hospital tech isn't enough

Hospital technician works by computer station.

TEXT OF STORY

Bill Radke: Every year, hundreds of hospital patients die from prescription drug mistakes. Computers, we're told, could help alert doctors and nurses to prescribing errors before they happen. But a study published in today's journal Health Affairs shows just having the technology is not enough. From our health desk at WHYY in Philadelphia, Marketplace's Gregory Warner reports.


Gregory Warner: Here's one way the technology's supposed to help hospitals: Doctors type a prescription onto a computer. The computer cross-checks it with the patient's information and alerts the doctor to red flags.

Jane Metzger: Let's say it's a medication to which the patient has a known allergy.

Jane Metzger is a researcher at the health care consulting firm CSC. She ran tests with 62 hospitals that use software like this. Some hospital computers flagged the errors. Others, though, caught barely 10 percent.

David Bates: The variability on the scores is extraordinary.

David Bates is chief of internal medicine at Brigham and Women's Hospital at Harvard. He co-authored the study on computerized prescribing safety, which came out today in the journal Health Affairs. He says its not that low-scoring hospitals need more tech geeks:

Bates: It's really a matter of having nurses and doctors work with the tech geeks so that the right clinical knowledge is put in place.

The White House has offered some $36 billion in incentives for hospitals to modernize by 2014.

In Philadelphia, I'm Gregory Warner for Marketplace.

About the author

Gregory Warner is a senior reporter covering the economics and business of healthcare for the entire Marketplace portfolio.
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The concerns raised in this story are real. Another consideration is that technology can be placed throughout the hospital workflow to prevent medication errors. For example, drug verification technology now exists to chemically verify that the medication in a dispensed vial matches the label. One example of this technology is PASS Rx by Centice. You can learn more about this at http://www.centice.com .

I felt this story was a bit myopic to leave out an entire profession dedicated to providing quality pharmaceutical services to ensure appropriate medication therapy and positive patient outcomes - pharmacists. The articles below are just a few that show the positive impact of a pharmacist on a hospital team in minimizing drug errors and, thereby, minimizing adverse events and medical costs.
Computers just cannot be updated with all the algorithms necessary to make a clinical judgment as pharmacists do with their in depth knowledge of physiology, pharmacology, medicinal chemistry, pharmaceutics, therapeutics, etc., the patient information at hand and their clinical experience. They can, however, be used to guide physicians in prescribing correctly and ensure basic errors are not made – such as alerts for prescribing medications to which the patient has an allergy, drug-drug interactions, when to check a lab prior to prescribing a particular drug, to name a few.
In this case, more tech geekery may be needed for only the IT side, but, to truly minimize and prevent drug-related adverse events in patients, more pharmacist-physician relationships need to be fostered; a team approach is necessary to ensure patient safety and efficacious drug therapy.
1) http://jama.ama-assn.org/cgi/content/full/jama;282/3/267
2) http://pediatrics.aappublications.org/cgi/content/full/119/1/e77

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