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Decreasing ADEs in Montana Frontier Critical Access Hospitals through HIT

Project Details -
Completed

The Montana Rural Healthcare Performance Improvement Network initiated this study to assess the opportunities to decrease adverse drug events (ADEs) in frontier Montana critical access hospitals (CAHs), and to identify appropriate, cost-effective health information technology (health IT) solutions to the medication use challenges of these facilities. The study involved 39 of Montana's 45 Critical Access Hospitals which are located in 39 of 56 Montana counties. A baseline assessment of current medication management systems and the ADE reporting culture was conducted in December 2004. Based on the results of this assessment, a six month pilot project to test the impact of a Web-based ADE reporting system on the numbers and types of ADEs reported, patient impacts, and organization benefits of health IT implementation was conducted in 2006. Implementation of the Web-based ADE reporting system appears to have reduced voluntary ADE reporting in IT sites to a level which is counter-productive to improving patient safety. However, the system appears to have improved the overall reporting of prescription, transcription, and dispensing process errors, clarified the impact of ADEs on patients, and reduced fear of censure or discipline as a barrier to reporting ADEs. Low patient and ADE volumes are barriers to achieving sufficient economies of scale to implement health IT in many Montana CAHs. The study identified financial, technical, and human resource factors which appear to have contributed to the successful installation of a web-based ADE reporting system in four of the five IT pilot sites.