title: Expert panel evaluation of health information technology effects on adverse events.
abstract: OBJECTIVE
  Adverse events (AEs) among hospitalized patients occur frequently and result in significant sequelae. Federal policy is incentivizing health information technology (HIT) use, although research demonstrating safety benefits from HIT is mixed. Our objective was to evaluate the potential effects of HIT on reducing 21 different inpatient AEs. Identifying AEs most likely to be reduced by HIT can inform the design of future studies evaluating its effectiveness.
  
  
  METHODS
  We conducted a modified Delphi panel of national experts in HIT and safety. We conducted a focused literature review to inform the experts. Using a novel framework, experts rated each AE as 'definitely reduced by health IT,' 'possibly reduced by health IT' and 'not likely to be reduced by health IT'.
  
  
  RESULTS
  From our panel discussion, experts identified six AEs as 'definitely reduced by health IT': (1) adverse drug events (ADEs) associated with digoxin; (2) ADE associated with IV heparin; (3) ADE associated with hypoglycaemic agents; (4) ADE associated with low molecular weight heparin and factor Xa inhibitor; (5) contrast nephropathy associated with catheter angiography; and (6) ADE hospital-acquired antibiotic-associated Clostridium difficile.
  
  
  CONCLUSIONS
  Understanding the effects of HIT on patient outcomes will be essential to ensuring that the significant federal investment results in anticipated improvements. This study serves as an important early step in helping with the design of future work evaluating level of HIT infrastructure and rates of inpatient AEs.
authors.affiliation: Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA; Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA; New York-Presbyterian Hospital, New York, NY, USA; Health Information Technology Evaluation Collaborative (HITEC), New York, NY, USA; Center for Healthcare Informatics and Policy, New York, NY, USA.
authors.forename: Erika L
authors.initials: EL
authors.lastname: Abramson
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kern
authors.forename: Samantha
authors.initials: S
authors.lastname: Brenner
authors.forename: Meghan
authors.initials: M
authors.lastname: Hufstader
authors.forename: Vaishali
authors.initials: V
authors.lastname: Patel
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
mesh_terms: D026683:Advisory Committees; D003697:Delphi Technique; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D008490:Medical Informatics; D061214:Patient Safety
keywords: adverse events; health information technology