Meaningful use of health information technology and declines in in-hospital adverse drug events.
OBJECTIVE
Nationwide initiatives have promoted greater adoption of health information technology as a means to reduce adverse drug events (ADEs). Hospital adoption of electronic health records with Meaningful Use (MU) capabilities expected to improve medication safety has grown rapidly. However, evidence that MU capabilities are associated with declines in in-hospital ADEs is lacking.


METHODS
Data came from the 2010-2013 Medicare Patient Safety Monitoring System and the 2008-2013 Healthcare Information and Management Systems Society (HIMSS) Analytics Database. Two-level random intercept logistic regression was used to estimate the association of MU capabilities and occurrence of ADEs, adjusting for patient characteristics, hospital characteristics, and year of observation.


RESULTS
Rates of in-hospital ADEs declined by 19% from 2010 to 2013. Adoption of MU capabilities was associated with 11% lower odds of an ADE (95% confidence interval [CI], 0.84-0.96). Interoperability capability was associated with 19% lower odds of an ADE (95% CI, 0.67- 0.98). Adoption of MU capabilities explained 22% of the observed reduction in ADEs, or 67,000 fewer ADEs averted by MU.


CONCLUSIONS
Concurrent with the rapid uptake of MU and interoperability, occurrence of in-hospital ADEs declined significantly from 2010 to 2013. MU capabilities and interoperability were associated with lower occurrence of ADEs, but the effects did not vary by experience with MU. About one-fifth of the decline in ADEs from 2010 to 2013 was attributable to MU capabilities.


CONCLUSIONS
Findings support the contention that adoption of MU capabilities and interoperability spurred by the Health Information Technology for Economic and Clinical Health Act contributed in part to the recent decline in ADEs.
Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, MD, USA.
Michael F
MF
Furukawa
Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, MD, USA.
William D
WD
Spector
Social and Scientific Systems, Silver Spring, MD, USA.
M
M
Rhona Limcangco
Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, MD, USA.
William E
WE
Encinosa
D000328:Adult; D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D057286:Electronic Health Records / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D000073892:Health Information Interoperability; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D062527:Meaningful Use / Q000331:legislation & jurisprudence; D008490:Medical Informatics / Q000331:legislation & jurisprudence; D006278:Medicare; D008508:Medication Errors / Q000517:prevention & control / Q000639:trends*; D008875:Middle Aged; D014481:United States / Q000453:epidemiology
adverse drug events; electronic health records; hospitals; interoperability; patient safety