The harm caused by adverse drug events is staggering. According to the U.S. Department of Health and Human Services (HHS), one in three adverse events in hospitals involve injuries to patients resulting from medications. These injuries affect approximately 2 million hospital stays each year, and prolong hospital stays by 1.7 to 4.6 days.
Despite these statistics, there is some good news: HHS also says most ADEs are preventable. In this blog post, I’ll review how hospitals—from a busy academic medical center to rural community hospitals—are relying on new technologies to improve medication reconciliation to prevent ADEs from negatively affecting patient outcomes.
Preventing a Serious Hypoglycemic Event at an Academic Medical Center
Boston Medical Center is a private, not-for-profit, 514-bed, academic medical center that serves as the largest safety-net hospital and busiest trauma and emergency services center in New England. More than half of the medical center’s patients come from underserved populations, such as the low-income and elderly, and approximately 32% of patients do not speak English as a primary language.
To better serve this patient population, Boston Medical Center implemented a digital medication reconciliation process to augment in-person patient interviews. Using MedHx™ from DrFirst, Boston Medical Center quickly accesses a patient’s medication history by pulling 12 months of data from sources such as pharmacy benefits managers (PBMs), pharmacy fill data, payer records, electronic health records (EHR) systems, and local health information exchanges (HIEs). By importing this data, the hospital fills in gaps in the patient record and corrects inaccurate medication histories reported by patients and families. It also streamlines the admissions and discharge process and eases workload for pharmacy and nursing staff, who would otherwise need to type this information into the record, a process that is itself prone to errors. Most importantly, MedHx adds vital information to the patient record that can prevent an adverse drug event.
Vinh Nguyen, pharmacy operations manager at Boston Medical Center, says, “With MedHx we are seeing increased efficiencies across the pharmacy department while improving our ability to reduce adverse drug events. For one patient, we identified a potential duplication of insulin ordering from the PCP and an external diabetes specialist. The patient never mentioned that they were seeing an outside specialist, but with DrFirst we were able to add the insulin to the patient list and monitor.”
Filling Gaps in Patient Medication Histories at Small Community Hospitals
William Newton Hospital is a critical access, not-for-profit, community hospital with 25 licensed beds. Located in Winfield, Kansas, a community of 12,000 people about 50 miles from the state’s largest city of Wichita, the hospital provides acute care, same-day and orthopedic surgery, skilled swing beds, home healthcare, and many diagnostic and therapeutic services. It also operates five rural health clinics in surrounding counties.
To improve the accuracy and completeness of home medication lists prior to treatment, William Newton Hospital implemented MedHx with SmartSig, an AI engine for reconciling medication history.
According to Kelle Thompson, Director of Pharmacy at William Newton Hospital, “MedHx has improved our ability to reduce adverse drug events. We use the day’s supply to calculate how a patient should take their meds. Many times they tell us incorrectly on the initial interview, and when we ask them again (using the MedHx information), they realize they have mixed it up with other medications.”
Previously, staff needed up to 30 minutes to collect, verify, and document a patient’s medication history. The new technology gathers comprehensive medication history data from multiple sources, then uses artificial intelligence to clean the data and fill in essential prescription instructions. The process now typically takes less than 15 minutes, and results in a more complete medication history in the patient record, reducing the risk of ADEs. It also gives clinicians more time for patient care and the ability to focus on other safety measures.
Across the country at Stephens County Hospital, a 96-bed acute care facility in northeast Georgia, Anne Moore, director of nursing, reveals how missing medications from a patient’s history can have dire consequences. “With one patient we almost prescribed Tridil for treatment, but after reviewing MedHx, we found out that he had taken Viagra within the last 24 hours. We intervened and avoided an ADE that would have caused irreversible hypotension.”
Automating Systems and Processes for More Complete Medication Histories
Multiple factors contribute to patient safety events, including ADEs. While hospitals require numerous interventions to ensure patient safety, automated medication reconciliation systems can go a long way toward immediate reduction of ADEs.