Meaningful Use IT reduces hospital-caused adverse drug events even at challenged hospitals

Abstract

Backgroundmany Meaningful Use (MU) requirements involve medication management. Little is known about what impact these will have on adverse drug events (ADEs) at challenged hospitals. Methodswe use the Florida State Inpatient Database (HCUP, AHRQ), the AHA IT Supplement, and Hospital Compare. Controlling for non-response selection bias, we use multi-level GLLAMM regression analysis to examine the impact of the 5 core MU medication elements on hospital-caused ADEs. Resultsadopting all 5 core MU elements was associated with a reduction in ADEs. Hospitals reporting costs as the main barrier to MU reduced their ADE rates by 35%; low quality hospitals reduced ADEs by 29%, compared to 27% at high quality hospitals. Among hospitals reporting these medication elements among their top MU challenges, ADEs were reduced by 69%, compared to 45% for hospitals with no drug functions as their top MU challenges. However, ADEs increased by 14% at hospitals with physician resistance to MU, compared to a 52% ADE reduction without physician resistance. Conclusionsthe bundling all five medication functions in MU is associated with large reductions in ADEs. Implicationswithout physician buy-in at the hospital, MU will have no impact on ADEs.