PMD114 - Impact of the Hitech Act’s Incentive Program on the Adoption of Drug-Drug Interaction Alerts and Electronic Prescribing in the Ambulatory Care Setting

Abstract

The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act has allocated billions of dollars as incentives through the meaningful use (MU) program to promote the implementation of electronic health record (EHR) systems nationwide. The use of drug-drug interaction (DDI) alerts, electronic prescribing (eRx), and computerized physician order entry (CPOE) systems integrated into EHR systems has now become mandatory for providers to achieve MU compliance and qualify for financial incentives, that ultimately aimed to reduce medication errors, and improve patient outcomes and adherence. This study examined the extent to which the HITECH Act’s incentive program enhanced the adoption of DDI alerts, eRx and CPOE medication ordering systems. A cross-sectional analysis of 10 years (2006–2015) of the National Ambulatory Medical Care Survey (NAMCS). The data were analyzed at the physician level using weighted analyses. Descriptive statistics for all study variables were calculated. Chi-square test for trend was used to assess the adoption trends. Chi-square test was used for comparison of the adoption proportions before and after initiating the HITECH Act’s incentive program. All analyses were performed using SAS 9.3 at alpha of 0.05. In 2015, 77% of ambulatory care practices had a CPOE medication ordering system that provide DDI alerts and send prescriptions electronically, increasing by 27% since 2011. Trends in adoption of DDI alerts, eRx, and CPOE medication ordering system showed significant increase from 2006 to 2015 (P<.0001). The period after initiating the HITECH Act’s incentive program (2012-2015), showed significant increase in the proportion of the adoption of CPOE medication ordering system (P<.0001) and concurrent use of DDI alerts and eRx functions (P<.0001), compared to prior period (2006-2011). The adoption of CPOE medication ordering systems that provide DDI alerts and send prescriptions electronically have significantly increased after initiating the HITECH Act’s incentive program.