Conducting Measurement Activities for Health Information Technology Initiative

In this project, the team identified the most appropriate and feasible methods of collecting data on national performance on the adoption, use, and outcomes of health IT. They went on to study three measures as seen in the objectives below. The main objectives of the project were to:

• Develop reliable, valid, useful, timely, and cost-efficient measures and national estimates for three key measures of health IT progress:
• Reduction in medication errors due to adoption of electronic prescribing systems.
• The number of clinicians who have adopted and are using clinical decision support (CDS) in ambulatory settings.
• The number of hospitals that have adopted and are using CDS.

The project team completed data analysis for each of the three measures.

Reduction of medication errors due to the adoption of electronic prescribing (e-prescribing). It was estimated that proximately 26 percent of all in-hospital prescription drug orders were processed by an e-prescribing system in 2008. The use of e-prescribing systems was estimated to avert approximately 14.3 million medication errors in 2008. Further, it was estimated that as many as 86 million medication errors could have been averted in 2008 with greater adoption and use of e-prescribing.

Adoption and use of CDS in ambulatory settings. When CDS is available, 94.4 percent of clinicians will use an aspect of the CDS at least some of the time. Adoption and use of CDS technologies is higher for physicians working in ambulatory care practices that are larger, multi-specialty, or located within a hospital medical center.

Adoption of CDS in hospitals. The team estimated that in 2008, 65 percent of hospitals in the study population had adopted at least one of six types of CDS (clinical guidelines, clinical reminders, drug allergy alerts, drug-drug interaction alerts, drug-laboratory interaction alerts, or drug dosing support). CDS technologies that inform courses of action (clinical guidelines, clinical reminders, and drug dosing support) were adopted at a lower rate than CDS technologies that correct courses of action (drug-allergy alerts, drug-drug interaction alerts, and drug-lab interaction alerts). Further, adoption was higher among hospitals that were larger, members of hospital systems, major teaching hospitals, urban, or those not classified as public hospitals.