HIT for Medication Safety in Critical Access Hospitals

Little is known about the status, needs, or impact of health information technology (health IT) on medication safety in critical access hospitals (CAHs). The purpose of this project was to plan for the implementation of medication-related health IT in Florida's CAHs. The partners in this project included all 12 Florida CAHs, University of Florida College of Pharmacy, UF & Shands, Shands Healthcare, Florida Office of Rural Health, and Florida Medical Quality Assurance, Inc. Two methods were used to plan for the implementation, including an on-site health IT survey, and two planning conferences. The survey supplied an assessment and description of current health IT, health IT needs, barriers to implementation, quality improvement activities and impact of health IT, and pharmacy/medication use information. The first planning conference was a vendor fair to impact product information and reach consensus regarding health IT system(s) desired. The second conference focused on health IT and medication safety, medication-related Joint Commission accreditation requirements, current health IT status, and obtaining a commitment of matching funds for health IT implementation. It was found that health IT in CAHs can impact medication safety at all nodes of the medication use process, from prescribing to administration. Health IT status varied among CAHs, thus, implementation efforts and support must be individually tailored. Implementation should concentrate on bringing all CAHs to an equal level. Medication-related health IT implemented must address lack of full time pharmacy staff. Health IT desired included three phases of implementation: first, pharmacy information management systems, then automated dispensing cabinets, then smart IV pumps. Barriers to health IT implementation included limited funds, staff resistance to change, staff adaptation to health IT and workflow changes, time constraints on small staff, facility/building barriers, and lack of IT support.