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Survey Finds Extensive Use of Technology in Hospital Pharmacies

Use of EHRs, clinical decision support, and patient-engagement tools growing

Technology is increasingly a core element of the medication-use process in U.S. hospitals and supports pharmacists in their efforts to provide safe, effective, and efficient patient care, according to a survey conducted by the American Society of Health-System Pharmacists (ASHP).

The survey, an expanded update of the first national survey of pharmacy informatics conducted in 2007, was published in the April 15 issue of the American Journal of Health-System Pharmacy. Reponses to the survey identify the specific medication-related technologies in use by hospitals and, in some cases, the extent to which they have been implemented.

The use of electronic health records (EHRs) is the foundation for an integrated health information technology infrastructure to support patient care activities. According to the survey, nearly one in three hospitals no longer use paper charts and have moved to a complete EHR. Two of three hospitals that have a partial or complete EHR also use electronic documentation to record all provider notes, including observations, assessments, care plans, and dosage adjustments. Eight out of ten hospitals with an EHR that allow pharmacists to see the EHR also allowed pharmacists to document and make recommendations.

Many hospitals are also showing significant progress in meeting the objectives of the Centers for Medicare & Medicaid Services “Meaningful Use” EHR incentive program, the survey suggests. More than half of the respondents had met all of the core measures in stage 1, and 25% reported meeting all of the core measures in stage 2. No hospitals reported an inability to meet any stage 1 core measures, and most (95%) were able to meet at least one core measure in stage 2.

Other key survey findings include the following:

  • While more than 75% of hospitals reported having a computerized prescriber order entry (CPOE) system in place, the presence of the system was not a guarantee of usage. In 80% of hospitals with CPOE systems, prescribers use the technology to enter only 50% of orders.
  • Sixty-one percent of hospitals with a CPOE system also use clinical decision support systems to help prescribers make the most effective medication choices. Twenty percent of respondents with a CPOE system were planning to add clinical decision support by 2016.
  • Sixty-four percent of hospitals use ePrescribing in outpatient settings, and 30% pair their ePrescribing systems with clinical decision support. Nearly 60% of respondents use ePrescribing to send outpatient clinic medication orders to community pharmacies, and 57% send discharge prescriptions to community pharmacies.
  • Forty percent of hospitals provide a patient portal that allows patients and caregivers to view test results; to send emails to providers; to obtain information on medications and medical conditions; and to schedule appointments. Thirty percent of hospitals make personal health records available to patients and caregivers.

The results of the survey also reveal broad adoption of online medication ordering, bar coding, automated dispensing, electronic medication administration records, and “smart” infusion pumps. Most respondents use an integrated pharmacy computer system, and nearly half have pharmacy information technology (IT) positions, an average of 3.12 full-time equivalents.

Paper remains the preferred method for medication reconciliation. Nearly half of all respondents use a paper-only system; 39% employ an approach that uses both paper and electronic processes; and only 13% of hospitals use a completely electronic process.

Source: ASHP; April 6, 2015.

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