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ASHP Survey Finds Nearly All U.S. Hospitals Use EHRs, CPOE Systems

In 13 years, use of paper-only patient health records fell from 69% to 1%

Technologies that improve medication use have been adopted by nearly 100% of hospitals across the United States, according to a survey by the American Society of Health-System Pharmacists (ASHP).

Implementation of technologies such as electronic health records (EHRs), computerized prescriber order-entry (CPOE) systems, and barcode-assisted medication administration systems supports pharmacists in their efforts to increase medication safety and provide effective and efficient patient care.

The rapid implementation of health information technology by hospitals has led to a sharp increase in paperless care. According to the “ASHP National Survey of Pharmacy Practice in Hospital Settings: Prescribing and Transcribing—2016,” 99% of hospitals across the country now use EHRs, compared with about 31% in 2003.

The use of CPOE systems by hospitals has also risen dramatically. Over the past 13 years, the number of hospitals that use paper-only patient health records has declined from 69% to 1%. In 2008, about 38% of hospitals used hand-written medication orders; in 2016, fewer than 3% of hospitals used hand-written orders. In addition, almost 93% of hospitals in 2016 use barcode medication administration systems.

“In addition to improving medication safety, the increased use of information technology shows great potential for pharmacists to spend more and more time providing comprehensive medication therapy management in and across all settings of patient care,” said ASHP Chief Executive Officer Paul W. Abramowitz, PharmD, ScD (Hon), FASHP. “These positive findings move us closer to achieving ASHP’s vision that medication use will be optimal, safe, and effective for all people all of the time.”

The speed at which EHR systems and technologies are being implemented by hospitals was a notable survey finding. “These developments clearly have the potential to improve access to clinical information to all caregivers and provide a platform for clinical decision support that offers safety alerts in real time,” wrote survey authors Douglas J. Scheckelhoff, MS, FASHP, Senior Vice President, Office of Practice Advancement at ASHP; Craig A. Pedersen, BSPharm, PhD, FAPhA; and Philip J. Schneider, MS, FASHP, FASPEN, FFIP.

The survey also evaluated pharmacists’ contributions to patient care activities during transitions of care, a period that is fraught with risk for medication errors and discrepancies in care. ASHP’s national survey showed that pharmacist and pharmacy technician use of medication histories at admission increased from 54% in 2012 to nearly 75% in 2016. Pharmacist-provided medication counseling at discharge more than doubled, from 22% in 2012 to 45% in 2016.

ASHP’s national survey, which is organized into six components of the medication-use system (prescribing, transcribing, dispensing, administration, monitoring, and patient education), provides an overall picture of the contemporary roles that pharmacists play in managing medication use. The survey focuses on two components of the medication-use system each year. The 2016 survey evaluated practices and technologies related to prescribing and transcribing, and included data from 392 hospitals in the United States ranging in size from fewer than 50 beds to more than 600 beds.

The survey is available online and appears in the September 1, 2017, issue of AJHP (American Journal of Health-System Pharmacy).

Sources: ASHP; September 6, 2017; ASHP survey; September 1, 2017.

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