EHRs Can Help Reduce Errors

David W. Bates MD, Chief Division of General Internal Medicine and Primary Care at Brigham and Women’s Hospital www.brighamandwomens.org, conducts studies for the Agency for Health Research and Quality (AHRQ) www.ahrq.gov. He has found that a significant portion of medication errors in hospitals have occurred when physicians place the drug order not when the drugs are dispensed or administered.

Several of Dr. Bates AHRQ funded studies are studying how to identify how health IT can improve the safety and quality of care through better use of CPOE, smart infusion pumps, clinical decision support, and EHRs.

Dr. Bates and his team at Brigham and Women’s Hospital have been working since 2014 on the AHRQ project “Ensuring Safe Performance of EHRs” with funding of $1,247,829. The study is expected to end August 31, 2019.

The study will enable Dr. Bates and the research team to build the “Leapfrog Computerized Provider Order Entry (CPOE) EHR” www.leapfroggroup.org.This tool will be used to evaluate the safety performance of EHRs after deployment especially focusing on high-impact patient safety and medication safety problems.

The tool is essentially testing the use of EHRs with CPOE so hospitals can practice downloading simulated predefined groups of orders for patients and then record whether critical decision support is responding to these scenarios.

The investigators are refining and further developing the Leapfrog CPOE/EHR test using the existing web-based testing approach which includes updates to the inpatient version of the test. This is necessary so that the test is compatible with the latest versions of the leading EHR vendor products and the latest hospital data. In addition, a new database will be created to host and administer the test.

The investigators will then work with four study hospitals using four different leading major vendor applications to refine the test further. The research obtained from the hospitals will enable the team to track how many hospitals nationally are using the system, how they are performing on the test, and also how much they are improving with time.