Study undertaken to determine if health IT prevents adverse drug events

WORCESTER, Mass. Researchers at the Meyers Primary Care Institute, which is a collaboration of University of Massachusetts Medical School, the Fallon Clinic and Fallon Community Health Plan, are starting a project to test health-information technology tools as solutions to the dangers of handoffs from hospital to primary care when it comes to prescribing and monitoring medications in people over 65, according to published reports.

Institute executive director Jerry Gurwitz will lead the study, funded by a three-year, $1.2 million grant from the federal Agency for Healthcare Research and Quality. The goal is to see if systems based on patients’ electronic health records prevent adverse drug events, emergency room visits and repeat hospitalizations. AHRQ is making similar grants across the country focusing on transitions in medical care.

“We’ve come to the conclusion that it’s really all the drugs that doctors and other health providers prescribe,” Gurwitz said. “It’s not just a certain finite list of medications that lead to problems. Mainly it’s how drugs are used, how drugs are prescribed, how drugs are monitored and how patients take them that can lead to problems.”

“Right now, a piece of paper is faxed to primary care physicians, but we’re going to use technology to highlight the changes to make sure it’s very clear what’s happened to the medications, what’s been stopped, what’s been started and what kind of monitoring needs to take place,” said Lawrence Garber, an internal medicine doctor and architect of Fallon Clinic’s transition from paper to electronic medical records. Doctors Garber, Jennifer Tjia and Terry Field are co-investigators on the Meyers project.

Beth Israel Deaconess Medical Center in Boston uses a medication-reconciliation system that automatically updates medication lists for its patients when they are seen at its affiliated primary-care clinics or in the hospital. The system also includes the decision-support piece of the package, flagging possibly harmful drug interactions and advising lab tests to monitor side effects if warranted.

“You typically see in the literature and in our experience that by putting in place e-prescribing and all the electronic medical record controls, you can reduce medication errors by about 50 percent,” said John Halamaka, chief information officer at Beth Israel Deaconess and Harvard Medial School. He added that, “About two million preventable medical errors are committed every year that cause harm.”