Some EHRs Lack Accurate Adverse Drug Event Detection

Although there are a number of benefits to implementing an EHR system in your hospital or clinic, one of the most significant benefits is the reduced risk to patients because of adverse drug events, or ADEs. Most, if not all, EHRS have a system to detect ADEs, which can not only save lives but save billions of dollars each year.

However, according to a new study in the Journal of American Medical Informatics Association, not all EHRs are making the grade when it comes to detecting ADEs. In fact, some systems have serious design flaws, giving them a failing grade in this area.

According to the study, 6.5% of hospitalized patients go through an ADE, which makes these mistakes a very real and significant threat to patient health. Again, one of the biggest advantages of EHR systems is their ability to catch ADEs before they happen. The researchers theorized that EHRs would be far more efficient at detecting ADEs because they’re faster, cheaper, and more objective than manual chart reviews.

However, the study shows that these detections are accurate only 50% of the time in the best of cases. And for some EHRs, this number was much lower. Here’s a summary of the study’s results, which are really interesting (you can find the full abstract here):

Forty-eight studies met our inclusion criteria. Twenty-four (50%) studies reported rule accuracy but only 9 (18.8%) utilized a proper gold standard (chart review in all patients). Rule accuracy was variable and often poor (range of sensitivity: 40%–94%; specificity: 1.4%–89.8%; positive predictive value: 0.9%–64%). 5 (10.4%) studies derived or used detection rules that were defined by clinical need or the underlying ADE prevalence. Detection rules in 8 (16.7%) studies detected specific types of ADEs.

The problem is that there are very few studies that look at ADE detection in a scientific way. Another problem is that there are no standard ADE definitions, which leads to missed or inaccurate detection of ADEs.

The good news is that NextGen has a very effective system in place to handle allergy, and drug-to-drug interactions. This is one of the biggest benefits of the NextGen EHR.

The researchers recommend that IT developers and investigators pay more attention to the algorithms they use to detect ADEs, and the various ways they can occur. If you’re researching different EHR systems for your own hospital or clinic, ADE detection is something you’ll want to pay particular attention to. Find out how accurate each vendor’s e-prescribing and ADE detection is, and ask what they’re doing to improve the accuracy of these two systems.

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