Hospitals See Fewer Errors With Smarter Electronic Records

Medication errors in HIV hospitalized patients reduced with EMRs

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Patients with HIV are tasked with taking a complicated regimen of drugs on a daily basis. But you think that staff at a hospital could keep everything straight, right?  Given the complexity of HIV medications, hospitals have issues too.

Two new studies have found that in approximately half of cases, there are mistakes in the medications given to HIV patients during hospital stays.

Any mistake can lead to dangerous drug interactions, and a lower quality of treatment.

But there's good news in a third study: Medication errors dramatically decreased when the hospital's electronic records system that tracks prescriptions was improved.

"Does your doctor use an EMR?"

The studies were presented at IDWeek 2012, a conference focusing on infectious disease research and treatment. Each study focused on failure to administer HIV medications properly.

"Treatment of HIV infection is complex, involving the administration of multiple drugs that often have the potential for major interactions," Dr. Joel E. Gallant, IDWeek chair for the HIV Medicine Association, said in a press release. "Hospitalized patients are at risk for serious medication errors, especially when drugs are added or changed by physicians without HIV expertise.”

Most HIV patients are on a combination of three or more anti-retroviral drugs, which suppress the virus and keep it from spreading. But HIV might not be their primary reason for the hospital visit – diseases like cancer or tuberculosis are common among HIV patients.

But the doctor treating them for cancer might not be familiar with the ins and outs of HIV medications. They might not know about the drugs' level of toxicity or the risk of side effects when combined with other drugs.

Researchers at the Cleveland Clinic knew that HIV patients were at high risk for medical errors. They looked back at their own charts for patients on anti-retrovirals.

The results were surprising. For 162 patients over a ten month period in 2011, the rate of prescription errors was 50 percent. Two-thirds of these errors were never noticed and resolved before the patient left the hospital.

Similar rates of errors were seen at the University of Chicago Medical Center.

Elizabeth Neuner, an infectious disease clinical pharmacist at the Cleveland Clinic, said part of the reason might be that so much HIV care is delivered outside of hospitals now. Hospital doctors might not be up to code on care, because they don't deal with it as often.

Since the study, the Cleveland Clinic has taken action to increase education around HIV care, and improve communication between inpatient and outpatient settings.

It also took steps to enhance its electronic records system. And that's what the third study focused on.

The study, which took place at Michigan's Saint Mary's Health Care HIV clinic, saw a 93 percent drop in medical errors when the clinic was diligent about maintaining patients' prescriptions in the electronic records system of a nearby major hospital.

In addition to improved patient care, they found that fewer medical errors meant lower costs for care.

“These studies emphasize the critical importance of electronic medical records and early expert consultation in hospitalized HIV-infected patients to prevent dangerous and costly medication errors," Dr. Joel E. Gallant said in the press release.

IDWeek took place in October 2012.  

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Review Date: 
October 15, 2012
Last Updated:
November 6, 2012