Document Detail


Impact of health information technology interventions to improve medication laboratory monitoring for ambulatory patients: a systematic review.
MedLine Citation:
PMID:  20962124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Medication errors are a major source of morbidity and mortality. Inadequate laboratory monitoring of high-risk medications after initial prescription is a medical error that contributes to preventable adverse drug events. Health information technology (HIT)-based clinical decision support may improve patient safety by improving the laboratory monitoring of high-risk medications, but the effectiveness of such interventions is unclear. Therefore, the authors conducted a systematic review to identify studies that evaluate the independent effect of HIT interventions on improving laboratory monitoring for high-risk medications in the ambulatory setting using a Medline search from January 1, 1980 through January 1, 2009 and a manual review of relevant bibliographies. All anticoagulation monitoring studies were excluded. Eight articles met the inclusion criteria, including six randomized controlled trials and two pre-post intervention studies. Six of the studies were conducted in two large, integrated healthcare delivery systems in the USA. Overall, five of the eight studies reported statistically significant, but small, improvements in laboratory monitoring; only half of the randomized controlled trials reported statistically significant improvements. Studies that found no improvement were more likely to have used analytic strategies that addressed clustering and confounding. Whether HIT improves laboratory monitoring of certain high-risk medications for ambulatory patients remains unclear, and further research is needed to clarify this important question.
Authors:
Shira H Fischer; Jennifer Tjia; Terry S Field
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of the American Medical Informatics Association : JAMIA     Volume:  17     ISSN:  1527-974X     ISO Abbreviation:  J Am Med Inform Assoc     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-10-21     Completed Date:  2011-02-18     Revised Date:  2011-11-08    
Medline Journal Info:
Nlm Unique ID:  9430800     Medline TA:  J Am Med Inform Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  631-6     Citation Subset:  IM    
Affiliation:
Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01605, USA. shira.fischer@umassmed.edu
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care Information Systems*
Decision Support Systems, Clinical*
Drug Monitoring*
Humans
Medical Order Entry Systems*
Medication Errors / prevention & control*
Medication Systems*
Quality of Health Care*
Reminder Systems

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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