This Article Full Text Full Text (PDF) All Versions of this Article: M1099v1 9/5/479    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Anderson, J. G. Articles by Hunt, T. J. Search for Related Content PubMed PubMed Citation Articles by Anderson, J. G. Articles by Hunt, T. J.

Evaluating the Capability of Information Technology to Prevent Adverse Drug Events: A Computer Simulation Approach

Affiliations of the authors: Purdue University, West Lafayette, IN (JGA); Indiana University School of Medicine, Indianapolis, IN (SJJ); Anderson Consulting, West Lafayette, IN (MA); Robert B. Katz and Associates, Chicago, IL (TJH).

Correspondence and reprints: James G. Anderson, PhD, Professor of Medical Sociology, Coordinator Rural Center for AIDS/STD Prevention, Department of Sociology and Anthropology, 1365 Stone Hall, Purdue University, West Lafayette, IN 47907; e-mail: <andersonj{at}sri.soc.purdue.edu>.

Background: The annual cost of morbidity and mortality due to medication errors in the U.S. has been estimated at $76.6 billion. Information technology implemented systematically has the potential to significantly reduce medication errors that result in adverse drug events (ADEs).

Objective: To develop a computer simulation model that can be used to evaluate the effectiveness of information technology applications designed to detect and prevent medication errors that result in adverse drug effects.

Methods: A computer simulation model was constructed representing the medication delivery system in a hospital. STELLA, a continuous simulation software package, was used to construct the model. Parameters of the model were estimated from a study of prescription errors on two hospital medical/surgical units and used in the baseline simulation. Five prevention strategies were simulated based on information obtained from the literature.

Results: The model simulates the four stages of the medication delivery system: prescribing, transcribing, dispensing, and administering drugs. We simulated interventions that have been demonstrated in prior studies to decrease error rates. The results suggest that an integrated medication delivery system can save up to 1,226 days of excess hospitalization and $1.4 million in associated costs annually in a large hospital. The results of the analyses regarding the effects of the interventions on the additional hospital costs associated with ADEs are somewhat sensitive to the distribution of errors in the hospital, more sensitive to the costs of an ADE, and most sensitive to the proportion of medication errors resulting in ADEs.

Conclusions: The results suggest that clinical information systems are potentially a cost-effective means of preventing ADEs in hospitals and demonstrate the importance of viewing medication errors from a systems perspective. Prevention efforts that focus on a single stage of the process had limited impact on the overall error rate. This study suggests that system-wide changes to the medication delivery system are required to drastically reduce mediation errors that may result in ADEs in a hospital setting.

This article has been cited by other articles:

				R Howard, A Avery, and P Bissell Causes of preventable drug-related hospital admissions: a qualitative study Qual. Saf. Health Care, April 1, 2008; 17(2): 109 - 116. [Abstract] [Full Text] [PDF]

				J. Karnon, A. McIntosh, J. Dean, P. Bath, A. Hutchinson, J. Oakley, N. Thomas, P. Pratt, L. Freeman-Parry, B.-T. Karsh, et al. Modelling the expected net benefits of interventions to reduce the burden of medication errors J Health Serv Res Policy, April 1, 2008; 13(2): 85 - 91. [Abstract] [Full Text] [PDF]

				V. L. Hinrichsen, B. Kruskal, M. A. O'Brien, T. A. Lieu, R. Platt, and Vaccine Safety Datalink Team Using Electronic Medical Records to Enhance Detection and Reporting of Vaccine Adverse Events J. Am. Med. Inform. Assoc., November 1, 2007; 14(6): 731 - 735. [Abstract] [Full Text] [PDF]

				A. G. Hartzema, A. G. Winterstein, T. E. Johns, J. M. De Leon, W. Bailey, K. McDonald, and R. Pannell Planning for pharmacy health information technology in critical access hospitals Am. J. Health Syst. Pharm., February 1, 2007; 64(3): 315 - 321. [Abstract] [Full Text] [PDF]

				R S. Evans, J. F Lloyd, G. J Stoddard, J. R Nebeker, and M. H Samore Risk Factors for Adverse Drug Events: A 10-Year Analysis Ann. Pharmacother., July 1, 2005; 39(7): 1161 - 1168. [Abstract] [Full Text] [PDF]

				B. Bogucki, B. R. Jacobs, J. Hingle, and the Clinical Informatics Outcomes Research Group Computerized Reminders Reduce the Use of Medications during Shortages J. Am. Med. Inform. Assoc., July 1, 2004; 11(4): 278 - 280. [Abstract] [Full Text] [PDF]

				R E Ferner Computer aided prescribing leaves holes in the safety net BMJ, May 15, 2004; 328(7449): 1172 - 1173. [Full Text] [PDF]

				D. S. Bell, S. Cretin, R. S. Marken, and A. B. Landman A Conceptual Framework for Evaluating Outpatient Electronic Prescribing Systems Based on Their Functional Capabilities J. Am. Med. Inform. Assoc., January 1, 2004; 11(1): 60 - 70. [Abstract] [Full Text] [PDF]