Medication Safety Tools: Evaluation of Vendor Offerings for Computerized Physician Order Entry and Medication Administration

In the two years since the first publication of Medication Safety Tools, our national focus on medication and safety has intensified. The need to bar code unit doses of medications
is being discussed at the executive level of the U.S. Department of Health and Human Services, the Leapfrog Group's initiatives have achieved strength, and hospitals are purchasing and implementing technology to improve medication safety. Consequently, Medication Safety Tools 2003 is more timely and potentially useful than ever. This report catalogues the functional richness of some of the commercially available medication safety software applications for the acute care setting: Computerized Physician Order Entry (CPOE) and Medication Administration.

The impact of the Leapfrog Group's initiative deserves special notice. When it was originally published, there was skepticism in many circles and the opinion expressed was
that Computerized Physician Order Entry (hereinafter referred to as CPOE) might be a good idea but that pervasive adoption was essentially unattainable. As Leapfrog Group participation by Purchasers has increased, more regions of the country have come under its scrutiny. Currently, 70% of the US population lives in an area where at least one hospital is responding to Leapfrog surveys. Hospitals, by participating in the surveys, have acknowledged that the issue of patient safety can't be ignored and are signing up to respond to the initiatives.

Interest has spread well beyond the provider community and it is now routine to read newspaper articles and editorials on the topic of medication safety and the potential role of
technology in its improvement. A new industry of conferences on Patient Safety and CPOE has been spawned and attendance has been strong. Nonetheless, the most recent survey information shows that fewer than 5% of US hospitals have implemented CPOE, although an additional 25% have specific plans to do so by 2004. Hospitals are thus either trying to develop their strategy or are hard at work on the process.

Medication Safety Tools 2003 has three major types of information which provider organizations can use to accelerate their medication safety efforts: Strategic Planning
Methods, Functionality Tutorials, and Vendor Assessments.

* Strategic Planning Methods

The purpose of implementing technology is to improve patient outcomes by transforming the clinical care process, consequently affecting how almost everybody in the organization
does their jobs. Hospitals need methods to successfully engage staff and ultimately deploy the tools they need to provide care and improve clinical outcomes. This report describes proven methods to nurture such evolution. Also included are an effective implementation sequence of clinical information systems functionalities, how to select a product, and methods for getting accurate information about the product from the vendor and reference sites

* Functionality Tutorials

In a marketplace where there are many vendors, with a panoply of complex products, it is essential that purchasers do their homework before viewing products. They must become educated on the functionalities and prioritize them before viewing products from any vendor. This report is designed to help purchasers through that process. For both CPOE and electronic Medication Administration Records, detailed lists of desirable functionalities are presented and explained, with enough detail for the un-initiated to come up to speed quickly. By standardizing the nomenclature, planning discussions can be more focused and effective.

* Vendor Assessments

This analysis focuses on the issue of inpatient Medication Safety. To successfully prevent medication errors there needs to be tight integration of four processes, each computerized: capturing and displaying clinical observations and results, pharmacy operations, physician order entry, and medication administration. This report evaluates commercial offerings of
only two of the four application sets, namely, Computerized Physician Order Entry and Medication Administration. To aid vendor selection, assessments are presented, demonstrating the use of a template that can also be employed by providers to do their own evaluations or validate those in the report. For CPOE, 74 criteria are examined, for Medication Administration, there are 42 criteria.

There are 3 health care provider audiences that will find the report useful:

The uninitiated can use the Introduction to get savvy fast about organizational process and how to tell when a vendor is overstating reality. They can read the Functionality descriptions to understand what these CPOE and med charting things are all about. Use the evaluations to calibrate what good functionality looks like and narrow the field of vendors.
The moderately savvy can use the Functionality descriptions as the basis for prioritization discussions within the already established steering committee. They can use the evaluations as a safety net for their own assessments since many subtleties are pointed out that might get missed unless you know to look for them.
The already in the middle of the struggle and very wise can use the Introduction to get others quickly up to speed. Use the Functionality descriptions and evaluations in dealing with the already selected vendor: "This report says you have this functionality, when can we have it?" "Your competitors have this functionality, why don't you?" "Why do you say this missing functionality is unimportant when this report says it is a 'high priority' item."

The complete 90 page Medication Safety Tools 2003 report costs $299 and may be purchased and downloaded electronically. Click to Buy Now