Michigan Hospitals Improve Usage of Computerized Physician Order Entry Systems


New report shows drastic improvement in Michigan hospital’s using computerized systems preventing medication errors

Analysis of The Leapfrog Group’s Data by Castlight Health Found CPOE Systems Failed to Flag 13 Percent of Potentially Fatal Orders, Emphasizing Need for More Checks

NOVI – April 7, 2016 Despite improvements in recent years, a report released today by the Leapfrog Group in connection with Medication Safety Awareness Week (April 1 to April 7) shows that not all hospitals have implemented crucial computerized physician order entry (CPOE) systems for preventing medication errors during hospital stays. Even hospitals with well-functioning CPOE systems must double- and triple-check orders to prevent harm to patients, the report recommends.

The report, Preventing Medication Errors in Hospitals, analyzes data collected by The Leapfrog Group, a Washington, D.C.-based organization representing consumers, employers and other purchasers aiming to improve health care safety and quality. Even in cases where hospitals had CPOE systems in place, 39 percent of potentially harmful drug orders weren’t flagged by the system to alert staff of potential errors. The analysis, done by Castlight Health, also found that 13 percent of potentially fatal orders failed to trigger an alert by the system.

“CPOE systems have done a remarkable job in reducing the likelihood of medication errors, but mistakes are still seen with far too much frequency,” said Leah Binder, president and CEO of Leapfrog. “Hospitals spend millions of dollars to implement CPOE systems, but our results clearly show that many hospitals’ systems are not operating as well as they should, putting patients’ lives at risk.”

Comparing 2015 data to 2014, more Michigan hospitals are participating in CPOE reporting, resulting in a drastic increase in CPOE improvement.  In 2014, 46 Michigan hospitals submitted CPOE results and only 54 percent of those hospitals fully met The Leapfrog Group CPOE standards.  In 2015, 57 Michigan hospitals submitted CPOE results and 75 percent of those hospitals fully met The Leapfrog Group CPOE standards.

“This is tremendous news for Michigan patients.  To improve from 25 hospitals fully meeting CPOE standards to 43 in just one year shows that transparency improves patient safety and quality of care,” said Bret Jackson, EAM President.  “The more hospitals participate in transparency reporting, like the Leapfrog Survey, the more we’ll see patient safety improvements which leads to lower health care costs for consumers and employers.”

Additional key findings highlighted in the report include:

  • Almost every reporting hospital now has a CPOE system, marking a significant advance for medication safety. Spurred in great part by federal investment in hospital IT infrastructure, nearly all (96 percent) of hospitals report adoption of a CPOE system, up from 33 percent in 2010 and just two percent when Leapfrog first began reporting on CPOE in 2001. CPOE is the best-known tool to prevent medication errors, which remain the most common mistake made in hospitals.
  • Nearly two-thirds of hospitals (64 percent) fully met Leapfrog’s CPOE standard for CPOE implementation and quality. To meet Leapfrog’s standard a hospital must demonstrate that its system alerts physicians to at least 50 percent of common, serious prescribing errors. Hospitals must also place at least 75 percent of medication orders through a CPOE system.
  • CPOE use varies state by state. Among the states with the lowest percentage of hospitals meeting Leapfrog’s standard – CPOE systems that alert physicians to at least 50 percent of common, serious prescribing errors and process at least 75 percent of all medication orders – were Indiana (25 percent) and Nevada (35 percent). Five additional states had fewer than 50 percent of hospitals meeting the standard. Alternatively, among the states with the most hospitals meeting the standard were Maine (85 percent), Georgia (83 percent), and New York (81 percent). Eight additional states reported 75 percent or more hospitals meeting the standard, including Michigan.
  • Hospitals can promote greater accountability for processes to check patients’ medications. In a series of 15 questions based on the National Quality Forum’s Safe Practices for Better Healthcare, hospitals were asked to report on efforts to implement policies and procedures that can prevent adverse drug events. Over half (62%) of reporting hospitals indicated they conduct all recommended medication reconciliation activities. Nearly all hospitals had implemented processes for documenting patient medications at admission (98 percent) and shared the updated medication list with patients and caregivers at discharge (99 percent).
  • However, not all hospitals had implemented the policies to ensure adherence to these processes. Only 84 percent of hospitals held their senior administrative leadership accountable for these processes through their performance review of compensation. What’s more, only 88 percent of hospitals had staff time or a budget allocated to developing best practices.

“It is critical that hospitals maintain well-functioning CPOE systems and proper accompanying manual reviews to ensure patients receive the best possible care,” said Kristin Torres Mowat, senior vice president of plan development and data operations at Castlight Health. “The absence of these systems increases the risk of a patient having an adverse drug reaction (ADR), which can result in a longer hospitals stay and average increased costs of $3,000 per patient. We have worked with Leapfrog to highlight the need for more checks and to educate consumers on the key quality and safety information they need to consider to make the best healthcare decisions.”

Today’s report is the second in a series of five reports to be released this year, each examining key quality and safety measures at hospitals nationwide based on data from the 2015 Leapfrog Hospital Survey of 1,750 U.S. hospitals with comprehensive analysis provided by Castlight Health. Future publications in the report series will be available at:  http://www.leapfroggroup.org/HospitalSurveyReport.


Michigan Hospitals Fully Meeting CPOE Standards

Bronson Hospital, Battle Creek

Bronson Methodist Hospital, Kalamazoo

C.S. Mott Children’s Hospital, Ann Arbor

Children’s Hospital of Michigan, Detroit

Detroit Receiving Hospital, Detroit

Garden City Hospital, Garden City

Harper-Hutzel Hospital, Detroit

Helen DeVos Children’s Hospital, Grand Rapids

Henry Ford Hospital, Detroit

Henry Ford Macomb Hospital, Clinton Township

Henry Ford West Bloomfield Hospital

Henry Ford Wyandotte Hospital

Huron Valley-Sinai Hospital, Commerce Township

Lakeland Community Hospital, Niles

Lakeland Regional Medical Center, St. Joseph

McLaren Lapeer Region, Lapeer

McLaren Northern Michigan, Petoskey

McLaren Flint

McLaren Macomb, Mount Clemens

Mercy Health Saint Mary’s, Grand Rapids

Metro Health Hospital, Wyoming

MidMichigan Medical Center, Gladwin

MidMichigan Medical Center, Clare

MidMichigan Medical Center, Gratiot

MidMichigan Medical Center, Midland

OSF St. Francis Hospital, Escanaba

Sinai-Grace Hospital, Detroit

Sparrow Carson City Hospital

Sparrow Hospital, Lansing

Spectrum Health Big Rapids Hospital

Spectrum Health Blodgett, Grand Rapids

Spectrum Health Butterworth, Grand Rapids

Spectrum Health Gerber Memorial, Fremont

Spectrum Health Kelsey Hospital, Lakeview

Spectrum Health Ludington Hospital

Spectrum Health Reed City Hospital

Spectrum Health United Hospital, Greenville

Spectrum Health Zeeland Community Hospital

St. Joseph Mercy Oakland, Pontiac

St. Mary Mercy Hospital, Livonia

UP Health System, Portage

University of Michigan Health System, Ann Arbor

War Memorial Hospital, Sault Sainte Marie

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