Stage 2 Can’t Come Soon Enough – For Patient Safety
If a primary goal of meaningful use of healthcare IT is improved patient safety, we better fast-forward to Stage 2 asap. A RAND Corp. research study just published in Health Affairs – “Today’s ‘Meaningful Use’ Standard For Medication Orders By Hospitals May Save Few Lives; Later Stages May Do More” – reports a statistically insignificant decrease in patient deaths from heart failure and heart attack with CPOE usage at the Stage 1-required level (30 percent). At 60 percent, however, the picture changes.
While RAND’s study was based on a simulation and 2007 data from the AHA Information Technology Supplement, observation of what’s happening on the ground today offers no cause to doubt their conclusions. Many hospitals have not changed a thing in their order entry operations to comply with Stage 1 – they’re using their existing ED systems to meet the current CPOE requirement – so why would patient outcomes be significantly different?
If, as a healthcare community, we want to see a real impact on patient safety, we’ll have to take real action. That starts with deploying the right CPOE. Not just any CPOE is “right”; systems that cause “alert fatigue”, or contain 20-page order sets, or require physicians to spend lots of extra time on non-value added tasks are risky at best.
What we’re seeing now (at some hospitals, anyway) is meaningless compliance with Stage 1. In that environment, Stage 2 can’t come soon enough.