Potential benefit of electronic pharmacy claims data to prevent medication history errors and resultant inpatient order errors

Abstract

Objective: We sought to assess the potential of a widely available source of electronic medication data to prevent medication history errors and resultant inpatient order errors.

Methods: We used admission medication history (AMH) data from a recent clinical trial that identified 1017 AMH errors and 419 resultant inpatient order errors among 194 hospital admissions of predominantly older adult patients on complex medication regimens. Among the subset of patients for whom we could access current Surescripts electronic pharmacy claims data (SEPCD), two pharmacists independently assessed error severity and our main outcome, which was whether SEPCD (1) was unrelated to the medication error; (2) probably would not have prevented the error; (3) might have prevented the error; or (4) probably would have prevented the error.

Results: Seventy patients had both AMH errors and current, accessible SEPCD. SEPCD probably would have prevented 110 (35%) of 315 AMH errors and 46 (31%) of 147 resultant inpatient order errors. When we excluded the least severe medication errors, SEPCD probably would have prevented 99 (47%) of 209 AMH errors and 37 (61%) of 61 resultant inpatient order errors. SEPCD probably would have prevented at least one AMH error in 42 (60%) of 70 patients.

Conclusion: When current SEPCD was available for older adult patients on complex medication regimens, it had substantial potential to prevent AMH errors and resultant inpatient order errors, with greater potential to prevent more severe errors. Further study is needed to measure the benefit of SEPCD in actual use at hospital admission.

Keywords: adverse drug events; health information exchange; medication reconciliation.

© The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Figures

Figure 1

Patient selection process and initial results for surescripts electronic pharmaceutical claims data (SEPCD) error prevention potential analysis.

Figure 2

SEPCD potential to prevent admission medication history (AMH) errors by severity.

Figure 3

SEPCD potential to prevent inpatient order errors by severity.

Figure 4

SEPCD prevention potential of admission medication history (AMH) errors by type.