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Technology boosts care of patients

| Tuesday, Dec. 21, 2004

PHILADELPHIA -- Health systems that adopt computerized patient records and tracking systems do a better job of getting people the medical attention they need, although technology might not be a cure-all for health care safety problems, two new studies suggest.

The first study found that patients in the Veterans Affairs system -- where doctors nationwide have electronic access to patients' medical files, from old treatment notes to recent X-rays -- received 67 percent of the recommended care for their conditions.

Patients in a control group of non-VA patients, some with insurance and some not, received just 51 percent of the care recommended. Most non-VA hospitals trail the agency in the use of electronic access to patient history, the study authors said.

The study appears in today's issue of the Annals of Internal Medicine.

"I think there are lessons for the rest of the country's health care system. The VA's built an information superhighway," the lead author, Dr. Steven M. Asch, said in a telephone interview.

"Politicians of all stripes, from the president to Hillary Clinton, have recommended that the country undertake (a similar system)," said Asch, a health services researcher at a VA facility in West Los Angeles.

The second study says nearly 20 percent of hospital medication errors in 2003 involved computerization or automation. United States Pharmacopeia, which did the annual study, is a nonprofit that runs MEDMARX, the nation's largest database of medication errors. About a dozen Pittsburgh hospitals use MEDMARX to track such errors.

"It would seem logical that applying computer technology to the medication use process would have a significant positive impact in preventing medication errors," Diana Cousins, vice president of USP's Center for the Advancement of Patient Safety, said in a statement. "Yet, depending on the computer's design or user competence, new points of potential errors can emerge. Health care providers need to be focused and vigilant in their use of computers."

The VA's electronic files track patient care and can alert doctors if a recommended procedure -- a patient's annual exam or flu shot, for instance -- has not been done.

Dr. John Daigh, a VA watchdog for the U.S. Office of Inspector General, said the VA's study appears to show the agency's high-tech records system, adopted over the past decade, is paying dividends.

The newest MEDMARX report looked at more than 235,000 medication error records voluntarily reported by 570 hospitals and health care facilities from 1999 to 2003.

The study found that computer data-entry errors were the fourth-leading cause of medication errors in 2003 and represent 11.5 percent of all MEDMARX records in the five-year period. Automatic drug storage and dispensing devices were implicated in almost 9,000 medication errors, with 1.3 percent of those errors leading to patient harm, according to 2003 data.

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