ASHP Survey Finds Nearly All U.S. Hospitals Use EHRs, CPOE Systems
Technologies that improve medication use have been adopted by nearly 100% of hospitals across the United States, according to the “ASHP National Survey of Pharmacy Practice in Hospital Settings: Prescribing and Transcribing — 2016.” Implementation of technologies such as electronic health records (EHRs), computerized prescriber-order-entry (CPOE) systems, and barcode-assisted medication administration systems support pharmacists in their efforts to increase medication safety and provide effective and efficient patient care.
The rapid implementation of health information technology by hospitals has led to a sharp increase in paperless care. According to the ASHP survey, 99% of hospitals across the country now use EHRs, compared to about 31% in 2003. The use of CPOE systems by hospitals has also risen dramatically. Over the past 13 years, the number of hospitals that use paper-only patient health records has declined from 69% to 1%. In 2008, about 38% of hospitals used hand-written medication orders; in 2016, fewer than 3% of hospitals use hand-written orders. In addition, almost 93% of hospitals in 2016 use barcode medication administration systems.
“In addition to improving medication safety, the increased use of information technology shows great potential for pharmacists to spend more and more time providing comprehensive medication therapy management in and across all settings of patient care,” said ASHP CEO, Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP. “These positive findings move us closer to achieving ASHP’s vision that medication use will be optimal, safe, and effective for all people all of the time.”
The speed at which EHR systems and technologies are being implemented by hospitals was a notable survey finding. “These developments clearly have the potential to improve access to clinical information to all caregivers and provide a platform for clinical decision support that offers safety alerts in real time,” wrote survey authors Douglas J. Scheckelhoff, M.S., FASHP, Senior Vice President, Office of Practice Advancement at ASHP; Craig A. Pedersen, B.S.Pharm., Ph.D., FAPhA; and Philip J. Schneider, M.S., FASHP, FASPEN, FFIP.
The survey also evaluated pharmacists’ contributions to patient care activities during transitions of care, a period that is fraught with risk for medication errors and discrepancies in care. ASHP’s national survey showed that pharmacist and pharmacy technician use of medication histories at admission increased from 54% in 2012 to nearly 75% in 2016. Pharmacist-provided medication counseling at discharge more than doubled, from 22% in 2012 to 45% in 2016.
ASHP’s national survey, which is organized into six components of the medication-use system (prescribing, transcribing, dispensing, administration, monitoring, and patient education), provides an overall picture of the contemporary roles that pharmacists play in managing medication use. The survey focuses on two components of the medication-use system each year.
The 2016 survey evaluated practices and technologies related to prescribing and transcribing, and included data from 392 hospitals in the United States ranging in size from fewer than 50 beds to more than 600 beds.
“The ASHP National Survey continues to be instrumental in identifying pharmacy practice trends in the United States. It helps quantify where hospitals stand with adoption of automation and technology, and other practices related to pharmacy and medication safety,” said Scheckelhoff. “The survey results are valuable to health-system pharmacy leaders, allowing them to compare their programs and services to national averages.”
“ASHP National Survey of Pharmacy Practice in Hospital Settings: Prescribing and Transcribing — 2016” is currently available online and appears in the September 1, 2017, issue of AJHP (American Journal of Health-System Pharmacy).
ASHP represents pharmacists who serve as patient care providers in acute and ambulatory settings. The organization’s more than 44,000 members include pharmacists, student pharmacists, and pharmacy technicians. For 75 years, ASHP has been at the forefront of efforts to improve medication use and enhance patient safety. For more information about the wide array of ASHP activities and the many ways in which pharmacists advance healthcare, visit ASHP’s website, www.ashp.org, or its consumer website, www.SafeMedication.com.
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