Using PHR To Correct Provider Drug Lists Can Improve Safety

Posted on May 21, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Especially in a rapid-fire hospital setting, providers don’t always find out whether the medication list they have on file is accurate, which can lead to mistakes or even patient harm.  But new research suggests that if patients get to review and update their medication list via PHR, the number of unexplained discrepancies between the list and the patient’s regimen falls substantially — and the risk of mistakes capable of causing serious harm falls as well.

The study, which was published in the Journal of the American Medical Informatics Association, was conducted largely by researchers from Brigham and Women’s Hospital. The team found research subjects within 11 primary care practices using the same set-up, a PHR tied to their EMR.

The main study group consisted of patients given special access to the linked PHR, specifically a medications module prompting patients to review med lists. When the patients found discrepancies in the list, they documented the problem using an “ejournal” format designed to make physician list updates easy.

To see what effect this would have, the researchers gathered data from 267 patients who used an “ejournal” to warn of med list discrepancies, and also from 274 patients who worked with a different PHR-related technology.

Researchers found that unexplained medication list discrepancies affected 42 percent of the study group, while the control group had 51 percent. More alarmingly, the number of unexplained discrepancies with potential for causing severe harm was 0.08 within the control group, but only 0.03 percent in the study group.

According to FierceEMR, which covered this story, other studies have shown that patients want access to information in their provider’s EMRs, and that such access improves the accuracy of EMR data.

This is all well and good. My question is, how did the researchers motivate patients to use the PHR?  While it may be that patients like fixing errors, if they’re not prone to PHRs they’ll never get around to fixing med lists or correcting errors in care documentation.

If patients were merely invited to participate and jumped at the chance, they were tech-friendly or at least open-minded, as people don’t generally salivate at the opportunity to plow through medical data.

I’d love to see a study that researched how to motivate patients to engage in this type of dialogue. If PHRs can really do such good, figuring out how to get them into wide use is critical, isn’t it?  And shouldn’t hospitals be using this type of approach, or at least testing it?