Approximately one third of U.S. hospitals have completely migrated to the electronic health record (EHR) and are no longer using paper charts. In those hospitals with an EHR that they use completely or in combination with paper charts, 80% give pharmacists the ability to make recommendations and document them in the EHR.
Approximately one third of U.S. hospitals have completely migrated to the electronic health record (EHR) and are no longer using paper charts, according to a report released by the American Society of Health-System Pharmacists.
Veterans Affairs hospitals had the greatest uptake of the complete EHR at a rate of 100% of the five hospitals that responded to the 2013 ASHP survey. That was followed by 51.7% of hospitals (n=35) with more than 600 beds, and 37.2% of hospitals (n=43) with 300-399 beds, according to Brent Fox and his colleagues in the April 15 edition of the American Journal of Health-System Pharmacy, which was published online ahead of print.
“The rate of adoption varied by hospital type and size, with the smallest reporting the lowest rates of EHR adoption,” noted the authors of the pharmacy informatics survey. This survey was the second one undertaken by ASHP, and conducted in 2013. The first national survey was completed in 2007.
In those hospitals with an EHR that they use completely or in combination with paper charts, 80% give pharmacists the ability to make recommendations and document them in the EHR.
Computerized prescriber order-entry (CPOE) systems are being used by more than three quarters of U.S. hospitals, except for specialty hospitals at a rate of almost 56%. In addition, prescribers used the CPOE systems about half of the time in 80% of the hospitals, the survey results showed.
More than 60% of hospitals with CPOE systems also used clinical decision support (CDS) concurrently. “Rates of CPOE and CDS usage varied significantly by hospital type and size, with specialty hospital reporting the lowest rate of use [41.7%],” the authors wrote.
With almost 71% of hospitals with outpatient ambulatory care offices, almost 64% of their outpatient facilities are using e-prescribing. Approximately 60% were sending e-prescriptions to community pharmacies. In addition, discharge medications were sent to community pharmacies by 57% of hospitals, according to the survey.
Medication reconciliation processes are still being done exclusively with paper in almost half of U.S. hospitals. However, about 40% of U.S. hospitals are using a combination of both paper and electronic methods.
“Among Veterans Affairs hospitals, the use of paper and combination systems was more predominant, with no respondents indicating the sole use of electronic systems,” the authors noted.
The need for medication therapy management (MTM) services, an important part of pharmacists’ jobs, was being documented by almost half of the hospitals with a real-time monitoring system. About one third of hospitals had a work queue and tools to manage MTM services. Approximately one quarter of hospitals were able to document pharmacist interventions and produce report metrics on the pharmacists’ value to the health systems.
“Differences existed by hospital type and size, except for the efficient capture and reporting of metrics, outcomes, data, and pharmacists’ value,” the authors wrote.
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