Increasing e-Prescribing Dosages

More frequent use of electronic medication orders is likely to have a significant impact on hospital mortality rates, according to a new RAND Corp. study.

The study, published in this month's Health Affairs journal, finds that the federal government's current meaningful-use threshold "is probably too low to have a significant impact on deaths from heart failure and heart attack among hospitalized Medicare beneficiaries," according to the article abstract. The current meaningful-use threshold requires using electronic medication order entry for at least 30 percent of eligible patients.

The U.S. Department of Health and Human Services proposes increasing that threshold to at least 60 percent of patients for the next stage of meaningful use. At that level, electronic ordering is more likely "to produce the improved patient outcomes at the heart of the federal health information technology initiative," according to the abstract.

The article, "Meaningful Use Standard For Medication Orders By Hospitals May Save Few Lives; Later Stages May Do More," looked at the incidence of heart attack, heart failure or pneumonia among Medicare recipients within 30 days of their being admitted to the hospital.

Most of the hospitals in the study did not use electronic medication order entry, the article notes. After adjusting for underlying patient risk factors, the research showed that using e-prescribing for up to 25 percent of patients lowered the risk of death from heart attack by 1.2 percent. Using e-prescribing for more than 50 percent of patients lowered the risk of dying from either heart attack or heart failure. At the 60 percent level, the risk of death fell by more than 2 percent, according to the article.

Electronic medication order entry did not appear to have a significant impact on pneumonia mortality rates.