Quality and Safety

The nonprofit patient safety organization found that nearly  40 percent of potentially harmful drug orders weren’t flagged by existing software systems, including medication orders for the wrong condition or the wrong dose based on things like a patient’s size, other illnesses or likely drug interactions. 

Clinical decision support misfires are commonplace but often hard to detect, according to a close examination of CDS systems at Brigham and Women's hospital in Boston published in the most recent Journal of the American Medical Informatics Association.

New research found variations in cholesterol levels that drew concern because they could potentially determine whether a physician at point of care would prescribe medication to a patient.

Physicians are embracing electronic prescribing more rapidly than ever before, according to new data from Surescripts – especially in New York. In the Empire State, more than 48,000 providers have embraced digital prescriptions as a way to avoid fraud and abuse of prescription drugs – and a way to avoid fines. The deadline for complying with the state’s Internet System for Tracking Over Prescribing, or I-STOP, mandate for digital prescribing is March 27. [See also: NY e-prescribing law takes effect March 27, doctors now face fines for pen-and-paper.] Since March 1, the number of New York providers adopting electronic prescribing of controlled substances increased 28 percent, Surescripts reports. New York Is ahead of other states in e-prescribing adoption with 47 percent uptake, compared with numbers nationwide at just 8 percent. “The industry has made remarkable progress in adopting this critical technology that can have a direct and immediate impact on improving patient care and saving lives,” commented Surescripts CEO Tom Skelton, in a news release. Skelton pointed out that pharmacy adoption of the technology is nearly universal, with 95 percent of pharmacies in New York ready to prescribe controlled substances electronically. In 2013, more than two million Americans abused prescription painkillers such as hydrocodone, oxycodone and methadone, according to Surescripts. Drug diversion is a significant concern when it comes to controlled substances, officials say, with between three and nine percent of diverted drugs for abuse tied to fraud or forgery of paper prescriptions.  Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

The National Quality Forum has published its guidance for the new Merit-Based Incentive Payment System. NQF's Measure Applications Partnership examined some five-dozen MIPS performance measures, proposed for implementation in 2017, from which data would be collected to track eligible providers' performance in 2019. "As the U.S. healthcare system increasingly shifts to a performance-based payment system, MAP’s role (is to serve) as an impartial advisor bringing stakeholders together from across the healthcare spectrum," NQF’s chief scientific officer Helen Burstin said in a statement. To that end, MAP offered some suggestions to the U.S. Department of Health and Human Services for better aligning with multiple federal healthcare programs, namely the Medicare Shared Savings Program. [Also: Meaningful use will still be part of MIPS reimbursement, CMS official says] Chief among those was that aligning of measures should be a top priority, and not just for MIPS programs and alternative payment models, but across all federal programs and with states and the private sector where possible. Indeed, NQF found that gaps still exist across clinician-level programs – most notably in patient-centered areas such as patient-reported outcomes, functional status and care coordination. These measures should go beyond patients' experience with the healthcare system to the impact of healthcare on patients' health and well-being. Meanwhile, MAP urged continued exploration of the impact of socioeconomic status and other demographic factors on measure results, noting that the program should be taking into account when providers are caring for high-risk populations. NQF also weighed in on measures for public reporting on CMS' Physician Compare website. With regard to those most useful for consumers and patients, MAP expressed a preference for those focused on care coordination, population health, appropriate care and on outcomes – especially those that are patient-reported. Twitter: @MikeMiliardHITN

Though more hospitals are reporting infection rates publicly, a new report from The Leapfrog Group shows that more than half of hospitals across the country still grapple with sometimes deadly healthcare-associated infections. "A record number of hospitals make their infection rates public, which shows commendable transparency and candor within the hospital industry,” Leapfrog President and CEO Leah Binder said in a statement. "The bad news is there are still too many infections." [Also: View all Leapfrog's 'F' hospitals] According to the Leapfrog report, the central line infection rate was too high at 75 percent of hospitals. Only 25 percent of hospitals met Leapfrog's standardized infection ratio of zero for CLABSI, or central line-associated bloodstream infection. Sixty-seven percent of hospitals had a infection rate between zero and 1.0, while 8 percent had a ratio above 1.0. Also, only 25 percent of hospitals met Leapfrog's urinary tract infection standard. CAUTI, or catheter-associated urinary tract infections are considered the most common type of healthcare-acquired infections, and Leapfrog's standard for this infection is close to zero. Infection rates also varied by state, choice of hospital and metropolitan area. On average, New Hampshire had the safest hospitals, with 67 percent reporting a CLABSI rate of zero. Rhode Island and Maryland are most in need of improvement, with no hospitals reporting a CLABSI rate of zero. What's more, hospital infection rates vary significantly within communities. For example, one West Coast city had CLABSI rates range from zero to more than five times the expected rate. Infection rates are declining, but more transparency and quality improvement are needed, the report stresses. [Like Healthcare IT News on Facebook] Public reporting through Leapfrog has helped reduce CLABSI rates, Binder said. For example, the percentage of hospitals reporting a CLABSI rate of zero has steadily increased from 18.8 percent in 2013 to 25 percent in 2015. Yet, three quarters of hospitals still do not meet Leapfrog's standards. The report on healthcare-acquired infections is the first in a series of five reports Leapfrog has planned to examine key quality and safety measures at hospitals nationwide. The reports are based on data from the 2015 Leapfrog Hospital Survey of more than 1,500 U.S. hospitals and analysis provided by Castlight Health. Twitter: @HealthITNews

The I-STOP legislation, first passed in 2012, aims to combat controlled substance abuse. A provision set to take effect at the end of this month requires doctors to prescribe almost everything electronically.

Step-by-step tools help providers unlock data to help prevent cardiovascular events.

Experts say healthcare providers need to turn up the pressure on tech vendors to create more intuitive products.

Christopher Harle will work with University of Florida researchers to develop software to help patients better understand what they are granting access to when they approve use of their electronic health records for research purposes.