Evaluating the Impact of Health IT on Medication Safety.

Health IT is becoming an increasingly powerful tool for improving medication safety. While errors may happen at all stages of the medication process, different tools have been developed to support the prescribing process (e.g. computerized prescribing with decision support), the dispensing process (e.g. barcoding or automated dispensing and unit-dose systems), or the administration process (e.g. electronic medication administration records and smart pumps). Health IT can reduce medication error and preventable adverse drug event rates by increasing documentation quality and transparency, enhancing accuracy and correctness of the medication process, and supporting information exchange and interlinking different stages of the medication process. Typical evaluated endpoints comprise process-related outcomes such as number of medication errors, harm-related outcomes such as adverse drug events, or cost-related outcomes. Typical study design to measure effectiveness of health IT in medication safety comprises before-after studies and randomized controlled trials. However, implementation is challenging; it often has a major impact on the overall workflow and such technologies must be carefully introduced and their effects must be closely monitored in order to achieve the desired reductions, as in addition to preventing errors they nearly always introduce new ones. As complex interventions, their impact depends crucially on the real world setting and the implementation details and thus, transferability of study results is variable.