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Building Health Information Technology Capacity: They May Come But Will They Use It?

BURKE-BEBEE, SUZIE DNP, MSIS, MS, RN; WILSON, MARISA DNSc, MHSc, RN-BC; BUCKLEY, KATHLEEN M. PhD, RN, IBCLC

CIN: Computers, Informatics, Nursing:
doi: 10.1097/NXN.0b013e318261fc3a
Feature Article
Abstract

Medical errors remain a major safety problem more than a decade after the Institute of Medicine reported 98 000 related deaths occur yearly in US hospitals. Medication errors account for one-third of these errors. Although medication reconciliation is an accepted care standard for patient safety, little evidence is available to make practice recommendations for primary care. The purpose of this study was to evaluate the effectiveness of using secure e-mail alerts within the reconciliation process on patient medication safety in clinics where electronic and personal health records are used. A nonexperimental, descriptive design with a convenience sample of 62 patients from two Veterans Health Administration clinics was used. Patients received secure e-mail instructing them to review their online medication list, update it based on home medications, and bring it to the appointment for discussion with their provider. A retrospective chart review was conducted examining changes made to medication lists in the electronic record after reconciliation. Data revealed the organization’s adoption of secure e-mail did not guarantee its meaningful use by providers and patients, a clear barrier to implementing technology as an adjunct to care in context of complex clinical processes such as medication reconciliation. Lessons learned from the project’s implementation are discussed.

Author Information

Author Affiliations: School of Nursing, University of Maryland, Baltimore.

This study was part of the requirements for Dr Burke-Bebee in support of her doctoral work while completing her doctor of nursing practice degree.

The views expressed in this article are solely those of the authors and do not necessarily reflect the views of the Department of Veterans Affairs or the University of Maryland, Baltimore.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Corresponding author: Suzie Burke-Bebee, DNP, MSIS, MS, RN, 655 W Lombard St, Baltimore, MD 21201 (suzie.burke-bebee@hhs.gov).

© 2012 Lippincott Williams & Wilkins, Inc.