It’s an easy scenario to imagine. A man consults his doctor for a particular condition. The doctor writes a prescription. Sometime later that same man develops a different condition and because he is on business out of town, he consults a different doctor. Once again he is given a prescription.
At this point the man has prescriptions for two different drugs, but nobody has checked to see how they might react with one another. He will go home and take two drugs that might be harmless while taken together, or they might make him sick. They might even kill him.
A recent study in Newfoundland and Labrador found that 2.9 per cent of emergency department visits are due to drug related events, many of them preventable. In Canada, an adverse event is estimated to occur in 7.7 per cent of all hospital admissions, many of which are drug related.
In the scenario described above, a drug information system (DIS) would have registered that the man was taking two different drugs and flagged any possible adverse reactions. Similarly, in another all too common scenario, doctors in an emergency room who are confronted by a patient in crisis would have almost immediate access to the person’s prescription history, telling them what drugs the patient is currently taking and therefore what drugs could safely be used. In both cases, patient safety is greatly enhanced.
“The difference that DIS is making is extraordinary,” says Jennifer Zelmer, Senior Vice-President of Clinical Adoption and Innovation at Canada Health Infoway (Infoway). “We’re seeing fewer adverse drug events, less medication abuse and generally better management of prescriptions by patients. What that really means is clinicians and pharmacists are better able to do their jobs, and patients are receiving better care.”
Deloitte was commissioned by Infoway to produce a study on the benefits associated with the second generation of drug information systems. Entitled National Impacts of Generation 2 Drug Information Systems, the study found that in 2010, 32 per cent of community pharmacies in Canada were using a DIS, along with 51 per cent of all hospital emergency departments. It also found Canada’s DIS investments generated an estimated $436 million in cost savings and predicted that, as these systems become more widely used, the savings generated will rise to approximately $1 billion per year.
Over and above the cost savings being realized, the study clearly indicates the potential of DIS technology to greatly improve patient safety. Ontario’s Drug Profile Viewer (DPV) system is a case in point, as it provides authorized health care providers at 245 Ontario hospital sites with the prescription drug claims information of some 2.5 million Ontarians. Over a 12 month period from September, 2010 to September, 2011, authorized health providers in Ontario accessed this information 1,572,770 times, helping them make more informed care decisions.
The study also notes that use of the DPV has reduced the number of patients with prescription conflicts or discrepancies from 28.3 per cent to 5.2 per cent and reduced the number of patients with clinically significant conflicts or discrepancies from 7.6 per cent to 0.9 per cent.
“There is no question that some provinces are ahead of others when it comes to development and implementation, but what’s important is that the entire country is moving in the right direction,” says Zelmer. “The day is coming when health care providers in every community pharmacy, every doctor’s clinic and every hospital emergency room, coast to coast to coast, will have timely, secure access to the information they need about their patients’ drug histories. And that will be a great day for healthcare.”