A tiered approach is more cost effective than traditional pharmacist-based review for classifying computer-detected signals as adverse drug events

  • Authors:

  • Carol Hope;J. Marc Overhage;Andrew Seger;Evgenia Teal;Vera Mills;Julie Fiskio;Tejal K. Gandhi;David W. Bates;Michael D. Murray

  • Affiliations:

  • Regenstrief Institute, Indiana University School of Medicine, 1050 Wishard Blvd., Indianapolis, IN and Purdue University School of Pharmacy, West Lafayette, IN;Regenstrief Institute, Indiana University School of Medicine, 1050 Wishard Blvd., Indianapolis, IN and Indiana University School of Medicine, Indianapolis, IN;Brigham and Women's Hospital, Boston, MA;Regenstrief Institute, Indiana University School of Medicine, 1050 Wishard Blvd., Indianapolis, IN;Regenstrief Institute, Indiana University School of Medicine, 1050 Wishard Blvd., Indianapolis, IN;Brigham and Women's Hospital, Boston, MA;Brigham and Women's Hospital, Boston, MA and Harvard Medical School, Boston, MA;Brigham and Women's Hospital, Boston, MA and Harvard Medical School, Boston, MA;Regenstrief Institute, Indiana University School of Medicine, 1050 Wishard Blvd., Indianapolis, IN and Purdue University School of Pharmacy, West Lafayette, IN

  • Venue:
  • Journal of Biomedical Informatics - Patient safety
  • Year:
  • 2003

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Abstract

Objective. To develop a cost-efficient method for identifying adverse drug events (ADEs) and medication errors (MEs) identified using outpatient electronic medical records within ambulatory settings.Design. Comparison of sensitivity and cost of "traditional" pharmacist based approach to identifying ADEs and MEs during a 4 month period with a tiered approach.Results. The proportion of computer generated signals analyzed identified as ADEs were similar using the two approaches while the number of MEs was nearly double with tiered reviews suggesting the same or better sensitivity. Traditional pharmacist review cost $68.70 to detect an ADE and tiered approach cost only $42.40.Conclusion. Tiered review of ADEs and MEs by personnel with increasing clinical capability is more cost-efficient than pharmacist review.