Newsclip

Drug-ordering systems get a boost
Study: Technology could save Mass. hospitals $275m
Boston Globe
By Liz Kowalczyk, Globe Staff  |  December 7, 2004

Nearly 70 percent of Massachusetts hospitals have failed to install special computer systems for ordering drugs for patients, mostly because they carry big price tags. But a new report from the Massachusetts Technology Collaborative says the state's hospitals would end up saving money if they install these sophisticated systems to reduce medical errors.

The collaborative, a quasi-public agency with a board that includes leaders from the healthcare and technology industries and universities, hired an outside consulting firm to analyze the cost and cost-savings if all Massachusetts hospitals install the systems, called Computer Physician Order Entry.

The firm, First Consulting Group, based in California, said it would cost $210 million in one-time start-up expenditures for the 46 Massachusetts hospitals that don't have the systems to install them, or update existing technology to a minimum agreed-upon standard. But, consultants said, the hospitals would save $275 million annually because the systems reduce errors and, as a result, medical care for unintentional injuries to patients. The systems alert doctors when patients are allergic to drugs, or when a doctor has ordered a dangerous overdose, among other problems.

"The purpose of this report is to provide such a compelling argument that it should be done, that all the players in the healthcare market come to the table and roll up their sleeves and make it happen," said Mitchell Adams, executive director of the collaborative. "It's a no-brainer. But it's not easy to do. Installing these systems is highly disruptive to the operations of the place."

Under increasing pressure from health insurers and employers, who believe that the drug-ordering systems reduce patient deaths and injuries, more large hospitals are devoting millions of dollars to electronic safety systems.

Partners HealthCare, the parent organization of Brigham and Women's Hospital and Massachusetts General Hospital, plans to spend $30.5 million over five years to expand Computer Physician Order Entry from Brigham and Mass. General to all its hospitals and electronic medical records to all its doctors. Children's Hospital plans to spend $35 million over three years to install similar systems throughout the hospital, while Beth Israel Deaconess Medical Center also has spent millions to install computerized order for drugs and tests.

"We've looked at it from a quality not a cost standpoint," said Dr. John Halamka, chief medical information officer at Beth Israel Deaconess. "But it seems valid if you're no longer creating situations where patients require extra care, you're going to save money."

But many small community hospitals cannot afford these systems, and even at some larger teaching hospitals, most famously Cedars-Sinai Medical Center in Los Angeles, doctors have rebelled. The hospital installed physician order entry in the summer of 2002, requiring doctors to demonstrate their ability to use the system or lose their privileges to treat patients. Hundreds of doctors opposed the move, arguing that the system was too time-consuming, and the hospital abandoned the project.

Leapfrog Group, a national coalition of employers pushing for safer hospitals, estimates the systems can cost up to $15 million to set up and as much as $2 million a year to maintain, depending on the hospital size and whether it's starting from scratch.

The Massachusetts Technology Collaborative is proposing that hospitals pay half the cost and health plans pay for half. Ronald Hollander, president of the Massachusetts Hospital Association, applauded the report as an important step and said the organization supports the systems in all hospitals. But he would not commit to hospitals paying for half the cost.