Cost-effectiveness analysis of a hospital electronic medication management system

Westbrook, Johanna I., Gospodarevskaya, Elena, Li, Ling, Richardson, Katrina L., Roffe, David, Heywood, Maureen, Day, Richard O. and Graves, Nicholas 2015, Cost-effectiveness analysis of a hospital electronic medication management system, Journal of the American Medical Informatics Association, vol. 22, no. 4, pp. 784-793, doi: 10.1093/jamia/ocu014.

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Title Cost-effectiveness analysis of a hospital electronic medication management system
Author(s) Westbrook, Johanna I.
Gospodarevskaya, Elena
Li, Ling
Richardson, Katrina L.
Roffe, David
Heywood, Maureen
Day, Richard O.
Graves, Nicholas
Journal name Journal of the American Medical Informatics Association
Volume number 22
Issue number 4
Start page 784
End page 793
Total pages 10
Publisher Oxford Univserity Press
Place of publication Oxford, Eng.
Publication date 2015
ISSN 1527-974X
Keyword(s) CPOE
adverse drug events
cost-effectiveness
decision analytic model hospital
electronic medication management system
electronic prescribing
inpatient care
medication error
Science & Technology
Technology
Life Sciences & Biomedicine
Computer Science, Information Systems
Computer Science, Interdisciplinary Applications
Health Care Sciences & Services
Information Science & Library Science
Medical Informatics
Computer Science
PHYSICIAN ORDER ENTRY
HEALTH INFORMATION-TECHNOLOGY
ERRORS
PREVENTION
IMPACT
INTERVENTIONS
QUALITY
CARE
Summary OBJECTIVE: To conduct a cost-effectiveness analysis of a hospital electronic medication management system (eMMS). METHODS: We compared costs and benefits of paper-based prescribing with a commercial eMMS (CSC MedChart) on one cardiology ward in a major 326-bed teaching hospital, assuming a 15-year time horizon and a health system perspective. The eMMS implementation and operating costs were obtained from the study site. We used data on eMMS effectiveness in reducing potential adverse drug events (ADEs), and potential ADEs intercepted, based on review of 1 202 patient charts before (n = 801) and after (n = 401) eMMS. These were combined with published estimates of actual ADEs and their costs. RESULTS: The rate of potential ADEs following eMMS fell from 0.17 per admission to 0.05; a reduction of 71%. The annualized eMMS implementation, maintenance, and operating costs for the cardiology ward were A$61 741 (US$55 296). The estimated reduction in ADEs post eMMS was approximately 80 actual ADEs per year. The reduced costs associated with these ADEs were more than sufficient to offset the costs of the eMMS. Estimated savings resulting from eMMS implementation were A$63-66 (US$56-59) per admission (A$97 740-$102 000 per annum for this ward). Sensitivity analyses demonstrated results were robust when both eMMS effectiveness and costs of actual ADEs were varied substantially. CONCLUSION: The eMMS within this setting was more effective and less expensive than paper-based prescribing. Comparison with the few previous full economic evaluations available suggests a marked improvement in the cost-effectiveness of eMMS, largely driven by increased effectiveness of contemporary eMMs in reducing medication errors.
Language eng
DOI 10.1093/jamia/ocu014
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Oxford University Press
Persistent URL http://hdl.handle.net/10536/DRO/DU:30075515

Document type: Journal Article
Collection: Population Health
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