Implementing health information technology in an outpatient setting to reduce duplicate prescriptions among patients with multiple chronic diseases.

Objectives: To determine the effect of implementing health information technology in an outpatient setting on reduction of duplicate prescriptions among patients with multiple chronic diseases. Methods: Adult patients with at least 2 refillable prescriptions for multiple chronic diseases at a medical center in southern Taiwan between 1 October 2012 and 30 June 2013 were enrolled in the current study. The key design principles in the ambulatory pharmaceutical care model included (1) using the SAS Enterprise Guide to systematically screen potential duplicate prescription orders using pre-specified criteria, (2) hospital pharmacists performed medication reviews and provided electronic alerts for duplicate medications to physicians, and (3) medical alerts and recommendations were integrated into the natural workflow of practice to correct duplicate medications. Patient characteristics and patterns of duplicate medications were assessed using descriptive statistical analyses. Results: Of 572 notifications (n=483), the most common duplicate prescriptions occurred in patients > 65 years of age, had > 3 outpatient specialist visits, and were treated with > 10 medications. The correction rate for duplicate prescriptions was high for cardiovascular diseases, endocrinopathies, and Parkinson disease. Among patients who had corrected duplicate medications (n=283), the average monthly medication cost decreased 47,325 TWD during the most recent 6 months when compared to the 6 months preceding the correction. Furthermore, the outpatient clinic, emergency room, and hospitalization person-visits decreased 5.8%, 18.3%, and 13.8%, respectively. Conclusions: Implementation of advancing health information technology in the outpatient setting for a group of patients with multiple chronic diseases revealed a high propensity to successfully reduce duplicate medications in a large population. [ABSTRACT FROM AUTHOR]