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Posted on Jun 02, 2005, 7 a.m.
By Bill Freeman
Medical errors kill nearly 100,000 American each year, with lethal drug interactions accounting for most of these deaths. Computerization -- which hospitals have been slow to embrace -- was supposed to eliminate most problems, but new research published Wednesday indicates that even the best computer system can
Harmful medication-related mishaps cropped up in a quarter of all patients at the Veterans Affairs Medical Center in Salt Lake City, one of the most high-tech hospitals in the country, according to a study published in Archives of Internal Medicine.
"If you were on an airplane and a quarter of the time it crashed, that would be a problem," said study co-author Dr. Jonathan Nebeker, a physician at the VA Medical Center.
Even though the hospital's computers were supposed to protect against dangerous drug interactions, illegible prescriptions and bedside mix-ups, nine of the 937 patients studied died as a result of medication problems, the study found.
If other hospitals have similar track records, 35 people may die each year for each 100 beds because of what researchers politely call "adverse drug events."
At the Salt Lake City hospital, for instance, health workers ordered the wrong drugs, ordered the wrong doses and failed to monitor patients properly. Ninety-one percent of the 483 mishaps were moderately harmful, and 9 percent were serious, according to the researchers.
The researchers didn't blame all the drug problems on human error -- sometimes the medications didn't work the way they were expected to -- but many of the mishaps were still preventable, Nebeker said.
If you think your own neighborhood hospital might do a better job than the hospital in the study, think again. Sure, the Salt Lake City facility is part of the frequently maligned VA system. But VA hospitals are widely lauded for their advanced medical technology and commitment to reducing medical errors.
In fact, the chances are good that your local hospital is still behind the times on the technology front. Among other things, the VA hospital has a bar-code system that requires nurses to scan medications before they're given to patients; the bar-code systems are still rare today.
And the hospital forced doctors to enter prescriptions on a computer instead of on paper; only an estimated 10 percent to 15 percent of hospitals have similar computerized drug order systems.
But nobody's recommending that hospitals save money and step off the technology train. Specialists in medical errors say the problem isn't that computers fail to prevent mishaps.
In fact, thanks to the Salt Lake City hospital's computerization of drug ordering, researchers didn't find a single case of a pharmacist misreading a doctor's chicken scratch and killing or hurting a patient.
The challenge instead, medical specialists say, is making the technology assist doctors in more ways than just sounding an alarm when penicillin is ordered for someone who's allergic to it.
"The system as it presently stands is very good at getting rid of the ravages of doctor's handwriting, checking ... drug allergies ... overdoses, and not allowing choices that are nonsensical," said Dr. Robert Watcher, a surgeon at the University of California at San Francisco. But the computers are far from sophisticated enough, he said.
Watcher is co-author of Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes, a book about why medical errors kill an estimated 98,000 Americans each year.
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