With the federal government threatening to withhold payment for treating preventable errors—and with increasing legislative pressure to make these errors public—hospitals have never had more incentive to curtail mistakes. Roughly 400,000 medication errors occur in hospitals each year, according to a 2006 Institute of Medicine report that said the figure could be cut substantially with the help of information technology.

In an attempt to forestall errors, more hospitals are using software programs that can ease heavy workloads and speed up communication between departments, providing everyone with a common language.

Because this technology can be expensive to build in-house, another option is an outside software provider that can tailor the information to the hospital’s specifications. One new version is Sentri7 by Pharmacy OneSource Inc., of Bellevue, Wash., a Web-based program that helps hospital pharmacists identify potential problems with patients far more quickly. Because healthcare workers use the Internet and subscribe to Sentri7’s services, hospitals are spared the cost of installing and maintaining servers.

“It automates the process of data gathering by always using real-time interfaces, constantly evaluating the information and applying rules to that information,” said Charles Westergard, MBA, vice president of product development for Pharmacy OneSource.

A hospital pharmacist spends a significant part of his or her day performing four steps tied to clinical productivity, said Mr. Westergard, who also has a bachelor’s degree in pharmacy. These steps include collecting information, such as laboratory values, about patients and determining what drugs they were on and other demographics; cross-tabulating that information in search of potential intervention measures; taking action on those measures, such as consulting with the doctor; and documentation. The Sentri7 system “handles the first three of those four steps,” he said. “It interfaces with a hospital’s drug, lab and census information, then pulls those data together and allows a pharmacist or a director to write logical rules against the data.”

For example, if a patient is on a potassium supplement, the Sentri7 system will “track the potassium level and alert you if there is a certain percentage increase,” said Steven Pickette, BSPharm, BCPS, system manager of pharmacy clinical services for Providence Health & Services, a 24-hospital system based in Seattle. “If it hits parameters that you’ve set, then it pops up on your screen [on a dashboard]. You don’t have to wait until it’s critically high to figure that out.” It could also monitor for the best use of anti-infective agents or alert a pharmacist that a patient has previously been administered naloxone to indicate that he has overdosed in the past, Mr. Westergard added.

Providence is a test system for Sentri7, and Holy Family Hospital in North Spokane, Wash., is the pilot hospital because it has computer-generated patient reports that pharmacists use as a guide for intervention.

“Sentri7 has lots of advantages,” Mr. Pickette said. “It’s much more current, it’s easier to modify and add rules, and it’s much more user-friendly to access versus a printed paper report.” And it has an even bigger advantage over hospitals without computer reports, where “pharmacists just have to go digging.”

Since Sentri7 was inaugurated, Holy Family saw a “90% increase in the number of weekly changes in recommended therapy by pharmacy related to lab evaluations,” Mr. Pickette said. Moreover, there was a 43% increase in the number of weekly changes in therapy related to appropriate indication for medication.

Objective Data Forthcoming

Mr. Westergard said that Pharmacy OneSource is still evaluating data on Sentri7’s effectiveness—for instance, adverse drug events avoided—at several sites, but the data are not ready for publication. Early reports, like those at Holy Family, are encouraging, especially in light of the Centers for Medicare & Medicaid Services’ (CMS) announcement that it is no longer paying hospitals to treat preventable conditions acquired by patients during hospital stays. “The damage to a hospital’s credibility from public reporting is bad enough, but when payments are linked to that, this [system] is going to be very helpful,” Mr. Westergard said. “You can actively monitor for CMS core quality measures.”

Karl F. Gumpper, RPh, director of pharmacy informatics and technology for the American Society of Health-System Pharmacists, said that such a system saves time for the healthcare workers, which in turn can save patients. “If you have patients who get started on antibiotics, and you don’t know which antibiotics soon enough, that could cost them their lives,” he said. “This will be something that an infection control department can use.”

Mr. Gumpper said he has seen and used several variations of these IT programs. “They all basically do the same thing,” he said. “They provide the information in an easier format. They may also have alerts and other items that the pharmacist can act upon without having to go out and look for the information.”

Hospitals with their own systems wouldn’t need this, according to Mr. Gumpper. “If you have the data and the tools, then it may not be necessary to use a third party,” he said. But Sentri7 differs from others because “it’s cheaper in the sense that you don’t have to maintain your own server. Having a Web portal is obviously important. If you’re in an institution that doesn’t have an integrated record, you are more likely to use this system.”

Integrating the Providence system, which has hospitals spread across five western states, is one reason the group adopted this program, said Mr. Pickette. Whereas reports could have taken months to generate, “with Sentri7, we can add a new report in three minutes ourselves,” he said. “That’s worth the price of the whole thing.”

Pharmacy OneSource won’t state the price, but spokeswoman Maeghan Killeen said the subscription fee is based on the number of hospital beds. In addition to the absence of hardware, there are no extra IT personnel to hire.

There are other savings, too, according to Ms. Killeen. “Through a survey on our Web site of pharmacy directors, we found that clinical staff pharmacists were spending one to two hours a day performing med-lab profile reviews on patients,” she said. “With the use of Sentri7, this time is reduced to 15 to 30 minutes per day. At the cost of $50 to $60 per hour per pharmacist, Sentri7 has been found to pay for itself and beyond in saved pharmacist hours, which can be directed toward other clinical initiatives.”