According to the latest survey from The Leapfrog Group, more hospitals are adopting computerized physician order entry (CPOE) systems to reduce medication errors. Meanwhile, the predicted survival rates for high-risk procedures and the hospital-acquired injury and infection rates for the hospitals vary significantly, according to the results of the 2013 hospital survey that was released last Friday.

An all-time high number of hospitals participated in the survey this year — 1,437 hospitals or 37 percent of hospitals nationwide, which was a 19 percent increase from 2012. The number of participants rose because health care purchasers and employer coalitions are now asking hospitals to participate in the survey.

“Employers are increasingly being confident about the fact that they can demand this information from hospitals,” Erica Mobley, director of communications and development at Leapfrog, told DOTmed News. “Large employers are spending millions and millions of dollars on these facilities and want to know how they’re performing.”

But the hospitals are also realizing that they must become more transparent with data. “I think a lot of hospitals are realizing that it’s a new era of transparency in health care and it’s not acceptable to hide and not be willing to share data and share your information,” said Mobley.

Leapfrog has been tracking how many hospitals implemented CPOE systems since 2001. They designed a standard that states that 75 percent of inpatient medications should be ordered through a CPOE system that includes decision support software.

Leapfrog has an evaluation tool that evaluates how well the hospitals’ CPOE systems work. “It’s not enough, we don’t think, just to know how frequently it’s used or the degree to which it’s implemented,” said Mobley. “It’s also important to figure out how well it works.”

In order to gauge the degree of implementation, each hospital participating in the survey received a set of fictitious patients and they were asked to enter doses into the CPOE system in order to test how well the system reacts to potential errors.

They found that 616 hospitals — 43 percent — met their standard for CPOE, which is a significant increase from the 113 hospitals that met the standard in 2009. They attribute the increase to the financial incentives for “meaningful use” of health information technology.

“[The systems are] incredibly expensive and so a lot of hospitals didn’t have the resources to use them until some of this federal funding came in,” said Mobley.

However, not all of the medication orders that were tested with the evaluation tool gave appropriate warnings for orders that would have caused a patient harm. “We are finding that they are working a lot better and there are fewer errors than what they saw several years ago, but there are still a fairly significant number of potential errors that are not being caught by the systems,” said Mobley.

She said that it’s really important that hospitals continue to refine their systems and get them tested every year to make sure they're working as well as they can.

The survey also showed that there were large differences in the estimated survival rates for high-risk procedures as well as hospital-acquired injury and infection. For instance, the predicted mortality rate varied five-fold for esophagectomies and six-fold for abdominal aortic aneurysm repair.

Only 232 out of the 1,037 hospitals had zero hospital-acquired injuries – the average rate was 0.521 injuries per 1,000 inpatient discharges. Six hospitals had a rate of more than five injuries.

One in six hospitals had a higher number of infections than they were expected to from central lines and one in 10 did a poor job preventing urinary tract infections.

Leapfrog has a standard for the amount of patients in ICUs who should be cared for by intensivists or physicians who are certified in critical care medicine. The standard states that one should be in the ICU at least eight hours a day, seven days a week and when they are not in the ICU, they should respond to pages within five minutes or have another health care professional reach the patient within that time.

The survey showed that 41.7 percent of the hospitals fully met the standard, which was a 3 percent increase from 2012. However, since it’s so important that ICUs are adequately staffed, Leapfrog believes that there hasn’t been enough progress.

“We really want people to be aware that a lot of hospitals don’t have the level of staffing that can reduce mortality in the ICU,” said Mobley.