Chartbook on Care Coordination

• Communication between providers and between providers and patients, within and across care settings, has been identified as a source of medication error.
• Improving communication is a key aspect of decreasing medication errors and improving patient safety (Kitson, et al., 2013).
• Disparities in access to health information, services, and technology can result in less use of preventive services, poorer chronic disease management, higher hospitalization rates, and poorer reported health status (Berkman, et al., 2004).
• Patients need to understand their medication (indications, administration, adverse effects) to safely and effectively use it. But evidence shows that important medication information is given to patients in a haphazard way (Persell, 2013).

Integration of Medication Information Measures

• Measures of integration of medication information include:
  • People under age 65 with a usual source of care whose health provider usually asks about prescription medications and treatments from other doctors.
  • Hospitals with electronic exchange of patient medication history with hospitals outside their system.
  • Hospitals with electronic exchange of patient medication history with ambulatory providers outside their system.

Providers Asking About Medications and Treatments From Other Doctors

People under age 65 with a usual source of care whose health provider usually asks about prescription medications and treatments from other doctors, by education and chronic conditions, 2002-2012

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Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2012.

• From 2002 to 2011, the percentage of people with a usual source of care whose health provider usually asked about prescription medications and treatments from other doctors improved from 75.1% to 82.7%.
• In 9 of 11 years, people with 0-1 chronic conditions were less likely than people with four or more chronic conditions to be asked about prescription medications and treatments from other doctors.
• In 7 of 10 years, people with less than a high school education were less likely than people with any college to be asked about prescription medications and treatments from other doctors.

Hospitals With Electronic Exchange of Patient Medication History With Other Hospitals and Providers

Hospitals with electronic exchange of patient's medication history with hospitals outside their system, by region and geographic location, 2009-2012

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Key: MSA = metropolitan statistical area.
Source: American Hospital Association (AHA), Information Technology Supplement, 2009-2012.

• In 2012, 30.7% of hospitals electronically exchanged patient information on medication history with hospitals outside their system, up from 13.4% in 2009.
• From 2009 to 2012, the percentage of hospitals that electronically exchange patient medication history with hospitals outside their system significantly increased for all regions by more than 50%.
• In 2012, hospitals in the West were most likely to have electronic exchange with hospitals outside their system, followed by the Midwest, Northeast, and South (35.3%, 32.6%, 30.5%, and 26.5%, respectively).
• From 2009 to 2012, the percentage of metropolitan hospitals that electronically exchanged patient medication history with hospitals outside their system significantly increased from 13.3% to 32.4%. The percentage of nonmetropolitan hospitals that electronically exchanged medication history increased from 13.5% to 28.5%.

Hospitals with electronic exchange of patient's medication history with hospitals outside their system, by ownership and bed size, 2009-2012

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Source: American Hospital Association (AHA), Information Technology Supplement, 2009-2012.

• In 2012, nonprofit hospitals were most likely to have electronic exchange with hospitals outside their system, followed by non-Federal, Federal, and for profit (investor owned) (34.5%, 28.3%, 21.3%, and 17.2%, respectively).
• In 2012, hospitals with <100 or 100-399 beds were less likely than large hospitals (400+ beds) to exchange information with hospitals outside their system.
• From 2009 to 2012, hospitals with 400 or more beds that electronically exchanged medication history with hospitals outside their system increased from 13.9% to 42.3%, hospitals with 100-399 beds increased from 12.1% to 31.1%, and hospitals with <100 beds increased from 14.8% to 27.3%.

Hospitals with electronic exchange of patient's medication history with ambulatory providers outside their system, by region and geographic location, 2009-2012

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Key: MSA = metropolitan statistical area.
Source: American Hospital Association (AHA), Information Technology Supplement, 2009-2012.

• In 2012, 37.2% of hospitals exchanged information with ambulatory providers outside their system, which was up from 28.2% in 2009.
• In 2012, hospitals in the West (40.5%) were the most likely to exchange information with ambulatory providers outside their system, followed by hospitals in the Northeast (40.2%), Midwest (37.3%), and South (34.1%).
• In 2012, hospitals in MSAs (40.2%) were more likely to exchange information with ambulatory providers outside their system than hospitals in non-MSAs (33.3%).

Hospitals with electronic exchange of patient's medication history information with ambulatory providers outside their system, by ownership and bed size, 2009-2012

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Source: American Hospital Association (AHA), Information Technology Supplement, 2009-2012.

• In 2012, large hospitals also were more likely than medium and small hospitals (51.1%, 39.0%, and 31.8%, respectively) to have electronic exchange with ambulatory providers outside their system.
• In 2012, nonprofit hospitals (42.0%) were most likely to have electronic exchange with ambulatory providers outside their system, followed by non-Federal (32.5%), for profit (24.3%), and Federal (14.7%).
• In all years, not-for-profit hospitals were more like to have electronic exchange with ambulatory providers outside their system than for-profit, Federal and non-Federal hospitals.

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