Health Information Technology: Meaningful Use and Next Steps to Improving Electronic Facilitation of Medication Adherence

Abstract

BackgroundThe use of health information technology (HIT) may improve medication adherence, but challenges for implementation remain.ObjectiveThe aim of this paper is to review the current state of HIT as it relates to medication adherence programs, acknowledge the potential barriers in light of current legislation, and provide recommendations to improve ongoing medication adherence strategies through the use of HIT.MethodsWe describe four potential HIT barriers that may impact interoperability and subsequent medication adherence. Legislation in the United States has incentivized the use of HIT to facilitate and enhance medication adherence. The Health Information Technology for Economic and Clinical Health (HITECH) was recently adopted and establishes federal standards for the so-called "meaningful use" of certified electronic health record (EHR) technology that can directly impact medication adherence.ResultsThe four persistent HIT barriers to medication adherence include (1) underdevelopment of data reciprocity across clinical, community, and home settings, limiting the capture of data necessary for clinical care; (2) inconsistent data definitions and lack of harmonization of patient-focused data standards, making existing data difficult to use for patient-centered outcomes research; (3) inability to effectively use the national drug code information from the various electronic health record and claims datasets for adherence purposes; and (4) lack of data capture for medication management interventions, such as medication management therapy (MTM) in the EHR. Potential recommendations to address these issues are discussed.ConclusionTo make meaningful, high quality data accessible, and subsequently improve medication adherence, these challenges will need to be addressed to fully reach the potential of HIT in impacting one of our largest public health issues.

Methods to improve medication adherence in patients with chronic inflammatory rheumatic diseases: a systematic literature review

“…Patients seek information online and websites or apps might participate in promoting adherence. 38 Therefore, further good-quality RCTs are needed to better evaluate interventions to optimise medication adherence in chronic inflammatory rheumatic diseases.…”

<p>Medication Therapy Management: Current Challenges</p>

“…While access to medical records has been noted as an important driver in the success of MTM, integrating the pharmacist into the health information technology (HIT) infrastructure has been difficult and adoption of shared electronic health record (EHR) systems in community pharmacies has been minimal. 22,[35][36][37] Specifically, interoperability and bi-directionality of health information, pharmacy informatics development, and burdensome documentation were cited as barriers for MTM delivery. 38 HIT has always posed challenges in healthcare simply due to the volume, velocity and variety of big data.…”

An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities

“…[ 10 ] In particular, we hypothesize that medication reconciliation, the process of creating the most accurate possible medication list, would be hindered in the absence of functional health information exchange and interoperability, including from pharmacies. [ 11 – 19 ] Data from other settings are critical to resolve unintended errors in medication histories, including drug omission, and incorrect dosage and frequency, [ 20 – 23 ] which affect up to 67% of hospitalized patients. [ 24 , 25 ]…”