The U.S. healthcare system spends billions managing the consequences of preventable medication errors. These errors, often the result of dosing mistakes, timing delays, or drug interactions, don’t just affect patient safety. They shape everything from hospital readmission rates to reimbursement penalties and legal exposure.
According to the Institute of Medicine, medication errors cost hospitals more than $3.5 billion each year. Other estimates, including from Senate testimony, place the broader cost between $17 billion and $37.6 billion annually. Despite decades of documentation, the numbers haven’t shifted meaningfully.
One reason is that hospital systems still treat medication safety as a clinical issue instead of a structural one. Dr. Karina Rudenberg has a vision to make a difference. As a board-certified emergency medicine pharmacist, she operates inside the emergency department alongside physicians, nurses, and trauma teams. Her job is to assess drug appropriateness, prevent harmful interactions, and ensure accurate administration during high-risk moments of care.
“There is no question that emergency medicine pharmacy improves outcomes,” she says. “A 2023 BMJ systematic review found that involvement of an emergency medicine pharmacist in the emergency department resulted in a 73% reduction in the number of patients experiencing at least one medication error, a 58% increase in appropriate prescribing, better medication histories, and faster administration of time-critical medications.”
Still, most hospital systems haven’t invested in these roles. It’s not a question of outcomes. It’s a question of ROI. “The economic value of emergency medicine pharmacists is not always easy to quantify or communicate in administrative terms,” Rudenberg says, “particularly when outcomes such as ‘preventing adverse drug events’ are indirect cost savings that are harder to capture in traditional financial models focused on direct revenue generation.”
This presents a clear opportunity for innovation. Rudenberg believes that entrepreneurs working at the intersection of healthtech and operations could fill this gap, specifically by building tools that document and quantify the financial impact of pharmacist interventions.
“Entrepreneurs can design platforms that capture key performance metrics such as intervention types, avoided adverse events, time-to-medications, and cost savings in real time,” she explains. “They can integrate these platforms with the electronic health record to streamline documentation and allow for analytics dashboards that translate frontline clinical actions into administrator- and policymaker-friendly reports.” This type of data infrastructure would not only validate her role, it could also accelerate adoption nationally.
Rudenberg’s work already aligns closely with federal payment models. Hospitals are increasingly reimbursed based on value, not volume. That means metrics like length of stay, sepsis bundle compliance, and readmission penalties matter. Her work directly influences those outcomes.
“Standardization of medication protocols, order sets and treatment algorithms in the emergency department leads to a lower likelihood of errors and therefore lowers costs through indirect long-term cost savings,” she says. “CMS links hospital readmission penalties to quality metrics influenced by medication errors, thereby incentivizing hospitals to reduce preventable readmissions.”
She also points to opportunities in procurement, staffing, and documentation, areas where uniformity reduces cost and error alike. Emergency pharmacists can help implement scalable protocols that support those goals. “My ability to intervene at bedside allows for a second layer of safety ensuring that the appropriate doses are drawn up by nursing staff, that pumps are programmed correctly, and that adverse drug events are addressed appropriately and expeditiously,” she adds.
For healthcare executives focused on operational efficiency, this approach offers measurable value. And for founders building in healthtech, it opens up a category of services that are both underutilized and economically powerful. “My work to reduce medication errors and improve patient outcomes is a major driver of hospital cost reduction and improved hospital reimbursement,” Rudenberg says. “Increased visibility leads to broader standardization of emergency medicine pharmacy within hospital systems and greater indirect long-term cost savings.”
The takeaway isn’t about one pharmacist. It’s about the infrastructure hospitals need to scale what works. Emergency pharmacy, when measured and supported correctly, isn’t just a clinical safeguard. It’s a strategic advantage that strengthens hospital performance, reduces system-wide costs, and directly supports federal value-based care goals.
As the U.S. faces rising healthcare spending and persistent gaps in patient safety, scaling this model could help stabilize a sector under strain. Widespread adoption wouldn’t just improve emergency care, it could save billions, prevent avoidable harm, and move America closer to a more efficient outcomes-driven healthcare system.
