June 14, 2016
Medication reconciliation is a hot topic, and has been for years. Obtaining a patient’s complete, accurate medication history remains a source of tremendous frustration for many clinicians.
The best medication reconciliations almost always begin with obtaining an accurate, complete, current, patient-validated home medication list. But that’s easier said then done – nurses, pharmacy techs and others involved in medication reconciliation know that it can take 30 to 60 minutes to complete medication documentation and reconciliation for a single patient. The process can take even longer if the patient isn’t able to provide a thorough and accurate accounting of what they are taking, requiring the clinician to work with caretakers, family members, the patient’s local pharmacy and/or provider to fill in the gaps.
So how do you drive efficiencies in medication reconciliation while enhancing patient safety and provider productivity? The answer begins with embracing electronic medication history.
Electronic medication history largely remained unchanged over the past 10 years. More recently, as electronic health records became widely adopted in healthcare delivery organizations, demand has grown dramatically for a streamlined medication reconciliation process that facilitates complete, accurate and up-to-date medication lists at intake, discharge and during transfers of care.
Many sources can and should contribute to electronic medication history data feeds, including pharmacy benefit claims, retail pharmacy fill records and other sources. However, electronic medication history remains in continued need of an overhaul. While helpful to stimulate a discussion about the patient’s medication list during an interview with the patient or caregiver, gaps in the electronically reported data pose a significant challenge to medication reconciliation. Many providers receive incomplete information from the patient or his/her caregivers. Furthermore, usability in many systems that import electronic medication history is poor.
Organizations considering an overhaul to their medication reconciliation process or changes in vendors providing electronic medication history services should consider the following three functionalities:
- Complete medication and source information: Medication lists should include a full drug description, including the drug, strength, formulation and complete patient instructions.
- Single-click workflows: The drug description and patient instructions should flow seamlessly into the electronic health record in a structured and reusable manner. Single-click workflows enable true interoperable workflows. Without structured drug descriptions and patient instructions, providers are prone to transcription errors and incomplete utilization of electronic medication history.
- Configurability: Electronic solutions should provide the ability to fine-tune the amount of data displayed to end-users. This helps users refine reported sources to the most likely pertinent information.
A strong technology foundation goes a long way to streamlining and improving the medication reconciliation processes. With the right technology partner and carefully vetted processes – including providers, pharmacists, and nursing staff – medication reconciliation can without question improve patient safety and drive greater productivity in your organization.