Medication Reconciliation and Polypharmacy
Medication Reconciliation and Polypharmacy Committee (MPRC)
This group assisted in the chartering of the MRPC (Chartered October 2020), which continued the work of the MRP Workgroup (MRPWG), and continually provides administrative support to the committee. Since the group first convened, a plan was laid out to build upon the previous work of the MRPWG. The committee started by prioritizing the 11 recommendations described in the workgroup's final report, where the Best Possible Medication History was determined to be the most important to address. Though not limited to a single focus, the group also endorsed a deprescribing survey, which assessed the awareness of CancelRx. The timing was appropriate given that health systems were required to comply with the NCPDP (National Council for Prescription Drug Programs) Script Standard v2017071. Learn more about the committee.
Medication Reconciliation Application
In an effort to make progress in addressing challenges around polypharmacy the medication reconciliation application development project focused on three specific problems facing physicians during medication reconciliation: obtaining medication list data from multiple disparate sources (e.g., EHRs from multiple providers); merging the complete medication list data at one, easy to access location; and, processing the complete medication list data to provide a Best Possible Medication History (BPMH). This BPMH could then be displayed to a physician, allowing the physician the ability to confirm that the medications presented are correct. On this premise the project team worked to develop an interface utilizing the Fast Healthcare Interoperability Resources (FHIR) standard to pull medication records from multiple electronic data sources and perform medication reconciliation, delivering a complete, merged list of medications.
Genetic Testing Prior Authorization
In October 2017, the HIE Use Case Design Group (charted by the Health IT Advisory Council) generated a report which outlines important use cases for future HIE in Connecticut to engage in. Following a Genomic Medicine workshop, held by the Connecticut Office of Health Strategy (OHS), this group was tasked with researching how the Connecticut Information Exchange (Connie) could be leveraged in improving care related to genomics and genetics.
Due to the novel coronavirus, healthcare practices were forced to quickly shift to telehealth. The inability to carefully assess available vendors led to the development of a survey to look at the current barriers and challenges, as well as an interest in a potential alternative if it was available through the Connecticut Information Exchange (Connie, the recently established health information exchange). The survey underwent an expedited IRB review process and was approved to be distributed to providers all across the state.
Advance Directive Assessment
Documentation relating to advanced care planning, physician orders for end-of-life wishes, and other end-of-life preferences are not easily accessible across different health systems. A health information exchange (HIE) may be able to solve this problem as long as the information is entered into a platform that is capable of sharing that information easily. This group was tasked to create a survey to gauge the interest of providers, both in the practice and pre-hospital setting, to determine the level of want and need for a platform, which could be offered through the Connecticut Information Exchange (Connie). The survey underwent an expedited IRB review process and was approved to be distributed to providers all across the state.
eCQM ( Electronic Clinic Quality Measure)
This UConn Health team will support the mission of the Connecticut Office of Health Strategy, i.e. “to implement comprehensive, data-driven strategies to promote equal access to high quality health care, control costs, and ensure better health for the people of Connecticut.” The UConn Health team’s work will also support the Health Information Alliance, a non-profit organization formed in 2019, to create a state-wide Health Information Exchange (HIE). This HIE, called ConnIE (Connecticut Information Exchange), is currently under development and will become operational later in 2020. Once the HIE is operational and QMs have been selected, the Office of Health Strategy can utilize these in a variety of ways to accomplish its mission.
Health IT for Clinicians Webinar Series
This series was created to address gaps in knowledge and awareness among providers in the state as it work's towards developing the Connecticut Information Exchange (Connie). Connnie is an establishing health information exchange (HIE) that seeks to advance the care for all patients in the state and give providers appropriate access to patient data to improve care. As such, providers, would need to understand the services that Connie will be offering and how to effectively leverage technology in healthcare. As of November 2020, three webinars have been held to address various needs, ranging from electronic deprescribing to telehealth.
Medication Reconciliation and Polypharmacy Workgroup (MRPWG)
The Health IT Advisory Council prioritized a list of ten high priority use cases for HIE services; medication reconciliation was one of the major objectives. The CT Legislature mandated the formation of the Medication Reconciliation and Polypharmacy (MRP) Work Group to make recommendations by June 2019, under the oversight of the CT Office of Health Strategy (OHS). Dr. Thomas Agresta, assisted in leading this workgroup which developed 11 recommendations and held a hackathon to address medication reconciliation (learn more below). This workgroup was later evolved into the Medication Reconciliation and Polypharmacy Committee (described above).
UConn Health, as an advisor to OHS on HIE efforts, co-sponsored a Medication Reconciliation Hackathon on Friday, April 5th and Saturday, April 6th, 2019 at the UConn Health Academic Building in Farmington.
- Educate participants about some of the current challenges and newer opportunities in the use of electronic systems for the medication reconciliation,
- Introduce basic technical aspects of Fast Healthcare Interoperability Resources (FHIR) for electronic exchange of healthcare information,
- Identify key “pain points” from various user perspectives and propose viable solutions, and
- Assist in the planning for medication management services for the State’s HIE.
Read the full report.