Medication Reconciliation

An effort to improve electronic health record medication list accuracy between visits: Patients’ and physicians’ response

Posted on by Ryan J Tran

 

Study Type/Setting
Methods
Outcomes
Recommendations
Source
A study to evaluate the efficacy of a secure webbased patient portal

 

Setting: Primary Care
- N= 163 patients;
- 84 Patient Gateway users vs. 79 non-users
- Sending PCP a clinical message providing patient-reported information vs. no clinical message
- A lower % of PG users’ drug regimen was reported to be correct than those of PG nonusers (54% vs 61%)
- Notifying physicians of medication discrepancies via email had no effect
- Med lists in EHRs were frequently inaccurate
- Patient access to PG was not associated with more accurate medication lists in EHR
- Clinical messages to physicians containing patient-provided medication updates did not result in physician updating the med list in EHR
Staroselsky et al
Staroselsky M, Volk LA, Tsurikova R, et al. An effort to improve electronic health record medication list accuracy between visits: Patients’ and physicians’ response. International Journal of Medical Informatics. 2008;77(3):153-160. doi:10.1016/j.ijmedinf.2007.03.001

 

Accuracy of the medication list in the electronic health record—implications for care, research, and improvement

Posted on by Ryan J Tran
Study Type/Setting
Methods
Outcomes
Recommendations
Source
Retrospective chart review

 

Setting: Outpatient
- N=180 patients w/ inflammatory bowel disease (IBD); 379 IBD medications
- Medication list vs. clinical narrative
- 6 gastroenterology centers
- There was a range in the accuracy of medication list compared to the clinical narrative
- Variation by center (90%-50% agreement between the med list and clinical narrative)
- Analytic or care decision should not solely rely on medication order data
- This information may be helpful for site seeking to improve data quality
Walsh et al 
Walsh KE, Marsolo KA, Davis C, et al. Accuracy of the medication list in the electronic health record—implications for care, research, and improvement. Journal of the American Medical Informatics Association. 2018;25(7):909-912. doi:10.1093/jamia/ocy027