EHRs Key To Medication Reconciliation

Mike Miliard | Healthcare IT News | July 29, 2014

But hurdles remain, including usability, physician engagement and access to reliable medication histories

Electronic health records have a big role to play in improving hospitals' medication reconciliation, a new study finds, but challenges related to data quality, technology and workflow remain.  Medication reconciliation is a systematic way to reduce medical errors by ensuring accurate patient medication lists at admission, during a hospitalization and at discharge. Unintended discrepancies are common, with some research finding they affect as many as 70 percent of hospital patients at admission or discharge – with almost one-third of those potentially causing harm.

Still, despite hospital accreditation and other requirements, use of med rec technology has lagged for many reasons – including insufficient physician engagement, which stems, in part, from lack of professional consensus about which physician is responsible for managing a patient's medication list, according to the new report from National Institute for Health Care Reform.  NIHCR is a nonpartisan, nonprofit organization launched by United Automobile Workers, Chrysler, Ford and General Motors. Between 2009 and 2013, it contracted with the Center for Studying Health System Change to conduct objective research and policy analyses of the organization, financing and delivery of healthcare in the U.S.

Conducted for NIHCR by researchers Joy M. Grossman, Rebecca Gourevitch and Dori A. Cross, this study examined how 19 hospitals nationwide were using EHRs to support medication reconciliation.  They found that key challenges to effective medication reconciliation include improving access to reliable medication histories, refining EHR usability, engaging physicians more fully and routinely sharing patient information with the next providers of care.
  "Enhancing ways for key stakeholders – patient safety advocates, policy makers, researchers, EHR vendors, hospitals and clinicians – to share the best EHR designs and hospital implementation strategies will be key to realizing the potential safety and efficiency benefits of EHR-based medication reconciliation," they write...