NIH Care Reform Study: EHRs Key to Improving Medication Reconciliation Processes
Improving the way hospitals and stakeholders use electronic health records could help to reduce discrepancies in patients' medications at admission and discharge, according to a study by the National Institute for Health Care Reform, Healthcare IT News reports (Miliard, Healthcare IT News, 7/29).
For the study, researchers interviewed hospital executives and clinical EHR users at 19 hospitals and health systems in 10 regions across the U.S. to determine how they were using EHRs to support medication reconciliation (NIHCR research brief, July 2014).
Medication reconciliation helps confirm that records of patients' medications are accurate at admission, during hospitalization and at discharge (Healthcare IT News, 7/29).
During the interviews, respondents were asked to describe how clinical staff:
- Collected and verified patients' pre-admission medication list;
- Reviewed pre-admission medication records and hospital orders to create inpatient and discharge medication lists;
- Shared the discharge medication lists with patients and their providers; and
- Used EHRs at patients' admission and discharge (NIHCR research brief, July 2014).
Overall, the researchers found that:
- More than 33% of the hospitals used a partially paper-based process at patient admission, discharge or both;
- Many hospitals had some form of access to external EHRs that included medication histories, but use of this feature was not widespread;
- Hospitals with processes that were fully electronic at admission or discharge had implemented EHR medication reconciliation modules; and
- Hospitals with processes that were fully electronic at discharge used their EHR to electronically generate more user-friendly discharge instructions and electronic prescriptions.
The researchers noted that the core challenges to medication reconciliation include:
- Better engaging doctors;
- Increasing access to accurate medication histories;
- Refining the usability of EHRs; and
- Systematically sharing patient information with their future providers.
The researchers wrote, "Enhancing ways for key stakeholders -- patient safety advocates, policymakers, 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" (Healthcare IT News, 7/29).
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