Life is full of complicated processes: cell metabolism, human learning and Congressional legislation, to name just a few. To this list many healthcare providers would add medication reconciliation.
What exactly makes med rec in a hospital so “messy”? Here are a few common challenges:
- Gathering an accurate list of a patient’s home medications – This is especially true when a patient’s admission to the hospital is unplanned. Typically it is the nurse’s responsibility to interview the patient and family members to gather this list.
- Factoring in post-admission information – Family members often report additional home medications for a patient during the initial days of an inpatient stay; e.g., “I found out that my mother also takes this red pill.”
- Therapeutic substitutions during hospitalization – It is common for certain home medications to be replaced by therapeutic substitutes during a hospitalization according to what the hospital’s pharmacy has on formulary. When a patient is discharged, however, it is important that the patient continue on the same medication he/she was taking before, so as not to unintentionally disrupt the therapy.
- Varying insurance coverage – Sometimes the attending physician does not have visibility into what discharge medications will be covered by the patient’s insurance plan.
- Separating med rec from ordering – They’re two sides of the same coin. So why are they separate processes within many hospital IT systems?
Healthcare IT can do much to alleviate physicians’ frustrations around med rec and generally improve the process; indeed PatientKeeper already has, and is doing more. It’s a high-priority fix for the healthcare industry as a whole, since “experience from hundreds of organizations has shown that poor communication of medical information at transition points is responsible for as many as 50 percent of all medication errors and up to 20 percent of adverse drug events in the hospital.”
Let’s make 2016 the year we clean up the med wreck.