Description: Despite the growing use of electronic health records (EHRs), patients’ medication lists are not frequently shared across the care continuum, such as when patients are discharged from hospitals to nursing homes, or transfer prescriptions from one pharmacy to another. This communication gap poses a serious risk to patients, as the misadministration of drugs can have dangerous, even deadly consequences.
To help address this challenge, Telligen, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Colorado, Illinois, and Iowa, created an online medication reconciliation tool to evaluate community-level reconciliation processes and promote quality improvement.
The tool requires participating providers to audit internal medication reconciliation processes by reviewing patient charts in a timely manner. It also requires them to include any adverse drug events (ADEs) or potential ADEs in an effort to build a more comprehensive electronic profile of a patient’s record. Using data gathered from the tool, Telligen staff assigns a reconciliation score and provides practical recommendations back to the provider to improve care. These recommendations can be relatively simple — from providers quickly assessing records after a patient is discharged — to more challenging, such as providers making changes in the EHR relevant to assessing high-risk medication.
The tool and evaluation process has helped identify gaps in medication information sharing and EHR usage, finding that smaller, community-based pharmacies are the least likely to be engaged in both.
Results: Telligen’s online tool and evaluation process helped providers identify opportunities to increase the sharing of medication information — particularly via EHR — as a patient moves from one care setting to the next. As of June 2016, 15 communities in Iowa, and Colorado have used the assessment tool, and approximately 1,350 patient records have been analyzed. Each “community” is a care collaborative comprised of health care providers and social service agencies. Thus far, the tool has helped prevent more than 440 potential ADEs.