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Medication Reconciliation Safety Concerns Linger Even With EHRs

· Steve Baum,

Has the broad adoption of EHRs helped address medication reconciliation concerns? I was recently reading the ECRI Institute’s 2015 report, “Top 10 Patient Safety Concerns for Healthcare Organizations,” where it lists “care coordination events related to medication reconciliation” as number 5 on the list.

While EHRs have the ability to share medication information across the organization, that list is only as accurate as the patient’s memory at the time of the encounter. If a patient arrives in the emergency department (ED), for example, unconscious or disoriented, a family member or caregiver would be responsible for informing the ED providers about the patient’s medications, sometimes handing over a bag of prescription medication containers. It’s then up to the clinicians to reconcile those medications against any existing list they may have in their EHR, which may be months or years old, or nonexistent.

Clinical communications enable team-based care

This is where mobility solutions with clinical communication functionality can make reconciliation more efficient, accurate, and, most importantly, safer. If a clinician does not recognize a medication that a patient presents at ED arrival, leaving the patient’s bedside to query it in the EHR or place a call to the hospital pharmacist is not always feasible. With PatientTouch Communications by PatientSafe Solutions, clinicians could send a secure, HIPAA-compliant text message from their smartphone to the pharmacist to check on potential drug-drug interactions and receive an answer while continuing to deliver care. Instead of interrupting and potentially delaying care to enter data into an EHR, clinicians can remain with the patient capturing additional data on their device or performing care tasks.

In addition, when patients are unable to accurately recall their current medications and the prescription bottles are not available, the unified clinical communications platform available with PatientTouch Communications can also be used to securely send messages and multi-media information to the primary care physician’s mobile device or pharmacy to help confirm active prescription medications. PatientTouch Communications also adds patient-context to these messages through ‘patient-tagging,’ helping ensure the right information is shared to support safe, efficient, and actionable care.

Safer discharges with mobile solutions

Finalizing the list at discharge is also where a clinical mobility solution is particularly useful. Mobile solutions allow the clinician to remain at bedside to remind and educate patients about their medications, especially new therapies that were prescribed during their stay and pre-existing medications.

Through mobile technology, the provider can more easily answer patients’ final questions and be reminded of educational opportunities through notifications on their device. Mobile solutions also allow for a final safety check from the bedside to identify any errors in the medication list, such as dosing errors, duplicate orders, or similar-sounding drugs. The ECRI recommends such a final review in its most recent report.

Clinicians want to remain at the bedside and not be interrupted to look up a medication on a computer-based EHR or send a message to another provider. Mobile solutions give them that option while protecting the patient’s safety and ensuring a high level of care quality.

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