Design and implementation of an application and associated services to support interdisciplinary medication reconciliation efforts at an integrated healthcare delivery network.
Confusion about patients' medication regimens during the hospital admission and discharge process accounts for many preventable and serious medication errors. Many organizations have begun to redesign their clinical processes to address this patient safety concern. Partners HealthCare, an integrated delivery network in Boston, Massachusetts, has answered this interdisciplinary challenge by leveraging its multiple outpatient electronic medical records (EMR) and inpatient computerized provider order entry (CPOE) systems to facilitate the process of medication reconciliation. This manuscript describes the design of a novel application and the associated services that aggregate medication data from EMR and CPOE systems so that clinicians can efficiently generate an accurate pre-admission medication list. Information collected with the use of this application subsequently supports the writing of admission and discharge orders by physicians, performance of admission assessment by nurses, and reconciliation of inpatient orders by pharmacists. Results from early pilot testing suggest that this new medication reconciliation process is well accepted by clinicians and has significant potential to prevent medication errors during transitions of care.
Poon
Eric G
EG
Clinical Informatics Research and Development, Suite 201, 93 Worcester St., Wellesley, MA 02481, USA. epoon@partners.org
Blumenfeld
Barry
B
Hamann
Claus
C
Turchin
Alexander
A
Graydon-Baker
Erin
E
McCarthy
Patricia C
PC
Poikonen
John
J
Mar
Perry
P
Schnipper
Jeffrey L
JL
Hallisey
Robert K
RK
Smith
Sandra
S
McCormack
Christine
C
Paterno
Marilyn
M
Coley
Christopher M
CM
Karson
Andrew
A
Chueh
Henry C
HC
Van Putten
Cheryl
C
Millar
Sally G
SG
Clapp
Margaret
M
Bhan
Ishir
I
Meyer
Gregg S
GS
Gandhi
Tejal K
TK
Broverman
Carol A
CA
D016303:Clinical Pharmacy Information Systems; D006801:Humans; D050316:Medical Order Entry Systems / Q000458:organization & administration*; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D008508:Medication Errors / Q000517:prevention & control; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D009936:Organizational Innovation; D010343:Patient Admission; D010351:Patient Discharge; D010865:Pilot Projects; D012985:Software Design; D014584:User-Computer Interface