title: Design and implementation of an application and associated services to support interdisciplinary medication reconciliation efforts at an integrated healthcare delivery network.
abstract: 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.
authors.affiliation: Clinical Informatics Research and Development, Suite 201, 93 Worcester St., Wellesley, MA 02481, USA. epoon@partners.org
authors.forename: Eric G
authors.initials: EG
authors.lastname: Poon
authors.forename: Barry
authors.initials: B
authors.lastname: Blumenfeld
authors.forename: Claus
authors.initials: C
authors.lastname: Hamann
authors.forename: Alexander
authors.initials: A
authors.lastname: Turchin
authors.forename: Erin
authors.initials: E
authors.lastname: Graydon-Baker
authors.forename: Patricia C
authors.initials: PC
authors.lastname: McCarthy
authors.forename: John
authors.initials: J
authors.lastname: Poikonen
authors.forename: Perry
authors.initials: P
authors.lastname: Mar
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Schnipper
authors.forename: Robert K
authors.initials: RK
authors.lastname: Hallisey
authors.forename: Sandra
authors.initials: S
authors.lastname: Smith
authors.forename: Christine
authors.initials: C
authors.lastname: McCormack
authors.forename: Marilyn
authors.initials: M
authors.lastname: Paterno
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Coley
authors.forename: Andrew
authors.initials: A
authors.lastname: Karson
authors.forename: Henry C
authors.initials: HC
authors.lastname: Chueh
authors.forename: Cheryl
authors.initials: C
authors.lastname: Van Putten
authors.forename: Sally G
authors.initials: SG
authors.lastname: Millar
authors.forename: Margaret
authors.initials: M
authors.lastname: Clapp
authors.forename: Ishir
authors.initials: I
authors.lastname: Bhan
authors.forename: Gregg S
authors.initials: GS
authors.lastname: Meyer
authors.forename: Tejal K
authors.initials: TK
authors.lastname: Gandhi
authors.forename: Carol A
authors.initials: CA
authors.lastname: Broverman
mesh_terms: 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