An effort to improve electronic health record medication list accuracy between visits: patients' and physicians' response.
OBJECTIVE
To evaluate the efficacy of a secure web-based patient portal called Patient Gateway (PG) in producing more accurate medication lists in the electronic health record (EHR), and whether sending primary care physicians (PCPs) a clinical message updating them on the information their patients provided caused physicians to update the EHR medication list.


METHODS
We compared the medication list accuracy of 84 patients using PG with that of 79 who were not. Patient-reported medication discrepancies were noted in the EHR in a clinical note by research staff and a message was sent to the participants' PCPs notifying them of the updated information.


RESULTS
Participants were taking 665 medications according to the EHR, and reported 273 additional medications. A lower percentage of PG users' drug regimens (54% versus 61%, p=0.07) were reported to be correct than those of PG non-users, although PG users took significantly more medications than their non-user counterparts (5.0 versus 3.1 medications, p=0.0001). Providing patient-reported information in a clinical note and sending a clinical message to the primary care doctor did not result in PCPs updating their patients' EHR medication lists.


CONCLUSIONS
Medication lists in EHRs were frequently inaccurate and most frequently overlooked over-the-counter (OTC) and non-prescription drugs. Patients using a secure portal had just as many discrepancies between medication lists and self-report as those who did not, and notifying physicians of discrepancies via e-mail had no effect.
Staroselsky
Maria
M
Partners HealthCare System Inc., Information Systems, 93 Worcester St. Suite 201, Wellesley, MA 02481, USA.
Volk
Lynn A
LA
Tsurikova
Ruslana
R
Newmark
Lisa P
LP
Lippincott
Margaret
M
Litvak
Irina
I
Kittler
Anne
A
Wang
Tiffany
T
Wald
Jonathan
J
Bates
David W
DW
D004346:Drug Information Services / Q000592:standards*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000592:standards*; D008875:Middle Aged; D010817:Physician-Patient Relations; D019338:Polypharmacy; D011320:Primary Health Care / Q000592:standards; D011787:Quality of Health Care