title: Accuracy of Electronic Medical Record Medication Reconciliation in Emergency Department Patients.
abstract: BACKGROUND
  Medication history discrepancies have the potential to cause significant adverse clinical effects for patients. More than 40% of medication errors can be traced to inadequate reconciliation.
  
  
  OBJECTIVE
  The objective of this study was to determine the accuracy of electronic medical record (EMR)-reconciled medication lists obtained in an academic emergency department (ED).
  
  
  METHODS
  Comprehensive research medication ingestion histories for the 48 h preceding ED visit were performed and compared to reconciled EMR medication lists in a convenience sample of ED patients. The reconciled EMR list of prescription, nonprescription, vitamins, herbals, and supplement medications were compared against a structured research medication history tool. We measured the accuracy of the reconciled EMR list vs. the research history for all classes of medications as the primary outcome.
  
  
  RESULTS
  Five hundred and two subjects were enrolled. The overall accuracy of EMR-recorded ingestion histories in the preceding 48 h was poor. The EMR was accurate in only 21.9% of cases. Neither age ≥ 65 years (odds ratio [OR] = 1.3; 95% confidence interval [CI] 0.6-2.6) nor sex (female vs. male: OR = 1.5; 95% CI 0.9-2.5) were predictors of accurate EMR history. In the inaccurate EMRs, prescription lists were more likely to include medications that the subject did not report using (78.9%), while the EMR was more likely not to capture nonprescriptions (76.1%), vitamins (73.0%), supplements (67.3%), and herbals (89.1%) that the subject reported using.
  
  
  CONCLUSIONS
  Medication ingestion histories procured through triage EMR reconciliation are often inaccurate, and additional strategies are needed to obtain an accurate list.
authors: Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado; Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado; Rocky Mountain Poison & Drug Center, Denver, Colorado.
authors: Andrew A
authors: AA
authors: Monte
authors: Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado.
authors: Peter
authors: P
authors: Anderson
authors: Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado; Rocky Mountain Poison & Drug Center, Denver, Colorado.
authors: Jason A
authors: JA
authors: Hoppe
authors: Mayo Clinic Department of Pharmacology, Rochester, Minnesota.
authors: Richard M
authors: RM
authors: Weinshilboum
authors: Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado.
authors: Vasilis
authors: V
authors: Vasiliou
authors: Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado; Rocky Mountain Poison & Drug Center, Denver, Colorado.
authors: Kennon J
authors: KJ
authors: Heard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019587:Dietary Supplements; D057286:Electronic Health Records / Q000592:standards*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D059065:Medication Reconciliation / Q000592:standards*; D008875:Middle Aged; D004366:Nonprescription Drugs; D028321:Plant Preparations; D055553:Prescription Drugs; D011446:Prospective Studies; D014815:Vitamins; D055815:Young Adult
chemical_list: D004366:Nonprescription Drugs; D028321:Plant Preparations; D055553:Prescription Drugs; D014815:Vitamins
keywords: electronic medical record; emergency department medications; medication history; medication reconciliation; reconciliation