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Medication Reconciliation Stages of Excellence

Meaningful medication reconciliation improvement must be multi-dimensional and involve three primary drivers:

the people, processes, and technology that work together to drive efficiency, enhance patient safety, and

increase provider productivity. In our work with healthcare organizations, we see commonality in challenges and

associated mitigation initiatives as we assist in progress through stage three to improve medication reconciliation.

• Medication history data gaps• Textual sig data requiring provider

intervention• NDC and inpatient formulary

mismatches• Inconsistencies in how medication

data is presented at discharge

• Unnecessary manual documentation• Lengthy history interview requiring

calls to family, pharmacies, and providers

• Outdated workflows driving bad medication reconciliation practices

• Compliance enforcement variation

TechnologyProcessPeople• External medication history not

consistently used across departments, disciplines, shifts

• Off hours staff competency gaps• External medication history directly

accepted into EHR without patient interview confirmation

• External medication history technology optimization

• Medication history data gap mitigation

• Point of encounter workflow enablement

Stage 2: Optimized State

• Leadership engagement• Interdisciplinary staffing including

optimized Pharmacy involvement• Ongoing training program

promoting organization-wide competencies

• Ubiquitous and comprehensive medication history seamlessly integrated within all EHR’s

• Intuitive and predictive supporting technology

• Tools to enhance drug data stewardship

• Opportunistically commencing medication history interview at preadmission

• Elimination of unnecessary and redundant med history data

• Continuous quality improvement feedback

Stage 3: Perfect Data State

• Patient engagement and accountability

• Community contributing to comprehensive data coverage and quality

• Provider engagement

TechnologyProcessPeople

TechnologyProcessPeople

• Policy, workflow and compliance refinement

• Complete & consistent medication history interview at every admission

• Downstream process improvement benefits

© 2017 DrFirst Corporation. All rights reserved.

Stage 1: Challenged State

© 2017 DrFirst Corporation. All rights reserved.

Medication Reconciliation: The Cornerstone of Quality Patient Care

Medication reconciliation is a critical cornerstone of patient care in the healthcare setting. When it’s done accurately and efficiently, medication reconciliation benefits everyone. Patients receive better care, clinical staff save time, and providers have a more accurate view of the patient’s medication history at every transition of care.

Conversely, poor medication reconciliation is a major cause of medication errors and can jeopardize the patient any time during the hospital stay. A recent study from Johns Hopkins University found that medical errors kill more than 250,000 patients per year in the US, making it the third leading cause of death behind heart disease and cancer.1 While not all of those deaths are directly caused by poor medication reconciliation, medication errors are a significant contributor to what is clearly preventable harm.

DrFirst’s Approach to Medication Reconciliation

At DrFirst, we combine our expertise in patient care data and clinical workflows with our passion for leveraging technology to solve healthcare related problems. It’s our deep understanding of the myriad complexities of the medication reconciliation process that led us to develop solutions that save staff time and increase the accuracy of medication history directly impacting safe patient outcomes.

We continually invest to seek optimal medication reconciliation at every hospital we serve. To begin with, we created a more complete data source to give clinicians the most complete picture of a patient’s medication history. Our MedHx℠ offering includes standard industry available data, payer data, local pharmacy fill data, and prescribing data from DrFirst’s network of more than 20 million patients and 62,000 providers.

Next, our SmartSuite℠ solution uses predictive analysis to improve data flows into your EHR. By automatically converting textual medication history data into discrete data elements, this technology eliminates the need to manually enter data, making your staff more efficient while reducing data errors.

The IN Group, our team of expert medication management professionals, evaluates your medication reconciliation workflow and associated EHR system build to offer actionable and innovative recommendations for improvement. Our experience proves that properly integrated workflow yields improved efficiency while minimizing medication errors.

Sandra Luffman, Point of Care Coordinator at Hugh Chatham Hospital in Elkin North, Carolina. shared her perspective on the improvements in medication reconciliation after working with DrFirst. Ms. Luffman said “We have completely changed our process for acquiring medication history. Now our ER nurses complete the process in 5 to 10 minutes. It’s faster, and more accurate, and we get a one-year history of medications instead of just a current list. This enables our doctors to do the admission medication reconciliation with the admission order. It’s better and safer for our patients, and saves us a lot of time.”

DrFirst welcomes the opportunity to discuss your hospital’s medication reconciliation vision and how we can work together to achieve medication reconciliation optimization success. Contact us at TheINGroup@drfirst.com.

1. Source: http://www.npr.org/sections/health-shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors