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An effort to improve electronic health record medication list accuracy between visits: patients' and physicians'
Maria Staroselsky1, Lynn A Volk, Ruslana Tsurikova
1Partners HealthCare System Inc., Information Systems, 93 Worcester St. Suite 201, Wellesley, MA 02481, USA.
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.
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