Medicines reconciliation using a shared electronic health care record

Area of Science:

• Health Informatics
• Patient Safety
• Clinical Pharmacy

Background:

• Medication errors are a significant concern in healthcare, particularly during transitions of care.
• Accurate medication reconciliation is crucial for patient safety.

Purpose of the Study:

• To evaluate the effectiveness of a shared electronic primary health care record (EHR) for medication reconciliation in a hospital setting.
• To compare medication reconciliation using conventional methods versus EHR-initiated methods.

Main Methods:

• Prospective, cross-sectional comparison study in a UK elderly admissions ward over two phases.
• Phase 1: Conventional reconciliation followed by EHR verification.
• Phase 2: EHR as the primary tool, validated by conventional methods.

Main Results:

• Errors were found in 28% of prescriptions when using conventional methods alone.
• Using EHR as the primary method still revealed errors in 38% of non-matching prescriptions.
• Significant inaccuracies were noted in patient medication lists within the EHR (26% and 36% incorrect).
• Common errors included drug omission on discharge and incorrect drug selection in the EHR.

Conclusions:

• Electronic health records (EHR) can aid in reducing medication errors.
• The EHR should complement, not replace, patient/carer information for reconciliation.
• Read-and-write access to EHR for both primary care and hospital clinicians is recommended to improve care transitions.