Access to Shared Electronic Medical Records to Improve Adherence and Management of Discharge Medications

OBJECTIVE: The aim of the study is to assess the impact of shared electronic medical records (EMR) on the ability of pharmacists to provide medication reconciliation and clinical interventions in home-based primary care (HBPC) veterans hospitalized outside of the Veterans Affairs Medical Center (VAMC).DESIGN: This was a single-centered, retrospective quality improvement study. An assessment of medical records was conducted to analyze changes in ability to conduct medication reconciliations and interventions in HBPC Veterans hospitalized prior- to and postaccess to shared EMR systems with local non-VA acute care facilities.SETTING: VAMC.PATIENTS: HBPC veterans hospitalized outside of the VAMC. Ninety-eight veteran cases were assessed and 59 enrolled into the retrospective study.INTERVENTIONS: Impact of access to real-time shared EMR systems outside of the VAMC facility on the ability to provide appropriate and timely medication reconciliations and interventions.MAIN OUTCOME MEASURES: Data collection occurred between January and March 2019 and January and March 2020. Number of medication reconciliations conducted, pharmacist interventions made, and time taken to complete transitions of care (TOC) evaluations following hospital discharge were assessed.RESULTS: The number of medication reconciliations completed preaccess to shared EMR was 41.9% versus 85.7% in the postaccess group. The percent hospitalizations with pharmacist interventions was 35.5% preaccess and 60.7% postaccess. The mean number of days to complete a TOC note following discharge from the hospital was 15.2 (±20.2) days preaccess versus 5.3 (±5.7) days postaccess.CONCLUSIONS: Shared EMR systems provide pharmacists reliable and real-time access to patient chart data, laboratory results, and discharge summaries, allowing for timelier medication reconciliations and clinical pharmacist interventions.