Identifying and Reconciling Patients' Allergy Information Within the Electronic Health Record

Allergy information is often documented in diverse sections of the electronic health record (EHR). Systematically reconciling allergy information across the EHR is critical to improve the accuracy and completeness of patients' allergy lists and ensure patient safety. In this retrospective cohort study, we examined the prevalence of incompleteness, inaccuracy, and redundancy of allergy information for patients with a clinical encounter at any Mass General Brigham facility between January 1, 2018 and December 31, 2018. We identified 4 key places in the EHR containing reconcilable allergy information: 1) allergy modules (including free text comments and duplicate allergen entries), 2) medication laboratory tests results, 3) oral medication allergy challenge tests, and 4) medication orders that have been discontinued due to adverse drug reactions (ADRs). Within our cohort, 718,315 (45.2% of the total 1,588,979) patients had an active allergy entry; of which, 266,275 (37.1%) patient's records indicated a need for reconciliation.