King's Daughters Medical Center in Brookhaven, Mississippi, found it challenging to provide an accurate, verifiable home medication record for its providers to trust as they made important decisions about existing medications both during an inpatient visit and after discharge.
While obtaining this information may sound straightforward, the ability to actually do it can be anything but. It often involves patient interviews, communicating with families, calling pharmacies, reviewing records or a combination of these.
King's Daughters now uses external medication history from pharmacy fill data as well as insurance claims data, provided by vendor DrFirst, to complement verification and push the information to the providers. There are many medication management information systems on the market. Other vendors include Allscripts, Cerner, GE Healthcare, Genoa Healthcare, Medication Management Systems, MedMinder, Omnicell, PointClickCare, Surescripts and Talyst.
While it is not intended as a replacement for the patient/family interview, its integration into the electronic health record greatly augments the conversation and can prompt a patient to include easily forgotten information, said Joe Farr, RN, an emergency department nurse.
On the back-end of the visit, King's Daughters uses the e-prescription functionality in its EHR, again using DrFirst technology. This reduces the risk of prescription loss and makes the process more efficient for the patient while ensuring the health record is updated in advance of future visits, said Farr.
"The typical user is not even aware of the work in the background and it feels like native EHR functionality," he explained. That includes workflows and processes, such as interface and search functions.
King's Daughters is required to report its performance on both medication reconciliation (with a threshold goal of 50 percent) and e-prescription (10 percent) to the Centers for Medicare and Medicaid Services.
"On our most recent reporting period, Q4 2017, our stats were 77 percent and 52 percent, respectively," Farr reported.
Farr added that integrating medication management tech into the EHR also helped King’s Daughters more effectively retrieve historical data and deliver that information to providers to facilitate new prescriptions in a trustworthy manner that both reduces errors and the abuse of controlled substances.
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