Objective

To create a way of collecting a more accurate medication reconciliation in a less time intensive way

Background

In medicine, much of the care we provide is very dependent on a patient’s adherence to the (often complicated) medication regimen we prescribe. Understanding what medications a patient is taking is therefore crucial to helping us understand how we can better improve their health outcomes.

On the inpatient medicine side, an admission medication reconciliation is vital to ensuring that the patient does not experience adverse outcomes from us misunderstanding what medications a patient was taking at home. However, collecting this information is exceptionally time consuming and oftentimes patients are unable to provide the necessary information.

Outpatient providers also want to know what the patient is taking. Despite the information listed in the electronic medical record, patients are often taking medications in a way quite disparate from what providers envision based on reading a chart.

 Brief description of intervention

I propose the creation of an integrated medication reconciliation tool that will allow both inpatient and outpatient providers to capture exactly what medications the patient is taking and how they are taking these medications. The ideal version of this application or program would require limited time on the providers part and instead would be very much patient--or patient’s family--driven

This application would have a number of features:

a)     For collecting medication names, this program could:

• pull information from the electronic medical record and/or SureScripts so that there is some information for the patient to go off from prior to starting the med rec
• allow for medication input via pictures of the medication bottles or pills
• allow patients to select medications based on pictures compiled from already existing databases

b)     For collecting information about frequency, timing, and dosage of medication ingestion, patients could

• Select a time of day when they take each medication
• Indicate if they take the medication with food

Much in the same way that the “Discharge medication regimen made easier” proposal nicely describes, I envision that when doing this, the patient would drag pictures of their medication pills with names into grids for morning, noon, evening, and bedtime. (Imagine what a pharmacist might do when blister packing medications.)

This information could be collected from patients independently while they wait to be seen by a provider in either an outpatient or inpatient setting. Thus this vital time is not wasted when the patient and provider finally connect.

Requesting patients to also place their medications into one of these four time slots can hopefully also reinforce grouping of medications to increased medication adherence (much like the universal medication schedule is designed to do).