Adding HIE, eRx data to electronic records improves prescription list accuracy

Combining medication history information from three sources improved accuracy and patient safety, according to a study published in the American Journal of Managed Care.

Funded by the New York State Department of Health, the study looked at records from seven clinics associated with St. Peter's Health Partners that share a common electronic health record; a commercial medication database containing data from a national e-prescribing network; and the community health information exchange portal offered through a Regional Health Information Organization..

The study involved the records of 858 patients, who collectively were on 7731 medications. The three sources were then compared with the gold standard--a validated list of the patient's medications taken at home.

The researchers found the hospital EHR accurately captured 80 percent of medications, the commercial medication database captured 45 percent and the community portal captured 37 percent accurately. However, when the three were combined, the accuracy rate improved to 91 percent.

Under pressure to reduce readmissions and improve patient outcomes, hospitals increasingly are relying on the medication reconciliation technology, but the technology is still evolving and challenges remain, hospital execs told FierceEMR.

In the New York study, patients' allergy information was 97 percent complete when data were combined from the hospital EHR and community portal. Likewise, using just two sources led to largely complete records for classes of medications associated with high risk for preventable adverse drug events, including hypoglycemic and blood flow medications.

Another study of more than 500 medication reconciliation breakdowns between November 2011 and November 2012 in Pennsylvania found that 69 percent occurred during admission medication reconciliation.

Researchers looking at secure messaging used in Veterans Affairs clinics in Boston found it has the potential to improve medication reconciliation and workflow at primary care clinics--and that doctors were enthusiastic about it because other staff members could handle it without their input.

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