Magazine article Drug Topics

Pilot Program in Drug Reconciliation Aims to Avoid Errors

Magazine article Drug Topics

Pilot Program in Drug Reconciliation Aims to Avoid Errors

Article excerpt

Many hospitals have instituted paper-based systems to capture inpatient prescription information as a way to avoid adverse drug events.

One community-based hospital has adopted an automated medication reconciliation program. Fauquier Health System, in northern Virginia, is testing a pilot system that electronically provides the hospital staff with a patients medication history. Patients often arrive at hospitals unfamiliar with their medications; others may be too ill, young, or disabled to share useful information with the hospital staff. Studies show that inconsistent medication knowledge and record-keeping cause up to 50% of all medication-related errors in hospitals and up to 20% of adverse drug events.

Medication errors such as dosing mistakes and drug interactions can be avoided through medication reconciliation systems. Fauquier's pharmacy department led the development of a new medication reconciliation system to comply with The Joint Commissions mandate to implement a medication reconciliation program by January 2006. The new program relied on the admitting nurse to write down a patients medications and transfer them into the hospital information system to become part of an electronic medical record that could be accessed throughout the hospital. Even as the paper-based system was being rolled out, hospital officials began to ponder the concept of developing an entirely electronic medical reconciliation process that would bypass handwritten notes and rely instead on third-party prescription information, explained Margaret Rowe, Pharm.D., director of pharmacy at the 86-bed hospital. "Our goal is to circumvent the problem of patients being poor historians of their medications and use an automated process to improve patient safety."

Building the program

Fauquier partnered with DrFirst Inc., a Maryland-based technology company. DrFirst had developed an electronic prescribing system that several large physician practices connected to Fauquier had earlier adopted. DrFirst adapted its program, called Rcopia, for the acute care setting to assist Fauquier in creating and reconciling an accurate list of patients' medications from admitting to discharge. The prescription information is also provided to the patient and can be electronically accessed by a patients physician. "We were interested in ways that we could introduce efficiencies into our medication reconciliation system and incorporate outpatient prescription information into the process through an automated fashion, as opposed to relying solely on the patients' accounting of their medications," said Rowe. …

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