Health care transformation / Technology

Making a Seamless Transition from Paper to Electronic MedRec

February 29, 2016

A modern solution

From the moment a patient is admitted to a hospital, to the time they are transferred to another department or discharged, numerous costly and dangerous errors could occur throughout the course of treatment, especially concerning their medications.

Medication Reconciliation (MedRec) is a systematic solution to this problem. It involves a comprehensive review of all the medications a patient is taking during the course of their treatment at a given facility, ensuring that any medications being added, changed or discontinued are assessed and documented carefully.

Shifting from paper-based MedRec (pMedRec) to an electronic (eMedRec) system is a critical step forward to ensuring timely, accurate, and effective communication and operations concerning patients’ medications, especially at transition points such as admission, transfer, and discharge.

Mandated to prevent medical errors

Of the 20% of patients who experience adverse events following discharge from acute care facilities, 66% of those are, preventable, drug-related incidents, which cost $2.6 billion annually in hospitalizations. In an effort to alleviate the growing problem of preventable medical errors, as part of the 2006 Safer Healthcare Now! (SHN) initiative, Accreditation Canada mandated that 1,100 health care organizations instate Required Organizational Practices (ROPs), such as formally implemented MedRec programs at each facility’s admission and transfer or discharge sites. Though the initiative served as a catalyst towards change, national compliance data indicated a need specifically for digital MedRec tools.

Electronic MedRec outshines paper-based solutions

A patient’s medication regimen can change frequently, and consist of the most minute alterations. Tracking MedRec activity is critical to preventing and reducing medical errors, which proved difficult with pMedRec. Compliance at admission is possible using paper solutions, however, any downstream alterations made during the course of treatment became hard to translate at transfer and/or discharge due to discrepancies that arise during care transitions. Additionally, as more and more health care facilities are moving away from paper charts and adopting Electronic Medical Record (EMR) infrastructure, implementing eMedRec solutions into natural workflow has proven to be faster and less difficult than pMedRec. By transitioning to eMedRec, hospitals are able to leverage the IT solutions that are already in place, such as integrating MedRec with a Computerized Provider Order Entry (CPOE), carrying out ordering processes with greater accuracy. Also, eMedRec can house a broader set of features, such as built-in clinical decision support tools, to help guide clinicians through patient visits while prompting them to possible medical discrepancies.

Things to consider when transitioning to eMedRec

Executing new programs across a facility can be a challenge, which is why it is critical that committed staff physicians champion the effort and lead by example when it comes to implementing an eMedRec solution. Institutions that experienced the greatest success with this tool had visible, strong leadership at the helm that set the precedent for better quality patient care tools and processes. It’s also imperative that the eMedRec solution be customized to clinicians’ workflow and clinical best practices, such as ensuring that patients are still undergoing verbal interviews to validate actual medication usage, in conjunction with maintaining a thorough electronic record of their medications.

Careful accountability and monitoring of medications using efficient, digital solutions is a positive step towards easing the burden of rising cost hospitalizations and high patient volumes due to preventable medical errors—eMedRec facilitates the future of medicine.

Notes

  • Forster, A.J., Murff, H.J., Peterson, J.F., Gandhi T.K., Bates, D.W. (2003). The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med, 4,138(3), 161-7
  • Hohl, C.M., Nosyk, B., Kuramoto, L., Zed, P.J., Brubacher, J.R., Abu-Laban, R.B., et al. (2011). Outcomes of emergency department patients presenting with adverse drug events. Ann Emerg Med, 58(3), 270-279
  • Etchells, E. et al (2012). The Economics of Patient Safety in Acute Care. Technical Report. Published by the Canadian Patient Safety Institute, 2012. Retrieved from http://www.patientsafetyinstitute.ca/en/toolsResources/Research/commissionedResearch/EconomicsofPatientSafety/Documents/Economics%20of%20Patient%20Safety%20-%20Acute%20Care%20-%20Final%20Report.pdf
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