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Medication Reconciliation

Medication Reconciliation (MedRec) is an essential part of any successful Transitional Care Program. Unfortunately, there is NOT a standardized method to utilize and attain accurate medication information for patients pre/post discharge. [Below are the MedRec challenges our PatientCare Rx™ Program has resolved by utilizing a standardized MedRec process.]

Medication Reconciliation
  • Patient enters the Emergency Department (ED) and CANNOT remember what medications they are taking
  • Formulary disparity between the hospital/SNF formulary and patient Rx insurance
  • Pharmacy unable to resolve medication access barriers
    Prior-authorization, drug not covered, co-pay too high, refill too soon or step therapy required
  • HCPs unable to confirm discharge Rx’s actually filled
    Patient/caregiver confusion with pre-admission vs post discharge medications
  • Electronic Health Record (EHR) patient information not received by Primary Care Physician/Clinic for patient follow-up visit

When entering the ED, PHARxSIGHT uses a cloud-based program that consolidates all adjudicated claims into one report using five sources of information generated within minutes. This comprehensive medication history report gives physicians the information needed when initiating treatment to patients in the ED.

The PatientCare Rx™ MedRec Program was designed to be flexible and can be utilized with existing programs and internal resources.

PHARxSIGHT’s staff of pharmacists understand the MedRec challenges and developed this solution for patients, caregivers, hospitals, SNF, insurance payers and health/wellness programs.

Our “One-of-a-Kind” PatientCare Rx™ MedRec Program:

• Enrolls patient into program pre-discharge
• Exchanges patient data
• Adjudicates post-discharge Rx’s via patients retail pharmacy
• Resolves any medication access barriers
• Confirms 100% discharged Rx’s are filled
• Confirms Rx’s ready for pick-up or delivery
• Performs MedRec post-24 hour of discharge by a pharmacist
• Sends summary document to PCP/clinic prior to follow-up visit

                                                           To learn MORE contact PHARxSIGHT and set-up an appointment


Medication Reconciliation Statistics

  • Approximately 1.5 million preventable adverse drug events (ADEs) occur annually as a result of medication errors, at a cost of more than $3 billion per year5
  • Approximately half of all hospital-related medication errors and 20% of all ADEs have been attributed to poor communication at the transitions and interfaces of care6,7
  • The average hospitalized patient is subject to at least one medication error per day5
Older Man Looks At All Of His Medications
  • ADEs account for 2.5% of estimated emergency department visits for all unintentional injuries and 6.7% of those leading to hospitalization8
  • The occurrence of unintended medication discrepancies at the time of hospital admission ranges from 30% to 70%, as reported in two literature reviews9,10
  • Results of the largest medication reconciliation study to date indicate that 36% of patients had medication errors at admission, of which 85% originated from the patient’s medication history11
  • Strategies shown to reduce medication errors at transitions include pharmacist medication review at discharge12,13
  • Pharmacist-provided medication therapy review and consultation in various settings resulted in reductions in physician visits, emergency department visits, hospitaldays, and overall health care costs4
  • Medication reconciliation reduced discharge medication errors from 90% to 47% on a surgical unit and from 57% to 33% on a medical unit of a large academic medical center 12


REFERENCES

1. Greenwald JL, Halasyamani LK, Greene J, et al. Making inpatient medication reconciliation patient centered, clinically relevant, and implementable: a consensus statement on key principles and necessary first steps. Jt Comm J Qual Patient Saf. 2010;36:504-13.

2. Chen D, Burns A. Summary and Recommendations of ASHP-APhA Medication Reconciliation Initiative Workgroup Meeting, February 12, 2007. Available at: http://www.ashp.org/s_ashp/docs/files/MedRec_ASHP_APhA_Wkgrp_Mtg Summary.pdf. Accessed July 1, 2011.

3. Patient Protection and Affordable Care Act, Pub. L. No. 111-148, §2702, 124 Stat (2010).

4. American Pharmacists Association. Medication Therapy Management in Pharmacy Practice: Core Elements of an MTM Service Model, Version 2.0. March 2008. Available at: http://www.pharmacist.com/AM/Template.cfm?Section =Pharmacists&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=19013. Accessed July 1, 2011.

5. Institute of Medicine. Preventing Medication Errors. Washington, DC: The National Academies Press; 2007.

6. Barnsteiner JH. Medication reconciliation: transfer of medication information across settings: keeping it free from error. J Infus Nurs. 2005;28(2 suppl):31-6.

7. Rozich J, Roger R. Medication safety: one organization’s approach to the challenge. J Clin Outcomes Manag. 2001;8:27-34.

8. Budnitz DS, Pollock DA, Weidenbach KN, et al. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006;296:1858-66.

9. Cornish PL, Knowles SR, Marchesano R, et al. Unintended medication discrepancies at the time of hospital admission.
Arch Intern Med. 2005;165:424-9.

10. Gleason KM, Roszek JM, Sullivan C, et al. Reconciliation of discrepancies in medication histories and admission orders of newly hospitalized patients. Am J Health Syst Pharm. 2004;61:1689-95.

11. Gleason KM, McDaniel MR, Feinglass J, et al. Results of the Medications At Transitions and Clinical Handoffs (MATCH) study: an analysis of medication reconciliation errors and risk factors at hospital admission. J Gen Intern Med. 2010;25:441-7.

12. Murphy EM, Oxencis CJ, Klauck JA, et al. Medication reconciliation at an academic medical center: implementation of a comprehensive program from admission to discharge. Am J Health Syst Pharm. 2009;66:2126-31.

13. Schnipper JL, Kirwin JL, Cotugno MC, et al. Role of pharmacist counseling in preventing adverse drug events after hospitalization. Arch Intern Med. 2006;166:565-71.