June 16, 2006

Rollout of Medication Reconciliation Program continues

To help reduce the risk of medication errors, the MGH launched an electronic medication reconciliation process in April that has been introduced to 22 patient care units and is more than halfway through the rollout phase. The goal of this new program, which is available in Provider Order Entry (POE), is to help clinicians track medication lists for both outpatients and inpatients and compare or "reconcile" the admission, transfer and discharge orders for medications to the original lists. This process helps avoid errors related to unintentional omissions, duplications or wrong dosages of prescriptions and over-the-counter pharmaceuticals or supplements.

The rollout of the new, centralized electronic version of the medication list, called the Pre-Admission Medication List (PAML), has been going well, according to Gregg Meyer, MD, medical director of the Massachusetts General Physicians Organization and chair of the Partners Signature II Initiative. "We have experienced a few challenges along the way, but we are addressing these issues based on the feedback we've been getting from users,"he says. "It is important for everyone to remember that we need to work together to make this initiative successful. Our patients deserve this program to keep them safe from medication errors."

Some of the challenges of the rollout have included concerns about how long it may take to enter lengthy medication lists into the system. For busy clinicians, this process can be time consuming when a patient is admitted, but the end result is that once the list is created, it can be easily changed electronically. Many clinicians have found the process ultimately can save time and facilitate the discharge process.

"In addition, clinicians can go back into a list to make changes after it has been initially completed, to add new information obtained from family members of the patient or other sources," says Chris Coley, MD, one of the Medication Reconciliation Project co-chairs. "This is an important initiative that requires all clinicians to participate regardless of what service a patient is admitted to, whether it is Pediatrics, Oncology, Cardiology, Surgery or Medicine to name a few. Even if a patient's medications remain the same from pre-admission through discharge, the PAML should be created, updated and reconciled with the POE orders. Enhancements to the software are being made frequently to facilitate the reconciliation process."