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Electronic medicines reconciliation

Electronic medicines reconciliation

This is an update on a story featured in our Quality Account for 2014/15 [view more about electronic medicines reconciliation at Waitemata DHB].

What is electronic medicines reconciliation?

Electronic Medicines Reconciliation is a medication safety process that uses computer software to import and document an accurate list of a patient’s current medicines on admission to hospital. The list contains the full details of all medicines, as well as information on any allergies and previous adverse drug reactions. Pharmacists use the software to compare this list with what has been charted (prescribed) in hospital. Any discrepancies (differences) are identified, documented and resolved.

When the patient transitions back home from hospital, the electronic medicines list automatically transfers into the hospital discharge summary, including the details of any medication changes. Changes are colour coded for the patient and general practitioner to easily identify.

What have we done?

We worked with Counties Manukau DHB and Orion Health to develop an electronic system (eMedsRec) in 2010.

  • Availability of eMedsRec has increased from 22 to 32 inpatient areas across medical, surgical and mental health services over the last 12 months.
  • Overall the proportion of patients that receive an eMedRec during their admission has increased from 57% in March 2014 to 85% in April 2016. 

Waitemata DHB Patient Admissions with Completed eMedRec (Mar14-Apr16)

Did we make a difference?

We audited a sample of 126 hospital stays between August and October 2015 and found that Electronic Medicines Reconciliation resulted in greater accuracy and quality of patients’ medication lists when they transferred out of hospital. 

Audit results showed that for patients with an eMedRec:

  • 77% had a complete and accurate list of medications on their discharge summary (compared with 25% without an eMedRec)
  • 90% had the reasons for medication changes documented (compared with 46%)
  • 91% had allergies and adverse drug reactions fully documented (compared with 77%)

Where to from here?

The next steps in the project are to:

  • Upgrade and improve the software to allow eMedRec to be completed in the emergency department, clinics and outpatient settings
  • Continue to maintain and improve the proportion of patients that receive eMedRec during their hospital stay