The use of shared medication record as part of medication reconciliation at hospital admission is feasible

ABSTRACT

INTRODUCTION: Medication reconciliation improves congruence

in cross sectional patient courses. Our regional

electronic medical record (EMR) integrates the shared

medication

record (SMR) which provides full access to current

medication and medication prescriptions for all citizens

in Denmark. We studied whether our SMR integration could

facilitate medication reconciliation.

MATERIAL AND METHODS: Patients admitted to the emergency

department for hospitalization were randomised to

consultation using EMR with or without the integrated SMR

access. Observed time used for medication reconciliation

was the primary efficacy parameter.

RESULTS: A total of 62 consecutive patient consultations

were randomised including 39 with more than five prescriptions.

EMR had data from previous consultations for 46 patients,

59 patients provided information on medication. In

all, 18 junior physicians in early postgraduate medical training

each participated with a median of three consultations

(range 1-9). Time expenditure for medicine reconciliation

was 5:27 min.:sec. (range: 2:00-15:37) with access to SMR

integration and 4:15 min.:sec. (1:15-12:00) without SMR access.

The number of active medicine prescriptions was eight

and nine, respectively. Incorporating SMR did not increase

the work load. Physicians judged the SMR integration and

workflow as being useful. Patients unambiguously supported

physicians’ use of SMR in this setting.

CONCLUSION: Integration of information on individuals’

medication from a national SMR into a hospital EMR was

feasible and useful, and it did not increase time expenditure

for medication reconciliation.

FUNDING: not relevant.

TRIAL REGISTRATION: not relevant.