Electronic Health Records

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Study: Patient Engagement Improves Medication Accuracy

By Jennifer Bresnick

Patient engagement through online portals can help to improve the accuracy of medication lists, according to a Geisinger study published this week in eGEMs, while also helping providers to meet the patient portal requirements of Stage 2 meaningful use.  Patients who changed information about the frequency or dosage of their medications were eager to ensure that their data was as up-to-date and accurate as possible, with 89% of feedback forms requiring a change.

Medication lists are a critical factor in patient safety, yet are frequently out of date or incomplete.  Many patients may not include over the counter drugs or herbal supplements in their history, or might discontinue or change the dosage of a certain prescription without alerting their physician.  The study, conducted by Prashila M. Dullabh, MD, Norman K. Sondheimer, PhD, Ethan Katsh, JD, and Michael A. Evans, RPh, notes that a recent literature review found medication omission rates between 27 percent and 53 percent, while inaccuracies were present in up to 95 percent of medication lists.  An additional survey found that three-quarters of patients would be worried about medication errors during a hospitalization.  Ninety-one percent of patients believe that they have the potential to prevent these mistakes by volunteering their information.

During the study, patients were very interested in contributing to their personal health record, but often found that their providers were not equipped to handle the changes within their workflows.  At Geisinger, where more than 40,000 patients are hospitalized each year and 1.5 million experience an outpatient visit, developing a medication management solution that functioned efficiently at scale was vital.  Patients were sent a link to an online medication feedback form, which was then routed to a pharmacist for review.  The pharmacist contacted the patient to verify changes when possible, then added an EHR note to the patient’s file to alert his or her physician to the change.

geisinger

The researchers saw success with the project partly due to the fact that many of the participants were long-time users of their electronic health portal.  Most participants were comfortable with the technology and routinely accessed their data, reporting higher levels of control and confidence when doing so.  Patients who provided medication feedback were generally older, with almost 60% falling in the 46 to 75 year range, and patients requested an average of 2.4 changes per feedback form.  Pharmacists agreed to 68% of the changes when they could contact the patient and 51% when they could not.

“Patient focus group findings suggest that most patients find that online access to their medication lists and the opportunity to provide feedback allows them to track their medications more easily,” the authors write.  “Patient access also improves communication with their providers in that it better prepares them for office visits.  Taken together, this increased access and communication allows patients to take a more active role in managing their medications.  Initial comparisons also suggest that medication reconciliation is more thorough when done at home versus in a provider office.”

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