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Step 5: Achieve Meaningful Use Stage 2

Medication Reconciliation

Objective:

The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.

Measure:

The EP who performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP.

Changes from Meaningful Use Stage 1:

The Medication Reconciliation Objective changed from being a Menu Objective in Stage 1 to a Core Objective in Stage 2.

Clinical Importance:

The medication reconciliation process can help reduce medication errors that are especially common among patients who use multiple pharmacies, have co-morbidity factors, and multiple healthcare providers. Creating an accurate medication list is important to patient safety. Medication errors can be reduced by capturing a complete and accurate list of the medications a patient is taking (including non-prescription and alternative medications) and comparing this list with both documentation in the patient’s medical record during ambulatory care visits and the physician’s admission, transfer, and/or discharge orders in inpatient settings.

CMS Resources:

The following resources are available to help you meet the Medication Reconciliation meaningful use core measure:

CMS EHR Incentive Program Frequently Asked Questions (FAQs)

Lessons from the Field:

We found it helpful to import medication lists from other EHR partners and modify them as needed. Our medical assistants then reviewed the medication list and if there were any discrepancies the provider is notified.”  Pam Schlauderaff, RN, Olympic Physicians Case Study, Rural Health Clinic Exchanges Information with Hospitals and Physicians for Improved Coordination of Care

Technology provides the ability to bring in different medication lists into the EHR. Technology and workflow processes both need to be utilized to reconcile the medication list so that a single accurate medication list can be provided to the patient and other providers. Communication with the provider to resolve discrepancies is imperative in order to come up with the most accurate list of medications. A complete accurate medication record helps the physician make better clinical decisions and has a positive impact on patient outcomes.

National Learning Consortium Resources:

The NLC resources are examples of tools that are used in the field today, and that are recommended by “boots-on-the-ground” professionals. The NLC, in partnership with HealthIT.gov, shares this collective EHR implementation knowledge and resources throughout this site. 

National Learning Consortium Resources
Resource NameDescriptionSource

Medication Discrepancy Tool (MDT)

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Tool for identifying and characterizing medication discrepancies that arise when patients are making the transition between sites of care.

The Care Transitions Program, University of Colorado Denver, School of Medicine

How to Create an Accurate Medication List in the Outpatient Setting through a Patient-Centered Approach

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[PDF - 3.3Mb] 

Toolkit that provides information and guidance for implementing a patient-centered approach in the outpatient setting focused on medication safety.

Consumers Advancing Patient Safety (CAPS), Aurora Health Care

Medication Safety Reconciliation Toolkit

Download

[PDF - 4Mb] 

Toolkit that provides extensive detail on where and how to reconcile medications at all transition points of care; how to implement a medication reconciliation process; and provides sample process maps, algorithms, and forms.

North Carolina Center for Hospital Quality and Patient Safety (NC Quality Center)

Meaningful Use Case Studies

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Case Studies that describe provider experiences and lessons learned throughout EHR implementation and the pathway to meaningful use. Case studies related to this meaningful use measure include:

Health Information Technology Resource Center (HITRC)

Medication Reconciliation Tool

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[DOCX - 1.7MB]

Toolkit that includes a self-assessment, to select a process model that serves as a guide for how to meet the Medical Reconciliation objective.

Health Information Technology Resource Center (HITRC)

The material in these guides and tools represents the collective EHR implementation experiences and knowledge gained directly from the field of ONC’s outreach programs (REC, Beacon, State HIE) and through the Health Information Technology Research Center (HITRC) Communities of Practice (CoPs) in their performance of technical support and EHR implementation assistance to primary care providers. The information contained in these resources is not intended to serve as legal advice nor should it substitute for legal counsel. The resource list is not exhaustive, and readers are encouraged to seek additional detailed technical guidance to supplement the information contained herein.

Reference in this web site to any specific resources, tools, products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.

 

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