Medication Reconciliation Tips for Epic
By Sheila Andrews

HMedication errors continue to be one of the most frequent causes of preventable harms in healthcare. That’s why The Joint Commission and the National Quality Forum pay particular attention to medication reconciliation as it relates to hospital admission and discharge processes. This article provides a brief medication reconciliation overview with a specific focus on discharge medication reconciliation in the Emergency Department (ED).

A full medication reconcilliation includes: prior to admission medication review, admission medication reconciliation, transfer medication reconciliation, and discharge medication reconciliation.

Epic has a series of clinician, analytical, and decision support tools that can help an organization meet requirements for completing medication reconcilliation:

• Clinician tools: medication reconcilliation workflow (specific navigator sections and patient list columns).
• Analytical tools: WorkBench reports, Clarity^® reports, and print group reports (including audit information print groups). These tools include real time reports for clinicians, as well as analytical reports for managers and project team members to track compliance trends.
• Decision support: Best Practice Alerts for each of the medication reconciliation worfklows, as well as order validation programming points for admission and discharge.

The following are specifics to consider to help ensure that patients are discharged from the ED with an accurate list of medications.

• Clinician tools: By using the discharge medication reconcilliation navigator section with print group (34225) clinicians can see an at-a-glance update on medication reconciliation during the usual discharge workflow. In addition, Patient List Columns (36309 and 36310) allow clinicians to see the status of medication reconciliation in text, as well as with an associated icon.
• Analytical tools:
  • Standard Clarity reports for discharge medication reconciliation are located in the Community Library on the Epic UserWeb.
  • Audit information print group report (46165) in the standard After Visit Summary (AVS).
    • NOTE: SmartLink 340- PTMEDDISCHARGE is the same as this print group (4165) and could be useful for clinician documentation.
• Decision support:
  • Programming point (85503) warns clinicians if they try to place orders after the After Visit Summary (AVS) has already been printed and might have been given to the patient.
  • Programming point (85502) warns clinicians if they try to place new discharge orders after medication reconciliation is complete.
  • Programming point (85501) warns clinicians if they try to print an After Visit Summary (AVS) before discharge medication reconciliation is complete.

Epic’s medication reconciliation functionality can help increase the number of inpatients with an outpatient medication list and the number of outpatient medication lists that have been reviewed during their admission. And most importantly, it will decrease the number of errors in outpatient medication lists. For more tips and tricks for your Epic system call us at 610.444.1233 or email us vcs@getvitalized.com. There is also a wealth of information on our website www.getvitalized.com.