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    Medicines Reconciliation Using a Shared Electronic Health Care Record.

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    Publication date
    2011
    Author
    Moore, P.
    Armitage, Gerry R.
    Wright, J.
    Dobrzanski, S.
    Ansari, N.
    Hammond, I.
    Scally, Andy J.
    Keyword
    Electronic health care record (EHR)
    Shared health electronic health care record
    Medicines reconciliation
    Prescription errors
    Medication errors
    Peer-Reviewed
    yes
    
    Metadata
    Show full item record
    Abstract
    Objective: This study aimed to evaluate the use of a shared electronic primary health care record (EHR) to assist with medicines reconciliation in the hospital from admission to discharge. Methods: This is a prospective cross-sectional, comparison evaluation for 2 phases, in a short-term elderly admissions ward in the United Kingdom. In phase 1, full reconciliation of the medication history was attempted, using conventional methods, before accessing the EHR, and then the EHR was used to verify the reconciliation. In phase 2, the EHR was the initial method of retrieving the medication history-validated by conventional methods. Results: Where reconciliation was led by conventional methods, and before any access to the EHR was attempted, 28 (28%) of hospital prescriptions were found to contain errors. Of 99 prescriptions subsequently checked using the EHR, only 50 (50%) matched the EHR. Of the remainder, 25% of prescriptions contained errors when verified by the EHR. However, 26% of patients had an incorrect list of current medications on the EHR. Using the EHR as the primary method of reconciliation, 33 (32%) of 102 prescriptions matched the EHR. Of those that did not match, 39 (38%) of prescriptions were found to contain errors. Furthermore, 37 (36%) of patients had an incorrect list of current medications on the EHR. The most common error type on the discharge prescription was drug omission; and on the EHR, wrong drug. Common potentially serious errors were related to unidentified allergies and adverse drug reactions. Conclusions: The EHR can reduce medication errors. However, the EHR should be seen as one of a range of information sources for reconciliation; the primary source being the patient or their carer. Both primary care and hospital clinicians should have read-and-write access to the EHR to reduce errors at care transitions. We recommend further evaluation studies.
    URI
    http://hdl.handle.net/10454/6371
    Version
    published version paper
    Citation
    Moore, P., Armitage, G., Wright, J., Dobrzanski, S., Ansari, N., Hammond, I. and Scally A. (2011) Medicines reconciliation using a shared electronic health care record. Journal Of Patient Safety, 7 (3),147-53.
    Link to publisher’s version
    https://doi.org/10.1097/PTS.0b013e31822c5bf9
    Type
    Article
    Collections
    Health Studies Publications

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