Improved Patient Safety Using Health Information Technology to Coordinate Medication Reconciliation between Patients and Providers
AbstractMedical errors remain a major safety problem a decade after the Institute of Medicine reported that 98,000 related deaths a year occur in U.S. hospitals (10M, 2000; Landrigan et al., 2010). Medication errors possibly account for one third of the medical errors (Milch, et. aI, 2006). Although medication reconciliation is an accepted standard of care for patients by organizations and providers, very little scientific evidence is available to make practice recommendations for the primary care setting. The purpose of this proposed project will be to evaluate the effectiveness of using secure wellness reminders sent to Veterans via their personal health record (PHR) prior to their scheduled appointment in a Veterans Administration outpatient clinic. The alert will ask them to view their medication listed in their PHR, to print and update this list, and to bring the paper copy for their next scheduled clinic visit. This modified patient list will be used by the provider to compare medications listed in the provider's EHR during the MR process in the outpatient clinic. Of primary interest will be any medication discrepancies identified after the project's intervention. This study is considered a proof of concept, quality improvement study in that the Veteran's PHR (MyHealtheVet) has the capability for alerts. Yet, it is unknown if Veterans will receive and review the reminders and if they will respond as instructed. The project will inform future research studies in the best use of innovative technologies for medication reconciliation when applied to the primary care setting. The results of this study will assist in building and translating evidence into the practice for improving medication reconciliation and enhancing patient safety.
Table of ContentsOverview : Background; Statement of the Problem; Purpose; Significance of Project; . Conceptual Framework. Literature Review : Medication Discrepancies and Errors Defined; Medication Reconciliation across the Continuum of Care - Home setting, Hospital admission, Summary ; HIT as Adjunct to MR Process - Extent of HIT in MR process , EHRs combined with paper medication lists, EHRs and pharmacists on MR team, EHRs and nurse call-center interviews, Summary ; EHRs and Patient Reminders - EHRs and engaging patients in MR; Summary; Methods : Study Design ; Setting ; Sample ; Procedures ; Human Subject Protection - Measures, Data Analysis, Limitations; Plans for Translation. References. Table I: Individual Evidence Summary: MR across Continuum of Care (1-6); HIT as Adjunct to MR process (7-13) ; ERRs and Patient Reminders (14-15) ; Figure I. MR discrepancies. Figure 2.DOI Model . Figure 3 MR Wellness Reminder. Figure 4. MR Wellness Reminder. Appendix A. Proposed Timeline for Capstone Project. Appendix B. VA Clinic Modified Workflow.
DescriptionUniversity of Maryland, Baltimore. Doctor of Nursing Practice Scholarly Project
KeywordMedical records--Data processing
Electronic Health Records
Medication Errors--prevention & control
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/2255
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