While EHRs were introduced as a tool that would greatly enhance providers’ ability to gather and organize patient information, organizing data such as patient medication lists has still involved a significant of manual oversight.
Until AI came along, that is.
To wit, in a recent article at EHRIntelligence, Aaron Smith, MD, chief medical informatics officer at Covenant Health in Saginaw, Michigan, relates how a new tool integrating AI into the system’s EHR made life for Covenant’s ED nurses a lot simpler.
“In the ED, there are lots of competing interests,” explained Smith, who is also a practicing emergency physician. “It can be a little bit chaotic at times, so getting an accurate medication list can be challenging.”
Noting the potential for any new patient medication lists to be “fraught with error,” Covenant’s ED clinical staff asked the hospital to hire staff specifically dedicated to the medication reconciliation process.
“We proposed a trial of a program to bring pharmacists within our emergency department to address this problem,” Smith said. “We tracked how many med errors were occurring in a patient's chart for a period of time compared to a complete medication reconciliation once they were admitted, then used literature to show what each potential med error could cause in terms of adverse drug events and the cost per adverse event.”
From there, the ED staff estimated the cost of having a pharmacy program within the ED staffed by pharmacists and pharmacy technicians whose responsibility is to gather an accurate medication list upfront.
The upshot?
“We were able to get approval from the executive team to have a trial, which was overwhelmingly successful,” Smith said. “We see on average anywhere from 250 to 300 patients a day, so we can't complete med recs on every one of those patients,” Smith explained. “We built some scoring mechanisms and added an order into the EHR for a physician to say if they were going to admit a patient to alert pharmacy technicians so they could start the med reconciliation process.”
Despite the advance, Smith said compiling an accurate medication list was still a very manual process, so “the hospital decided to leverage an EHR integration that brings in prescription fill data from pharmacies to mitigate the administrative burden of medication reconciliation.”
Two iterations later, and the hospital has finally registered a significant time saving.
The integration helps take the human error element out of medicine reconciliation, Smith explained. Rather than focusing on manual investigation, the integration allows pharmacy technicians to validate medication lists to ensure lists are accurate.
“Healthcare is under a tremendous amount of stress right now,” Smith said. “I'm optimistic that we can survive this, but there's going to be a cost to the system. We're really burning out providers. Any kind of technology we can use to offload some of the cognitive work and to streamline their processes is more valuable now than ever.”
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