Medication History Part II
A Practical Approach to Gathering Rx Histories - Fast, Efficient and Reliable
When you speak of medication reconciliation, there are two things that physicians, clinicians, pharmacists and risk managers will agree on. One -- it’s absolutely essential to patient safety and quality care. Two -- it’s a struggle to reconcile medications across the continuum of care when processes are inefficient and inconsistent.
As established in the first article of this two-part series, one common problem in the process is the way medication histories are gathered. Even automated medication reconciliation systems often rely on manually compiled medication histories and sometimes require calling pharmacies, prescribing physicians or other caregivers. Yet, for all that effort, medication histories are often incomplete. And when they depend heavily on patient or family recall, they may also be inaccurate. One industry study found that 67 percent of medication histories gathered was inaccurate.
Seeing an opportunity to help, Standard Register set out to develop a tool that would provide a simple, standardized approach for gathering medication histories to enhance accuracy and patient safety while improving clinical efficiency. The result of those efforts is Rx History Capture, which was unveiled at the American Society of Health-System Pharmacists’ (ASHP) Mid-Year Clinical Meeting, held December 7-10.
Here are answers to some of the frequently asked questions about Rx History Capture.
What is Rx History Capture?
Rx History Capture is a technology solution that addresses the key issues that have stood in the way of accurate medication reconciliation by providing timely information from objective sources. It gathers a patient’s medication history from the pharmacy benefit manager and retail pharmacy networks to generate an “as-filled” list of prescription medications. It can also draw from a hospital’s information systems to pull medication history from the patient’s last visit.
The result is a list of medications that can be used to validate with the patient or a family member. It’s an excellent tool for the medication history interview.
What kind of coverage can hospitals expect to see? Does this vary state-to-state?
The networks provide access to prescription data for approximately 220 million Americans and this coverage is constantly growing. Another way to express the coverage that the network provides is to look at it from a percentage standpoint. The pharmacy benefit managers’ side of the network represents approximately 70-75 percent of the insured population in the United States. It is important to note that this percentage does vary state-to-state, depending upon which pharmacy benefit managers and retail pharmacies are represented for that particular state or region. For some states, the percentage may be lower and for others the percentage may be higher.
What is equally important to consider is the difference in value between what medication history information hospitals are getting today during their med rec process and what they will be getting through the network. Additionally, Standard Register’s goal is to provide the most comprehensive medication prescription history available. Our efforts on medication reconciliation will lead to the development of products that are focused on increasing this coverage. We are looking to add additional data sources to expand the network. Our goal is to capture as comprehensive a medication history as possible.
What type of data is available through Rx History Capture?
Some of the prescription information available includes drug, dosage, type of medication (i.e. a tablet, capsule, inhaler, etc.), generic drug name, oldest fill date, most recent fill date, number of times the drug has been refilled, pharmacy name, pharmacy phone number, prescriber’s name, refill history, quantity of pills and number of days supply. Hospitals can decide which of the available data fields is relevant for care for inclusion in their form design.
Medication history information can be retrieved from the hospital’s HIS revealing any documented medications from a patient’s last visit. This might include discharge medications, as well as any over-the-counter supplements the patient may be taking. .Additionally, if allergies are listed in the HIS, this information may also be pulled forward.
How will Rx History Capture impact workflow? Does it matter if my med rec process is paper-based or electronic?
Flexibility is a hallmark of Rx History Capture. It can be used with paper-based, hybrid and automated reconciliation processes at any point of entry and all levels of care.
Rx History Capture has been designed to support the hospital’s established workflow. It can be configured to work with a hospital’s admission process, so the network query is automatically generated using the patient’s demographic information from their registration process with patient consent forms, wristbands and other registration materials, without requiring any additional steps for the registration staff. The query can also be generated on an as-needed basis. The medication history can be merged onto the hospital’s current medication history or reconciliation form – paper or electronic.
Wherever it’s used, Rx History Capture streamlines the process by giving clinicians an efficient tool to do their jobs. It reduces the time-consuming tasks of identifying pills, and phoning pharmacies and physicians, so clinicians can focus more of their time on patient care. It can provide pharmacists with more accurate medication histories that can lead to reduced errors related to clinical transcription and poor penmanship, enabling them to focus on medication safety. It can improve communication between physicians, patients, clinicians and pharmacy by providing an objective framework for medication information, enhancing medication orders for every transition of care during the med rec process.
Given these efficiencies and the way Rx History Capture aligns with current workflow, we anticipate that hospital staff will embrace it readily.
We spoke briefly to Molly Procuniar, BSN-RN, BA, FF-P, whose experience as an ER nurse helped guide Rx History Capture’s development.
"Hospitals have an opportunity to improve patient outcomes, given better tools for medication reconciliation. Rx History Capture provides a foundation upon which hospitals can build a standardized process for medication reconciliation that can impact patient safety, the patient experience and clinician efficiency," she said.
For further information about Rx History Capture or guidance in enhancing the efficiency and effectiveness of your medication reconciliation process, contact us now.