On August 3rd Audacious Inquiry’s Edmond Magny and partner organizations presented a webinar highlighting the features and benefits of the MEDS-ED Link Pilot Project, which launched at Inova Alexandria Hospital in April. Edmond provides project management services for the endeavor, partnering with NoVaRHIO, Inova, GE, Picis, GMU and the Commonwealth of Virginia, with the goal of providing electronic access to patient medical histories in hospital Emergency Departments (EDs) and integrating with hospital ED systems. MEDS-ED brings prescription information from data sources across the US directly into the patient’s electronic health record (EHR), helping physicians provide better emergency treatment by giving them instant access to a patient’s medication history in emergency situations. The service is workflow integrated so there are no extra logins, passwords or searches for the physician to contend with, resulting in faster and more focused emergency treatment.
The process of comparing a patient’s medication orders to all of the medications that the patient has been taking is called medication reconciliation, and it should be done at every transition of care in which new medications are ordered or existing orders are rewritten. The benefits of using MEDS-ED to conduct medication reconciliation include: helping physicians to avoid drug interactions, duplication, dosing errors, or omissions; facilitating improved transition in care quality and timeliness; preventing medication transcription/entry errors and workflow interruptions; and providing invaluable information for patients that are incapacitated or have a language barrier. Additionally, the standards based technologies used to develop the application facilitate meeting American Recovery and Reinvestment Act (ARRA) Meaningful Use requirements.
Using Health Information Exchanges (HIEs), EHRs, and applications like MEDS-ED helps coordinate care, which leads to better care for patients as well as cost savings. The total annual cost of uncoordinated care to the U.S. public is estimated to be $240 billion. For example: a 65 year old man goes to the ED with symptoms of an infection. His regular doctor is not available and the patient forgets to mention that he has been on blood thinning medication because of his history of atrial fibrillation when asked about his medication history in the ED. The ED doctor places him on an antibiotic, and as a result of the interaction with the blood thinning medication he develops a blood clot next to his brain. This leads to many weeks of rehabilitation and he continues to have visual problems and mild confusion. In addition to the effect on the patient’s health and life, Medicare now has to pay for much more care than if the physician had been able to obtain the information he needed when the patient originally went to the ED.
Since the project launched on April 15th healthcare providers at Inova Alexandria have received medication results for 7466 patients containing drug name, dosage, and last filled date. 87% of patients have consented to participate in medication history retrieval through MEDS-ED, with a 43-50% result return rate for patients seen. Future efforts will include extending MEDS-ED technology to labs, radiology, physician community desktops, immunizations, and discharge summaries, as well as investigating possible connections with VA and DoD.