11/17/2008 | RESOURCES

Medication History Service

Audacious Inquiry developed a service that makes patients’ recent medications available to emergency departments during hospital visits. Currently, it is being piloted in a handful of ambulatory care settings in Maryland. In support of the JCAHO mandate for medication reconciliation, Audacious Inquiry worked as part of a team with GE, RxHub, and Erickson Retirement Communities (ERC) to provide real-time, electronic delivery of printed medication history reports to hospital emergency departments.

The core clinical value of the medication history service is to streamline the obligatory process of asking each new patient what prescription and non-prescription medications he or she is taking. Data collected in this fashion is often inaccurate, as patients are frequently forgetful and rarely know the exact names or doses of their current and recent prescriptions. After this initial interaction, caregivers may pull charts, search internal systems, query other hospitals’ databases, or call pharmacies to obtain further information. But because the health system is so fragmented, the medication discovery process is often cumbersome, time-consuming, and challenging. It is also risky—a missed medication could cause a debilitating allergy or other adverse reaction. Data searches may be further compounded by unresponsive patients, inability to access remote hospital systems, inability to access internal databases, and closed pharmacies. Not surprisingly, the success of data finding is highly variable.

Our team’s medication history solution allows for increased workflow efficiencies and more time spent with patients. The service begins by obtaining a patient’s written consent. From here, a screen within the emergency department’s registration system sends demographic data to a GE datacenter through a secure VPN connection. After verifying the information, GE passes the request to RxHub, who in turn routes the request to the pharmacy benefit managers in the network. RxHub then sends data received from pharmacy benefit managers back to GE, where the data is formatted into a human-readable printout. The printout is then sent to a secure printer in the emergency department and printed out just seconds after the request was initiated. Physicians can use the complete list of recent medications to expedite the discovery process and make more informed decisions.

Our medication history service is successfully deployed and ongoing at the Memorial Hospital at Easton. To date, feedback from Easton staff on clinical utility has been positive. We intend to expand the service by including more emergency departments in Maryland, adding new data sources, and potentially delivering the data electronically rather than via printer.