Accuracy of Electronic Medical Record Medication Reconciliation in Emergency Department Patients

The Journal of Emergency Medicine
Andrew A MonteKennon J Heard

Abstract

Medication history discrepancies have the potential to cause significant adverse clinical effects for patients. More than 40% of medication errors can be traced to inadequate reconciliation. The objective of this study was to determine the accuracy of electronic medical record (EMR)-reconciled medication lists obtained in an academic emergency department (ED). Comprehensive research medication ingestion histories for the 48 h preceding ED visit were performed and compared to reconciled EMR medication lists in a convenience sample of ED patients. The reconciled EMR list of prescription, nonprescription, vitamins, herbals, and supplement medications were compared against a structured research medication history tool. We measured the accuracy of the reconciled EMR list vs. the research history for all classes of medications as the primary outcome. Five hundred and two subjects were enrolled. The overall accuracy of EMR-recorded ingestion histories in the preceding 48 h was poor. The EMR was accurate in only 21.9% of cases. Neither age ≥ 65 years (odds ratio [OR] = 1.3; 95% confidence interval [CI] 0.6-2.6) nor sex (female vs. male: OR = 1.5; 95% CI 0.9-2.5) were predictors of accurate EMR history. In the inaccurate EMRs, prescript...Continue Reading

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Citations

Jun 2, 2017·Emergency Medicine Australasia : EMA·Matthew MillerKate Curtis
Apr 26, 2018·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Joshua ElogeBezalel Dantz
Nov 9, 2016·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Thomas H Payne, Bimal R Desai
Aug 23, 2019·Journal of Clinical Pharmacy and Therapeutics·Yeo Jin Choi, Hyunah Kim
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Feb 12, 2021·Journal of the American College of Radiology : JACR·Lakshmi AnanthakrishnanMatthew S Davenport
Nov 5, 2021·BMC Medical Informatics and Decision Making·Catherine WaldronTamasine Grimes

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