Joint Commission, Meaningful Use Have Hospitals Focused on Medication History and Reconciliation

Meeting new technology based regulatory requirements is an increasing concern for hospital executives. The Joint Commission for the Accreditation of Hospital Organizations (JCAHO) and Meaningful Use (MU) requirements and how to address them were recently discussed during a webinar entitled Medication History for Hospital Settings: Better Data, Better Decisions. Based on discussions during the webinar, the call to action is clear: governing bodies are demanding healthcare providers implement electronic medication history and reconciliation processes to ensure patient safety. 

For example, the Joint Commission listed "reconciling medication" as a National Patient Safety Goal in 2011. As part of the agency's accreditation program, hospitals are expected to:

  • Obtain information on medications the patient is currently taking when he or she is admitted to the hospital or is seen in an outpatient setting.
  • Provide patients (or family as needed) with written information on medication the patient should be taking when he or she is discharged from the hospital or at the end of an outpatient encounter.

"These are important aspects [of patient safety] from a regulatory standpoint.  This is how we will begin to incorporate medication history and reconciliation into the whole patient safety process," said Shelly Spiro, executive director, Pharmacy Health Information Technology Collaborative, a Washington, D.C.-based organization focused on assuring the US healthcare system is supported by meaningful use of health information technology and the integration of pharmacists for the provision of quality patient care. 

The federal government's electronic health records adoption program adds an automation stipulation into the mix. MU Stage 2 requirements call for hospitals to perform medication reconciliation when receiving a patient from another setting or provider of care and to generate and transmit permissible discharge prescriptions electronically. In addition, MU Stage 3 will likely require connections to pharmacy benefit managers to retrieve external medication fill history for medication adherence monitoring. 

To comply with these regulations, Lee Mork, MS, RPh, director of ambulatory pharmacy services at Allina Health System, needed to find a way to implement electronic medication reconciliation at the 12 hospital system. To do so, Mork and other staff members engaged the system's executive leaders by pointing to the fact that electronic medication reconciliation with medication history data was becoming a more common regulatory must-have and also could improve efficiency. With medication history information electronically transmitted to the point of care, clinicians can easily see what medications have been prescribed to a patient and what prescriptions are currently being filled. "Clinicians can immediately see that a patient's blood pressure is up because they are not having their prescriptions filled. So, clinicians know right at the point of admission what the patient needs and can immediately start treatment," Mork said. "When using manual methods to collect medication history, there is no way you could have this kind of finding." Indeed, meeting emerging regulations while realizing improved efficiency has emerged as an important goal at Allina.   

With Allina's executives on board, in 2011 the pharmacy department moved forward with the implementation of Surescripts Medication History for Hospitals, a data service that provides electronic access to medication history for more than 250 million covered lives through connections with the nation's pharmacies and pharmacy benefit managers. With this real time data integrated directly into the hospitals' EHR system functionality, clinicians can improve the medication reconciliation process and provide safer and more efficient care from admission to discharge. 

Indeed, since implementing the Surescripts medication history data in 2011, Allina hospitals have experienced a multitude of improvements. For example, the more comprehensive medication reconciliation enables clinicians to make care decisions quicker. In addition, having access to real-time medication information makes it possible for clinicians to quickly detect when patients are not adhering with their prescribed medications. In the most extreme cases, when a patient comes to the ER unconscious, access to the patient's medication history allows clinicians to make safer care decisions, avoiding the administration of medication that might be harmful due to allergies, drug interactions or overdose. These are truly benefits intended by the Joint Commission and Meaningful Use regulations.   

View the HIMSS/NCPDP 2014 Pharmacy Informatics Town Hall Session entitled, Medication History for Hospital Settings: Better Data, Better Decisions.

For more information about Medication History for Hospitals, visit http://surescripts.com/medication-history-for-hospitals.