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Medication Reconciliation (Med Rec) Tool

  • Updated

Background
What is the Med Rec Tool?
Why Use the Med Rec Tool?
Access the Med Rec Tool
Launch the Med Rec Tool
Step 1: Verification Methods
Step 2: Medications in Medinet
Step 3: Medications in EMR
Step 4: Available Actions
Update and Match Usual Meds List
Ignore a Medication in the Medinet List
Update a Medication in the Usual Meds List
Add a Medication to the Usual Meds List
Discontinue a Medication in the Usual Meds List
Close and Review Scripts

Background

The Institute for Safe Medication Practices Canada (ISMP) states that: “Medication reconciliation is intended to prevent medication errors at transition points in patient care, whereas medication review is intended to address drug-related problems arising over time.”

The terms Medication Reconciliation (Med Rec) and Best Possible Medication History (BPMH) may be used interchangeably in this article.

What is the Med Rec Tool?

The Med Rec tool is built into Profile EMR to allow providers to update a client's EMR Usual Scripts/Meds list based on PharmaNet data and ideally, client/caregiver input.

Why Use the Med Rec Tool?

There are several advantages to using this tool to keep the Usual Meds list up to date:

  • Keeping the Usual Meds list up to date makes re-prescribing much easier
  • The patient’s Usual Meds list is always visible in CareConnect to aid ED providers
  • Subsequent visits with other providers at your clinic will be much easier
  • Having all the prescription information in one place reduces med errors and improves patient safety

Alternatively, if all you need is a current list of medications from Pharmanet, see Best Possible Medication History (BPMH) Tool: meds\ Typing Template – Profile EMR User Help (zendesk.com). The disadvantage to using these typing templates is that you have to update the Usual Meds list manually. See Use the Scripts Module.

Access the Med Rec Tool

To access the Med Rec tool, you are required to have Medinet access. If you have used the Medinet button before, you already have the correct access. Otherwise, speak with your clinic manager.

Medinet.png

Launch the Med Rec Tool

Med_Rec.png

  1. Initiate a New Encounter
  2. Click on Med Rec in the Actions toolbar

Note: Some clients require a Medinet Keyword which you will get a prompt for. The client will provide you their Medinet Keyword.

BPMH.png

Step 1: Verification Methods

There are 4 different verification methods in EMR and you can select only one per session:

  1. Medinet & EMR Only (incomplete verification)
  2. Verified with Patient/Caregiver
  3. Verified with Other (specify Other)
  4. Unable to verify (specify reason)

Step_1.png

Step 2: Medications in Medinet

This list populates medications filled by the client from a pharmacy in the last 6 months.

Step_2.png

Note: The same medication might appear more than once because the pharmacy likely used a different preparation or brand name on separate occasions. If the Drug Identification Number (DIN) is different, the medications will display as separate entries with the same name. See Ignore a Medication in the Medinet List.

Step 3: Medications in EMR

This list populates medications currently in Profile EMR Usual Meds list.

Step_3.png

Step 4: Available Actions

There are several actions you can take for every entry in the Medinet list.

  1. Add new medication from Medinet to EMR usual med list
  2. Ignore this medinet entry
  3. Discontinue Medication in usual meds

When updating the EMR usual med list, you can also:

  • Overwrite Name
  • Disregard Dose and Frequency
    Greys out dose and frequency field to direct clinician to follow the Directions box instead
  • Update DIN
    If medication was previously added as Adhoc, adding the DIN will convert it to a formulary item
  • Overwrite Directions

Important: Review that the dose, frequency, and directions are correct!

Step_4.png

Update and Match the Usual Meds List

After selecting an action in Step 4, commit to the change by clicking on Update & Match.

Note: Changes to medications cannot be reverted after being saved. Any corrections should be completed in New Encounter: Scripts action panel.

Ignore a Medication in the Medinet List

This is applicable for:

  • Duplicate medications in the Medinet list
  • Medications in the Medinet list that already exists in the Usual Meds list with the same correct details
  • Medications in the Medinet list that does not exist in the Usual Meds list and is reported not being taken

Note: The medication will re-appear in Medinet list if another Med Rec is done after 24 hours

  1. Select a verification method
  2. Select a medication from Medinet list
  3. The corresponding Usual Med appears in green font
  4. Confirm that the Usual Med details are unchanged

    Ignore.png

  5. Click Ignore this medinet entry
    • Removes the medication from the Medinet list as it has been processed
    • Does not mark the medication in Usual Meds list as Matched
  6. If you are done with Med Rec, click Close and Review Scripts

Update a Medication in the Usual Meds List

This is applicable for medications in the Medinet list that already exists in the Usual Meds list but needs some details updated or modified.

  1. Select a verification method
  2. Select a medication from Medinet list
  3. The corresponding Usual Med appears in green font
  4. To instruct clinicians to follow the Directions box instead of dose and frequency fields, tick Disregard Dose and Frequency which greys out those fields
  5. To update the Directions box, tick Overwrite Directions
  6. Update the directions box

    Update.png

  7. Click Update & Match
    • Removes the medication from the Medinet list as it has been processed
    • Marks the medication in Usual Meds list as Matched
      Matched.png
  8. If you are done with Med Rec, click Close and Review Scripts

Add a Medication to the Usual Meds List

This is applicable for medications in the Medinet list that does not exist in the Usual Meds list and is reported being taken.

Duplicate Usual Meds cannot be added and will result in an error:

Exists.png

  1. Select a verification method
  2. Select a medication from Medinet list
  3. Click Add new medication from Medinet to EMR usual med list
  4. The Usual Meds list populates with the same medication (according to DIN) with the same details
  5. Update and overwrite details as you see fit

    Add.png
  6. Click Update & Match
    • Removes the medication from the Medinet list as it has been processed
    • Marks the medication in Usual Meds List as Matched
      Matched2.png
  7. If you are done with Med Rec, click Close and Review Scripts

Discontinue a Medication in the Usual Meds List

This is applicable for medications in the Medinet list that already exists in the Usual Meds list and needs to be discontinued.

  1. Select a verification method
  2. Select a medication from Medinet list
  3. The corresponding Usual Med appears in green font

    Discontinue.png

  4. Click Discontinue Medication in usual meds
    • Removes the medication from the Usual Meds list (visible in Discontinued Scripts tab)
      Click Yes to confirm you want to Discontinue
      Discontinue1.png
      Click OK to confirm Discontinued
      Discontinue2.png
  5. To remove the medication from the Medinet list, also click on Ignore this medinet entry
  6. If you are done with Med Rec, click Close and Review Scripts

Close and Review Scripts

You have completed Med Rec when the Medinet list is empty.

Close.png

  1. Click Close and Review Scripts
  2. Med Rec Tool closes and you are back to New Encounter
    Contact is titled Best Possible Medication History Review with text:
    "Med Rec tool utilised to update the Usual Meds list"

Note: Upon clicking on Close and Review Scripts, you will get a warning to convert medications which were added as Adhoc meds (without DIN).

Convert.png