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Sue:
We have been working with this for some time, and are still trying to
get the buy-in from the physicians for the entire process to work.  Here
it is:

The nurse (upon admit) gathers home med info from the patient.  These
queries are on a CDS, attached to the admit hx intervention.  There is a
query that asks: Is this list complete?".  If  "Y"  it sends an OA
message to pharmacy to begin the reconciliation process. 

Our pharmacy really stepped up to the plate and actually volunteered to
be involved and is a major player in this process...the pharmacy techs
compare the meds the physician ordered on admit and the home meds.
Pharmacy personnel are in NUR and use an intervention called "PHARMACY
ONLY- Home Meds" to start this.  This intervention has all the home meds
defaulted in from the nursing assessment.  The techs answer the queries
"ordered on admit" and/or "same dose" queries.  This is then edited by a
pharmacist and reviewed for accuracy, etc.

Iatrics wrote an NPR report for us that prints an order form to the
patient's location (upon the edit) that lists all the home meds that
were not ordered on admit or a different dose.  These order forms are
put on the patient's chart for the docs to order, review and sign.

Once the patient is discharged, we do have Patient Discharge
Instructions from Iatrics that we use to print out the meds the patient
has taken in the hospital and will get sent home with, along with home
meds to continue or stop.

That's it in a nutshell...of course the docs don't want to sign the
order form, or go to the computer to print out the discharge
instructions!!...The nurses do GREAT...but trying to figure out how to
get the docs to do it is another matter entirely!!...

If you have any questions, please don't hesitate to contact me.
Thanks...have a great weekend!!..

Diane Folsom, RNC
Clinical Information System Specialist
Sid Peterson Memorial Hospital
Kerrville, TX  78028
830-258-7080

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Deepe, Sue
Sent: Thursday, August 03, 2006 3:00 PM
To: Dana Pfingstler; Meditech L
Subject: RE: [MEDITECH-L] Home medication reconciliation

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Our process is almost entirely back on paper.  Originally we were
entering the home medications into Meditech, but since they only give
you one text box to enter all of these medications, it does not flow
like you need it to for the Medication Reconciliation Process.  So, we
stopped entering medications into Meditech for the time being, and we
use a paper form to list the home medications on.  We start when the
patient is admitted to the ED or to the floor.  

Once the patient is admitted, if the medications have to be reconciled
again because the patient has moved from unit to unit, then I do have a
computer generated report that lists the patient's current medications
being used in the hospital.  The nurses like this and would like to do
this on admission...but we have not found that doing it in Meditech to
be helpful.

Once again on discharge, we use a paper form to list all of the
medications that the patient will be taking at home and list all of the
new prescriptions that the patient will be adding to their current list.


I would like to build a more seamless approach to this, but Meditech
needs to build in some more fields to accommodate the Medication
Reconciliation process.

Sue Deepe
Clinical Systems Analyst


We are interested in learning how other facilities are reconciling home
medications.  We currently capture home meds on a nursing CDS but the
reconciliation process is burdensome and not as effective as we would
like
it to be.  Would anyone be interested in sharing their method for
reconciling home medications at discharge?

Thanks

Hap Beckes
Information Systems Director
Sullivan County Community Hospital
2200 N. Section Street
P.O. Box 10
Sullivan, IN 47882-0010
email:  [EMAIL PROTECTED]
phone:  812.268.2641
fax:  812.268.2650


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