An audit of the accuracy of medication information in electronic medical discharge summaries linked to an electronic prescribing system

Yixin Tan; Rohan A. Elliott; Belinda Richardson; Francine E. Tanner; Michael I. Dorevitch

doi:10.1177/1833358318765192

An audit of the accuracy of medication information in electronic medical discharge summaries linked to an electronic prescribing system

Yixin Tan, Rohan A. Elliott, Belinda Richardson, Francine E. Tanner, Michael I. Dorevitch

Centre for Medicine Use and Safety

Research output: Contribution to journal › Article › Research › peer-review

8 Citations (Scopus)

Abstract

Background: Poor communication of medication information to general practitioners when patients are discharged from hospital is a widely recognised problem. There has been little research exploring the accuracy of medication information in electronic discharge summaries (EDS) linked to hospital e-prescribing systems.

Objective: To evaluate the accuracy of medication lists and medication change information in EDS produced using an integrated e-prescribing and EDS system (where EDS discharge medication lists were imported from discharge e-prescription records, medication change information was manually entered, and medications were dispensed from paper copies of the patients' e-prescriptions).

Method: Retrospective audit of EDSs for a random sample, representative of adult patients (n = 87) discharged from a major teaching hospital. EDS medication lists were compared to pharmacist-verified paper discharge prescriptions (considered to be the most accurate discharge medication list) to identify discrepancies. EDS medication change information was compared to medication changes identified by comparing pharmacist-verified “Medication History on Admission” forms with pharmacist-verified paper discharge prescriptions.

Results: There were 85/87 (98%) EDSs that included a discharge medication list. Of these, 50/85 (59%) contained one or more medication list discrepancies (median 1, range 0–15). The most common discrepancy was omission of medication (58%); 84/131 (64%) discrepancies were considered clinically significant (risk of adverse outcome); 162/351 (46%) clinically significant medication changes were stated in the EDS; and 153/351 (44%) changes were both stated and included a reason.

Conclusion: EDS discrepancies were common despite integration with e-prescribing. Eliminating paper prescriptions, enhancing e-prescribing/EDS functionality and involving pharmacists in EDS preparation may reduce discrepancies.

Original language	English
Pages (from-to)	125-131
Number of pages	7
Journal	Health Information Management Journal
Volume	47
Issue number	3
DOIs	https://doi.org/10.1177/1833358318765192
Publication status	Published - 2018

Keywords

continuity of patient care
electronic health records
electronic prescribing
hospitals
patient discharge summaries

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/1833358318765192

Cite this

@article{c5c948d1a3a64962a620f9c1c0dbcde5,

title = "An audit of the accuracy of medication information in electronic medical discharge summaries linked to an electronic prescribing system",

abstract = "Background: Poor communication of medication information to general practitioners when patients are discharged from hospital is a widely recognised problem. There has been little research exploring the accuracy of medication information in electronic discharge summaries (EDS) linked to hospital e-prescribing systems. Objective: To evaluate the accuracy of medication lists and medication change information in EDS produced using an integrated e-prescribing and EDS system (where EDS discharge medication lists were imported from discharge e-prescription records, medication change information was manually entered, and medications were dispensed from paper copies of the patients' e-prescriptions). Method: Retrospective audit of EDSs for a random sample, representative of adult patients (n = 87) discharged from a major teaching hospital. EDS medication lists were compared to pharmacist-verified paper discharge prescriptions (considered to be the most accurate discharge medication list) to identify discrepancies. EDS medication change information was compared to medication changes identified by comparing pharmacist-verified “Medication History on Admission” forms with pharmacist-verified paper discharge prescriptions. Results: There were 85/87 (98%) EDSs that included a discharge medication list. Of these, 50/85 (59%) contained one or more medication list discrepancies (median 1, range 0–15). The most common discrepancy was omission of medication (58%); 84/131 (64%) discrepancies were considered clinically significant (risk of adverse outcome); 162/351 (46%) clinically significant medication changes were stated in the EDS; and 153/351 (44%) changes were both stated and included a reason. Conclusion: EDS discrepancies were common despite integration with e-prescribing. Eliminating paper prescriptions, enhancing e-prescribing/EDS functionality and involving pharmacists in EDS preparation may reduce discrepancies.",

keywords = "continuity of patient care, electronic health records, electronic prescribing, hospitals, patient discharge summaries",

author = "Yixin Tan and Elliott, {Rohan A.} and Belinda Richardson and Tanner, {Francine E.} and Dorevitch, {Michael I.}",

year = "2018",

doi = "10.1177/1833358318765192",

language = "English",

volume = "47",

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T1 - An audit of the accuracy of medication information in electronic medical discharge summaries linked to an electronic prescribing system

AU - Tan, Yixin

AU - Elliott, Rohan A.

AU - Richardson, Belinda

AU - Tanner, Francine E.

AU - Dorevitch, Michael I.

PY - 2018

Y1 - 2018

N2 - Background: Poor communication of medication information to general practitioners when patients are discharged from hospital is a widely recognised problem. There has been little research exploring the accuracy of medication information in electronic discharge summaries (EDS) linked to hospital e-prescribing systems. Objective: To evaluate the accuracy of medication lists and medication change information in EDS produced using an integrated e-prescribing and EDS system (where EDS discharge medication lists were imported from discharge e-prescription records, medication change information was manually entered, and medications were dispensed from paper copies of the patients' e-prescriptions). Method: Retrospective audit of EDSs for a random sample, representative of adult patients (n = 87) discharged from a major teaching hospital. EDS medication lists were compared to pharmacist-verified paper discharge prescriptions (considered to be the most accurate discharge medication list) to identify discrepancies. EDS medication change information was compared to medication changes identified by comparing pharmacist-verified “Medication History on Admission” forms with pharmacist-verified paper discharge prescriptions. Results: There were 85/87 (98%) EDSs that included a discharge medication list. Of these, 50/85 (59%) contained one or more medication list discrepancies (median 1, range 0–15). The most common discrepancy was omission of medication (58%); 84/131 (64%) discrepancies were considered clinically significant (risk of adverse outcome); 162/351 (46%) clinically significant medication changes were stated in the EDS; and 153/351 (44%) changes were both stated and included a reason. Conclusion: EDS discrepancies were common despite integration with e-prescribing. Eliminating paper prescriptions, enhancing e-prescribing/EDS functionality and involving pharmacists in EDS preparation may reduce discrepancies.

AB - Background: Poor communication of medication information to general practitioners when patients are discharged from hospital is a widely recognised problem. There has been little research exploring the accuracy of medication information in electronic discharge summaries (EDS) linked to hospital e-prescribing systems. Objective: To evaluate the accuracy of medication lists and medication change information in EDS produced using an integrated e-prescribing and EDS system (where EDS discharge medication lists were imported from discharge e-prescription records, medication change information was manually entered, and medications were dispensed from paper copies of the patients' e-prescriptions). Method: Retrospective audit of EDSs for a random sample, representative of adult patients (n = 87) discharged from a major teaching hospital. EDS medication lists were compared to pharmacist-verified paper discharge prescriptions (considered to be the most accurate discharge medication list) to identify discrepancies. EDS medication change information was compared to medication changes identified by comparing pharmacist-verified “Medication History on Admission” forms with pharmacist-verified paper discharge prescriptions. Results: There were 85/87 (98%) EDSs that included a discharge medication list. Of these, 50/85 (59%) contained one or more medication list discrepancies (median 1, range 0–15). The most common discrepancy was omission of medication (58%); 84/131 (64%) discrepancies were considered clinically significant (risk of adverse outcome); 162/351 (46%) clinically significant medication changes were stated in the EDS; and 153/351 (44%) changes were both stated and included a reason. Conclusion: EDS discrepancies were common despite integration with e-prescribing. Eliminating paper prescriptions, enhancing e-prescribing/EDS functionality and involving pharmacists in EDS preparation may reduce discrepancies.

KW - continuity of patient care

KW - electronic health records

KW - electronic prescribing

KW - hospitals

KW - patient discharge summaries

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DO - 10.1177/1833358318765192

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VL - 47

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JO - Health Information Management Journal

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ER -

An audit of the accuracy of medication information in electronic medical discharge summaries linked to an electronic prescribing system

Abstract

Keywords

UN SDGs

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