Earlier this week, we hosted a webinar on Google hangout on the complex and vexing problem of medication reconciliation. Joining Intake.Me co-founders Darla Brown and Dr. Emily Lu were pharmacist Goldina Erowele of Carenovate Magazine and Michael Ramirez of PillFill. For those of you that missed the hangout, here is the Youtube of it below:

Here are the key points from the video: 

What is Medication Reconciliation and what makes it so difficult?

  • Medication reconciliation is the process of figuring out which medications a patient is actually on before they enter a new system, whether that is entering the hospital, leaving the hospital, going into a nursing home, entering a new clinic, etc.
  • The health care system is incredibly fragmented. There is no guarantee that the systems, even in the same hospital building, will communicate with each other.
  • The patients involved in the process are often very ill (coming in and out of the hospital, going through a serious diagnosis) and are expected to juggle this on their own without involving the caregivers that will be managing the medications
  • Patients not only go to multiple doctors but also use multiple pharmacies or receive medications from other sources (e.g. their doctor’s office, mail-order pharmacies, etc.) so there is no pharmacist that has a complete and accurate list of what medications that they are on.
  • There are huge implications for patient safety, and healthcare quality. It’s a big contributor to avoidable readmissions – which cost the health care system $3 billion a year – and medical errors, like highlighted by Bob Watcher’s article Beware of the Robot Pharmacist.
  • Some of that process has been automated by technology, but as Goldina and Darla out, pharmacists often play a huge role in this as well, helping patients look through their bags of medication bottles, asking about herbal supplements, etc.

What does it have to do with empowering patients?

  • Patients are the key to actually knowing what goes into their bodies. In a world of fragmented systems, they are the only one with the “ultimate” list of what medications go into their bodies.
  • It’s a big opportunity for health care providers, from doctors to pharmacists, to engage and educate patients in their own health care.
  • “Making patients own the medication taking process … is really important.” – Goldina Erowele, Carenovate Magazine
  • “There is no replacement [system] for patients that have their medication list on hand.” – Michael Ramirez, PillFill

What can patients do to get involved?

  • Asking questions about the medications that they are taking, knowing what their ingredients are, and what they do
  • Keep a list of all the medications that you take and bring it whenever you go into clinic, or to the hospital
  • Pay very close attention to the specific ingredients of your over-the-counter medications and herbal supplements and include these in your medication list!
    • Hot tip: take a picture of the ingredient list on the box so you don’t have to bring all the boxes and bottles with you to your doctor.
  • Sometimes the low-tech ways work: asking questions of your health care providers before you leave the hospital, keeping a spiral notebook of what medications you are taking, etc.

What resources are available?

  • Use your doctor’s health care portal! It’s not just for sending messages to your doctor, but you often can print out your medication list from that portal. Your insurance and your pharmacy may often have a portal that includes a list of your medications.
  • Talk to your pharmacist! Resist the temptation to just take your prescription as run. Even at a retail pharmacy, pharmacists can be a great resource for answering your questions about your medications.
  • Talk to your doctor – resources for what to ask your doctor when you start a medication
  • Pillfill – medication management mobile app

Thanks for joining us and watch this space for announcements of more webinars hosted by Intake.Me!

Emily Lu

Emily Lu

Co-founder at Intake.Me
As a medical student going into family medicine, Emily joined Intake.me to leverage technology to create a more patient-centered health care system. Emily is now a resident in the UCSF-SFGH Family and Community Medicine program. She is focused on developing a primary care system that uses technology to empower patients. Emily is passionate about underserved medicine, public health and quality improvement. She was selected to present an Ignite!Talk at Medx2015 on streamlining doctor visits.
Emily Lu