Outpatient Pharmacy Version 7

Medication ReconciliationPatient Wellness Handout (PWH)

Outside Medication

CDR Wil Darwin, PharmD, CDE, NCPSJune 2011

Foot Worthy Disclaimer

• EHR/RPMS optimization is essential• EHR GUI template may/may not be configured• RPMS PDM may/may not be configured• CAC and Pharmacist CAC may need to

configure components• Chronic Meds vs Acute Meds: A Difference• EHR/RPMS is a moving target• Meeting Meaningful Use measures

Objectives

• Review Medication Reconciliation Documentation (Patient Education Codes)

• Review Outside Medication processes

• Use the Patient Wellness Handout to assist with Medication Reconciliation Process

MEDICATION

RECONCILIATION

Medication Reconciliation

• Improve patient safety

• Assist in identification of chronic

medications across the continuum of care

• Encourage patients to become more

involved with their healthcare

• Improve compliance with Joint

Commission standards regarding

medication reconciliation

Medication Reconciliation

• Everyone’s responsibility including the RPh

• Train > Train > Train

• Consistency is key

• Many ways to slice & dice Med Rec processes but only one way it will be counted

• PWH Med Rec “print outs” to be counted

• Document M-MR Pt Education in EHR

Process - Outpatient Staff

• Nurse/Nursing Assistant – Call patient into exam room – Screen patient– Enter chief complaint and

vitals via EHR– Document health screenings

(tobacco, alcohol, depression, domestic violence)

– Print PWH Med Rec

• Patient – Review PWH Med Rec while

awaiting for provider– Assist in record update

• Provider– Examine patient– Review PWH Med Rec with

patient to determine required updates (new meds / outside Rx, discontinued meds, OTC products, vitamins, herbal remedies)

– Identify medications that need to be ordered today

– Document updated med list in EHR progress note

– Send new revised PWH Med Rec home with patient to compare with home meds

Process – Pharmacist Screening

• Roll-n-Scroll Med Management– Chronic Med designation – Med Profile screen of Chronic Med

Process – Pharmacist Screening• EHR GUI Med Management

– Managed in the MED tab– Chronic Only, >6mo, Alphabetized med list– Review Med List– Re-designate

“discontinued” meds

and duplicate meds

as non-Chronic– Med Rec specialist

Process – Pharmacist Screening

• EHR GUI Med Management– Document M-MR Pt Education in EHR– Managed in the PT ED tab

Practice Activities

• Med Rec pharmacist processes in database

PATIENT

WELLNESS

HANDOUT

Patient Wellness Handout (PWH)Med Reconciliation

– Developed by National IHS OIT team – Letter format - patient friendly– PWH Med Rec Contains:

• Patient Demographics• Current documented food / drug allergies and

adverse reactions• Outpatient Medication profile

– Active Med– Outside Med– Unknown Med

Patient Wellness Handout

(Med Rec)

Practice Activities

• PWH Med Rec button and print in database

OUTSIDE

MEDICATION

Outside Medication

• It is a Med Rec Measure

• End-user documents in EHR

• Facilitates with communication

• Medical Provider/Nurse driven

• No executable for RPh to finish order

• Each Meds need to be defined in PDM

Outside Medication

• One Methodology • Managed in the ORDERS tab

Outside Medication

Outside Medication

• “Unknown Miscellaneous” drug name

• Include drug name and strength if possible

• Needs to be built in PDM file

• Instruction outlined in EHR Patch 6 notes

• Specified medications should be entered in drug file and outside med entry converted ASAP

• Can run a report to capture data for PDM update

Outside Medication

Outside Medication

Outside Medication

• Second Methodology

– Data entry into the MED Tab– Outside Med > right hand click in Outside Med > New Medication

Outside Medication

Practice Activities

• Outside Medication processes in database

Questions and Discussions