In October 2016, the American Journal of Managed Care published “A Call for a Statewide Medication Reconciliation Program,” by Dr. Elizabeth Askin and Dr. David Margolius. The article called for policymakers to push for the expansion of state-run prescription drug monitoring programs (PDMPs), which currently only list information related to opiate prescriptions.
Because PDMPs are already in place in 49 states, it’s natural to consider that they could serve as the basis for such a program by creating statewide medication reconciliation programs (SMRPs) that track all medications, not just opioids. But PDMPs are not the optimal answer to the challenge of building a functional, and successful, medication reconciliation program. As noted in our recent response to the AJMC article, there are a number of reasons for this:
- Health systems might be disinclined to invest to make their electronic health records (EHRs) interoperable with SMRPs. PDMP datasets have not been universally integrated in physician EHRs or pharmacy management systems, and this lack of seamless integration compromises physician accessibility and usability, thereby negatively affecting their utilization.
- Absence of a single nationally adopted and accredited standard, common vocabularies, and uniform data formats by PDMPs will result in EHR and pharmacy vendors potentially needing to certify and implement 50 different SMRPs—a cost-prohibitive and resource-intensive endeavor.
- Prescribers and pharmacies who serve patients in multiple states may have to register with each SMRP separately to access its data, which would result in additional workflow burdens.
- EHR and pharmacy integration challenges across SMRPs can thus negatively impact clinician usability and subsequently reduce the efficiency of the overall medication reconciliation process
Instead, we believe a more viable solution already exists. Surescripts connects prescribers, pharmacies, EHRs and pharmacy benefit managers (PBMs), making it easy for clinicians to access patient medication lists at the point of care. In fact, physicians using Surescripts’ Medication History for Reconciliation service have reported a 30% improvement in medication history completeness as well as an increased ability to identify medications that may cause adverse drug effects. Our service enables the medication reconciliation process within the provider’s EHR. If clinicians don’t have to leave their workflow, the likelihood of them using it greatly increases. Surescripts adheres to a single standard EHR certification and integration process, so states, EHRs and providers don’t need to worry about integration variations and accessibility differences across 49 states. Each year, Medication History for Reconciliation delivers more than 1.7 billion medication histories using CMS’ Meaningful Use Stage 3 compliant National Council for Prescription Drug Program (NCPDP) v10.6 medication history transaction standard.
Access to a patient’s medication history is crucial for a physician who needs to make a decision about a patient’s treatment options. Building upon an existing capability that is already embraced by clinicians, pharmacies, EHRs and PBMs, would allow the healthcare industry to address critical gaps in medication reconciliation in real time, giving caregivers access to the information they need to make the decisions possible for patient safety.
Learn more about how the Surescripts network and Medication History for Reconciliation service deliver current, accurate information to providers at the point of care.