According to a 2018 survey of physician leaders, including chief medical information officers (CMIOs), the system-wide use of enhanced medication reconciliation has improved patient safety,  and issues common just a few years ago are less likely to occur today because of these checks and balances. However, the same survey revealed that more work is needed to ensure that continued gaps are completely addressed. The survey was conducted by DrFirst, which is a national provider of medication-management solutions and e-prescribing platforms.

Over 80% of the CMIOs surveyed indicated that improvement initiatives associated with medication management reduced the incidence of adverse drug events; however, over 10% of the respondents also noted that they were not satisfied with the current medication-management and reconciliation process. Among the points of dissatisfaction were gaps in obtaining and reconciling patient medication histories and inappropriate medication-reconciliation processes that resulted in care-transition cycles leading to misinformed decisions by care teams.

Some of the top concerns identified include adherence issues that are caused by financial constraints and the lack of “price transparency” and knowledge of what the medication will cost the patient. Over 70% of respondents noted that they did not even have a sense of what the copay might be for patients who had insurance that covered medication therapy. The fiscal issue also affects patients and, as reported in a previous study conducted last year by Truven Health Analytics-NPR, almost 70% of patients describing that high cost was the reason they had not filled a prescription within the last 90 days.

Another key patient-safety gap identified by this survey related to the current opioid epidemic, with over 60% of survey respondents highlighting the need for an improved workflow that facilitates a more integrated and efficient coordination process. Such a process would include electronic prescribing, access to the drug-monitoring programs, and access to a complete and accurate list of medications that the patient is receiving from all care providers in order to prevent harmful drug-drug interactions. Physician leaders also expressed concern over the ability to distinguish patients who are legitimately in need of care from those seeking medications that they intend to misuse.

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