News Feature | September 4, 2013

HIEs Provide More Complete Records Than Emergency Department

Source: Health IT Outcomes
Katie Wike

By Katie Wike, contributing writer

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Patient information is more accurate using HIEs than emergency room documentation according to a recent study

The Journal of the American Medical Informatics Association reports on a study designed to “determine the extent to which community medication histories documented in the emergency department (ED) differed from records of dispensed medications provided by community pharmacies, and the patient and drug-related predictors of discrepancies that could be used to identify higher risk groups.”

The study found, “Pharmacy records identified a substantial number of medications that were not in the ED chart. There is potential for greater safety and efficiency with automated access to pharmacy records.” The authors also suggests, “The development of health information exchanges (HIEs) could improve the efficiency and accuracy of information about community medication histories if they enable automated access to dispensed medication records from community pharmacies, particularly for the most vulnerable populations with multiple morbidities.”

A total of 613 patients participated in the study and the pharmacy records identified 41.5 percent more prescribed medications than were noted in the ED chart. Patients either forgot about or failed to report nearly half the prescriptions they were taking when admitted to the ED. The largest discrepancies were found with medications like anticoagulants, cardiovascular drugs, and diuretics - often critical medications.

Fierce EMR reports the study, conducted in Montreal, found, “The number of prescribed drugs and the number of pharmacies used were associated with discrepancies, but not age, sex, number of hospitalizations or communication problems.” Of the participants, 45.7 percent had more than one physician prescribing their medications and 26.1 percent were taking more than 12 medications. Patients using more than 12 prescription medications had triple the likelihood of discrepancies in the pharmacy record.

The study concluded, “We found community pharmacy dispensed medication records identified a substantial number of additional medications that were not noted in the ED chart, particularly for the most vulnerable patients. There is potential to gain greater safety and efficiency within hospital ED with automated access to these pharmacy records.”