Medication lists generated by EHRs lack accuracy

Electronic health records do not capture the most accurate, up-to-date information about medications, according to a study from the University of Michigan Kellogg Eye Center.

Published in JAMA Ophthalmology, researchers examined medication-related information contained in the EHRs of patients treated for microbial keratitis, an infection of the cornea.

What they found was that almost one-quarter of medications did not match between the clinician’s clinical progress note and the formal EHR medication list.

“Corneal infection is an important disease condition to study ophthalmic medication lists because the medications change rapidly,” says the study’s lead author Maria Woodward, MD, assistant professor of ophthalmology and visual sciences at the U-M Kellogg Eye Center.

“This level of inconsistency is a red flag," warns Woodward, who is also a health services researcher at the U-M Institute for Healthcare Policy and Innovation. “Patients who rely on the after-visit summary may be at risk for avoidable medication errors that may affect their healing or experience medication toxicity.”

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“Issues arise when a medication is started by an outside provider and continued at the new hospital and when patients require compounded medications that must be telephoned in to a pharmacist in the evening,” observes Woodward, noting that data about medications in EHRs is captured in multiple formats in multiple locations.

“The only way to ensure that the medication list is completely accurate is to double-document,” adds Woodward. “The same information must be entered into the clinician’s note and the formal medication list—two separate places.”

To address the problem from a health information technology perspective, researchers recommend that EHR developers create software solutions to lessen the burden of clinical documentation and make it easier to reconcile medication names and dosages.

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