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First published April 24, 2008 as JAMIA PrePrint; doi:10.1197/jamia.M2561
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J Am Med Inform Assoc. 2008;15:449-452. DOI 10.1197/jamia.M2561.
© 2008 American Medical Informatics Association

Implementation Brief

Evaluation of an Inpatient Computerized Medication Reconciliation System

Alexander Turchin, MD, MSa,b,d,*, Claus Hamann, MD, MSb,c,d, Jeffrey L. Schnipper, MD, MPHa,d, Erin Graydon-Baker, MS, RRTa, Sally G. Millar, RN, MBAc, Patricia C. McCarthy, PA, MHAc, Christopher M. Coley, MDc,d, Tejal K. Gandhi, MD, MPHa,d and Carol A. Broverman, PhDb

a Brigham and Women's Hospital, Boston, MA
b Partners Information Systems, Wellesley, MA
c Massachusetts General Hospital, Boston, MA
d Harvard Medical School, Boston, MA.

* Correspondence: Alexander Turchin, MD, MS, Clinical Informatics Research and Development, Suite 201, 93 Worcester Street, Wellesley, MA 02481 (Email: aturchin{at}partners.org).

Received for publication: 07/17/07; accepted for publication: 03/24/08.

We designed the Pre-Admission Medication List (PAML) Builder medication reconciliation application and implemented it at two academic hospitals. We asked 1,714 users to complete a survey of their satisfaction with the application and analyzed factors associated with user efficiency. The survey was completed by 626 (36.5%) users. Most (64%) responders agreed that medication reconciliation improves patient care. Improvement requests included better medication information sources and propagation of medication information to order entry. Sixty-nine percent of admitting clinicians reported a typical time to build a PAML of <10 min. Decreased reported time to build a PAML was associated with reported experience with the application and ease of use but not the average number of medications on the PAML. Most users agreed that medication reconciliation improves patient care but requested tighter integration of the different stages of the medication reconciliation process. Further training may be helpful in improving user efficiency.






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Copyright © 2008 by the American Medical Informatics Association.