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First published April 24, 2008 as JAMIA PrePrint; doi:10.1197/jamia.M2561
Journal of the American Medical Informatics Association 2008;15(4):449-452
© 2008 American Medical Informatics Association

A more recent version of this article appeared on July 1, 2008
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Submitted on July 17, 2007
Accepted on March 24, 2008

Evaluation of an Inpatient Computerized Medication Reconciliation System

Alexander Turchin MD, MS1*, Claus Hamann MD, MS2, Jeffrey L. Schnipper MD, MPH1, Erin Graydon-Baker3, Sally G. Millar RN, MBA4, Patricia C. McCarthy PA, MHA4, Christopher M. Coley MD5, Tejal K. Gandhi MD, MPH6, and Carol A. Broverman PhD7

Affiliation of the authors: 1 Brigham and Women's Hospital, Boston, MA; Partners Information Systems, Wellesley, MA; Harvard Medical School, Boston, MA ; 2 Partners Information Systems, Wellesley, MA; Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA ; 3 Brigham and Women's Hospital, Boston, MA; 4 Massachusetts General Hospital, Boston, MA; 5 Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA ; 6 Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA ; 7 Partners Information Systems, Wellesley, MA

* To whom correspondence should be addressed.

We designed 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 less than 10 minutes. 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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