Medication Reconciliation

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Medication Reconciliation

• Physician/Provider Workflow
• 3/7/13

2
On Admission

• The Pre-Admit Medication List (PAML) information
  may be collected by the nurse or provider
• All areas of entry to hospital use same PAML tool
  
• Emergency Department
• pre-op
• direct admit
• Provider electronically stamps signature in HEO
  that list has been acknowledged

3
Provider acknowledgement screen
choose one of the three options
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Pre-Admit Med List

• Accessible to providers in multiple applications
• StarPanel
• HEO
• StarNotes
• Allows importing of PAML data into other
  electronic documents
• Can be modified/updated at any time by provider
  or nurse

5
Click the arrow to add to Pre-admit Med List
(right side) Click Done to save PAML list
6
In HEO you can click on PAML in the upper left
window and view details of what the patient has
reported as home medications. You can also modify
at any time.
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During admission

• Orders for medications are entered in HEO
• Upon transfer to another unit or level of care
  medications are reviewed and updated as needed
• HEO is the most up to date record of current
  medications

8
At Discharge

• Physician/Provider responsibility to reconcile
  medications
• Use Discharge Process to compose patient letter,
  and comply with all discharge requirements
• Compare home meds next to current inpatient
  medications
• Indicate those to continue, stop and start
• Create prescriptions in RxStar

9
Review the Take Medications list imported from
StarPanel Patient Summary (right side). Add
medications to the list from the medication lists
currently in HEO/Wiz PAML (left side). To Stop
a medication click the red button. To add
medication from HEO or PAML list to home
medication list, click the green button.
10
Once Take Medication list complete Click Mark
DMR Done to save new list to StarPanel patient
Summary.
Click RxStar tab to complete new prescriptions
for patient.
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Tips for Providers Regarding Medication
Reconciliation

• Having the PAML be as accurate as possible at the
  beginning (admission) saves documentation steps
  at discharge
• PAML can be completed by physicians and MUST be
  acknowledged electronically
• The final step at discharge is the MARK DMR DONE
  which saves the new patient medication list to
  StarPanel

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Questions?

• Please call the Help Desk at 3-HELP or 343-4357
  with any questions or concerns.