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Medication Reconciliation



What is medication reconciliation? It is the process of identifying the most accurate list of medications a patient is currently taking, and comparing it against physicians’ order to avoid any possible errors. The medication reconciliation process should take place every time there is change in setting, service, practitioner, or level of care. One of the most common changes in setting is when a patient is treated at a hospital, either in the emergency department or upon admission. The medication reconciliation process is vital in avoiding medication errors such as omissions, duplications, dosing errors, or drug interactions.


In 2009, after only five years as a mandatory safety goal, the Joint Commission, the organization that evaluates health care organizations to improve health care outcomes for the public, stopped surveying health care organizations for the compliance of medication reconciliation. However, medication reconciliation remains an important factor in patient care. How important? Medication errors represent that most common patient safety error and more than 40% of medications errors are believed to result from inadequate medication reconciliation during patients’ transitions of care. In the Unites States, adverse drug events harm an estimated 1.5 million people annually and cost hospitals about $3.8 million a year. Even though medication reconciliation seems like an easy task, there are multiple potential difficulties in obtaining an accurate medication list from a patient. One main difficulty is who is responsible to do medication reconciliation. Is it doctors, nurses, or pharmacists? The three disciplines try to work as a multidisciplinary team but there is usually little agreement on the role each disciplines in the medication reconciliation process. Additionally, even if there was an agreement on who was responsible, a patient’s acuity can influence the process of reconciliation. If a patient cannot remember or respond, obtaining an accurate medication list will be hindered. Even in a closed health care system, the variability of medication reconciliation makes it a continual area of pursuit to help improve patient outcomes.


Scriptio is trying to bridge the multiple disciplines of medication, pharmacy, and nursing, to make the medication reconciliation process much simpler and more accurate across any health care settings. It also aims to remove patient acuity from the process by having medication lists updated prior to patients seeking medical care.


Medication reconciliation is a task the Joint Commission made a goal to promote medication safety but removed from their list to survey for compliance due to difficulties organizations were experiencing. Yet, is so important because more than half of patients have at least one unintended medication discrepancy at hospital admission, with 6% having potential for severe harm. Medication reconciliation needs to be streamlined and Scriptio intends to do that.



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