Part of a series on primary care challenges and their solutions.
Medication reconciliation is something we do every day, in the clinic and in the hospital. It shouldn’t be as hard as it is.
A patient with multiple medical problems returns for a fifteen minute quarterly visit. He saw his cardiologist three weeks ago and was told to double his metoprolol.
There are two ways to catch this change: when the cardiologist’s office note comes in, or as we check the patient in for his visit.
The cardiologist’s office note, generated by one of the leading EMRs, runs seven pages and contains entries about immunizations, fall risk and other quality measures of little relevance in specialty care. On one of the last pages, tucked away in a nondescript paragraph, at the very bottom, waiting for me to find it, is the notation that my patient’s metoprolol dose was doubled.
Quality measures began as tools to quantify the healthcare process, using outcomes, patient perceptions, and organizational structures associated with the provision of high-quality health care. Overall, the goals should focus on delivery of care that is effective, safe, efficient, and equitable. Did you notice a particular word missing? Yes, I missed the word physician too, because they have been left out of the conversation entirely.
