Case Study: MedsTracker excels in physician adoption at Valley Medical Center
“The breakdown occurs when nursing prepares one list and the physician prepares another. The patient may tell the nurse something, but not the physician, or vice versa, and nobody knows there is a difference because the two lists are on paper….”.
Problem
Valley Medical Center (VMC) is a thriving, award-winning suburban hospital committed to quality patient care. When The Joint Commission first initiated the new patient safety goal for medication reconciliation in 2005, it prompted Valley Medical Center to carefully review its medication reconciliation processes; from admission, through transfer, to discharge. As with most multi-vendor hospital environments, analyzing the med rec flow uncovered deficits: incomplete and inaccurate home medication
histories, gaps in communication to the next provider of care, and unintentional duplication or omission medication errors. Paper-based systems were prone to error due to legibility issues; electronic solutions lacked integration, leading to redundant and inefficient systems that wasted clinicians’ time.
Dewey Howell, MD, PhD, a physician in residency and already an established software developer, had experienced firsthand the frustrations of electronic tools that impeded clinician workflow. He resolved to create a med rec solution that worked with clinicians rather than against them,that supported the process by thinking like a clinician—while ensuring patient safety and regulatory compliance.
Solution
Dr. Howell engaged the VMC medical staff and IT staff to create a physician-friendly, fully electronic, web-based medication reconciliation product. One of the first issues identified was the need to simplify the compilation of medication lists. Using First DataBank’s National Drug Data File (NDDF) Plus™ and OrderView Med Knowledge Base™, combined with an intuitive user interface, MedsTracker more easily and completely populates the home medication history, then reconciles it with new admission medications on a single screen. MedsTracker also provides intuitive clinical decision support through relevant safety alerts. At discharge, MedsTracker reconciles inpatient and home medications on one screen, creates electronic prescriptions, notifies the patient’s primary care physician of the changes in regimen, and provides simple, lay language printouts to help improve patient understanding and compliance.
Results
Valley Medical Center went live with MedsTracker on April 3, 2007. Elated to have a med rec tool that understands and respects clinician workflow and improves patient safety, physicians flocked to MedsTracker. VMC enjoyed unprecedented physician adoption. Three weeks after implementation, more than 91 percent of discharges were successfully reconciled with MedsTracker. Today, VMC continues to demonstrate clinician efficiency and improved accuracy in reconciliation. The average time to complete the reconciliation events is less than 3.5 minutes, and the accuracy of the home medication list is 85 percent. HSTM Research scores in discharge readiness have soared, with percentile ranking going from the 40s and 50s in 2007 to the high 80s and low 90s in 2008 and 2009. Discharge follow-up calls reveal patients have less confusion and fewer questions about medications since the implementation of MedsTracker. These results have contributed significantly to high clinician adoption and ultimately, improved medication safety for patients.
