Implementation of a Medication Reconciliation Risk Stratification Tool Integrated within an electronic health record: A Case Series of Three Academic Medical Centers

Medication errors during transitions of care are common, dangerous and costly. Medication reconciliation can help mitigate this risk, but it is a complex and time-consuming process when performed properly. Increasingly, pharmacy staff have been engaged to help improve medication reconciliation. However, many organizations lack the resources and staff required to perform accurate medication histories and other reconciliation tasks on all patients. We describe how three academic medical centers implemented risk scoring systems to allocate limited pharmacy resources to patients with the highest likelihood of medication reconciliation related errors. We found that (1) development of a tailored medication risk scoring system and integration into the electronic health record is feasible, (2) workflow around the risk calculator is critical to the success of the implementation, and (3) the complex coordination of professional disciplines during the medication reconciliation process remains an ongoing challenge at all three institutions.