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Discussion
PART I:
Most would agree that an accurate list of medications that patients are taking is a key component of safe, high quality healthcare. However, creating an accurate medication list (medication reconciliation) has proven to be incredibly difficult. It was thought that implementation of electronic health records would lead to improvements in accuracy of medication lists, but this has not proven to be the case. If you work with clinical informatics teams that include pharmacy concerns, chances are you’ll be working on the medication reconciliation process.
Briefly describe two factors that make accurate medication reconciliation difficult. What aspect of your two factors creates a roadblock to accurate medication reconciliation? Based on what you learned this week about drug terminologies, describe how use of National Drug Codes (NDC) and RxNorm facilitate creation of accurate medication lists.
PART II: After posting your submission, read and respond to the postings of at least two classmates.
Jason
Medication reconciliation stands as a challenge due to the fact that patients visit multiple providers that use different EHRs and many patients’ EHRs aren’t properly updated with the medications and supplements they currently take. If the provider lacks access to the other EHR systems used by the other providers, they won’t know if the patients’ medication list is accurate. The same issue applies if the patient can’t recall the medications they are currently taking and their previous providers failed to update their record.
The use of NDCs and RXNorm helps ensure medications aren’t mistaken for another, which helps ensure patients receive the proper medications. RXNorm assigns specific names to each medication based on the ingredients, strength and dosage while NDCs give information on the medications through 3 segments of descriptive codes that identifies the manufacturer, dosage and package size.
Reference
Warfield, M., 2023 Classifications and Code Sets Used to Code Human Drugs and Biologics. Bellevue College
Syrel
Two factors that can make accurate medication reconciliation difficult are the provider’s lack of knowledge about the patient’s medications and some medications and drugs not having certain codes or terminologies specific to them. A provider’s lack of knowledge about a medication can be caused by not having experience with a certain drug or from a patient’s medical record not including medications they have taken in the past or are currently taking which will result in confusion and the accuracy of medication lists to be inaccurate or incomplete. Some medications and drugs may not have certain terminologies attached to them and may be confused with another drug in which the National Drug Codes (NDC) and RxNorm help this situation by giving providers a list of codes and terminologies that describe medications or drugs and the specifics of them such as the medications brand name or dosage form.
Maksim
Creating an accurate medication list, also known as medication reconciliation, is a challenging task in healthcare. Two factors that make this process difficult include the complexity of patients’ medication regimens and lack of communication and coordination between healthcare providers.
The complexity the regimens can make it difficult to keep track of all the medications they are taking, including their dosages and schedules. This can lead to errors and inconsistencies in medication lists. The lack of standardization and consistency in the way medications are named and described is the aspect of these factors that creates a roadblock to accurate medication reconciliation. Different providers may use different names or descriptions for the same medication, making it difficult to match them up.
To facilitate the creation of accurate medication lists, National Drug Codes (NDC) and RxNorm are used as standardized nomenclature for clinical drugs. The NDC is a unique identifier assigned to each medication by the FDA and is used to identify the product and its manufacturer. RxNorm links drug-related information across different databases, making it easier to identify and manage drugs, improve drug safety and support medication reconciliation.
References:
Medication reconciliation. Patient Safety Network. (n.d.). Retrieved January 25, 2023, from https://psnet.ahrq.gov/primer/medication-reconciliation
Pevnick, J. M., Shane, R., & Schnipper, J. L. (2016, September).
The problem with Medication Reconciliation. BMJ quality & safety. Retrieved January 25, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4956589/
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