al., 2003; Kaushal et al., 2003; Field et al., 2004). CPOE systems for both ambulatory and inpatient care support faxing, messaging, and bidirectional communication of prescription information (eHI, 2004). Each of these tools improves access to original data and provides these data in a format that is legible and potentially interoperable.

In sum, the availability of interoperable data is a lynchpin of a safer health care system, as noted by the Institute of Medicine (IOM) in its report on patient safety (IOM, 2004). Systems provided with these data are uniquely able to provide health care providers with feedback on aspects of their medication prescribing practices about which they might otherwise be unaware (Meyer, 2000; Galloway et al., 2002). This information can also be used for continuing medical education (CME) and evaluation as a part of maintenance of certification, helping providers remain current with the best practices for safe health care delivery. Research suggests that when provided with information on how their behavior can be improved in a timely fashion, health care providers will make these changes (Neilson et al., 2004). Finally, it must be emphasized that as noted by the Commission for Systemic Interoperability, “Having an electronic medication record for every American is a critical step toward achieving true interoperability in healthcare, giving treating physicians the information they need when they need it, allowing more effective care for their patients. It will bring all the medications an individual is currently taking to the doctor’s attention at the time important decisions about new prescriptions are being made” (CoSI, 2005).

In effect, interoperable medication data can facilitate more efficient medication reconciliation,2 particularly at admission and discharge, when discrepancies are an important problem and a frequent cause of ADEs (Forster et al., 2005). Providing such data electronically is even more important now that JCAHO has established that by 2006, hospital organizations must institute a process for comprehensive medication reconciliation at admission, at transitions to and from internal patient care units, and at discharge with the “next provider of service.” Interoperable medication data will be the most feasible approach to accomplishing this goal.

MONITORING AND SAFETY IMPROVEMENT

Providers should assess the safety of medication use through active monitoring and use these monitoring data to inform the implementation of prevention strategies.

2

Reconciliation involves comparing what a person is taking in one setting with what is being provided in another setting to avoid errors of transcription, omission, duplication of therapy, and drug–drug and drug–disease interactions.



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