Information Technology Reference
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Fig. 5.4 Medication Reconciliation Ensures that Everyone on the Care Team Knows What
Everyone Else has Prescribed
So, to review, each practice has the iNexx platform installed. Their local copy is
“aware” of what EMR they are using and can integrate with its data flows. It also is
“aware” of the local node so it can send and receive data as requested. Figure 5.3
illustrates how the platform can be used. At discharge, a care coordinator can send
tasks to various members of the patient's team. These are received at the proper
office and the originating office can monitor their status via the icons in the Action
Updates column (U - unacknowledged, A - acknowledged, C - Complete or
Calendar - Overdue). As shown, clicking on an icon provides the details - in this
example, unacknowledged tasks.
This not only creates much needed care coordination but it is an example of pro-
cess reengineering, something we've discussed repeatedly. Here, an electronic pro-
cess can replace phone calls, emails, faxes and other more time consuming methods
of communicating. Moreover, everything is in one place so things are less likely to
slip through the cracks.
The Patient Updates column reports on actions other team members have taken
that this office may need to be aware of. An example might be a new medication
order. In that case the app can provide a medication reconciliation screen (Fig. 5.4 )
summarizing what medications the practice has a record of and what medications the
grid is aware of. This display can help make sure every office has a clear view of each
patient's complete treatment program to help prevent errors and promote patient
safety. Medication reconciliation is a Meaningful Use requirement.
Finally, each practice can use the Risks column at the right to display patients
meeting their own criteria for being at high risk. It should be obvious at this point
that this would be of particular interest to practices under a pay-for-performance or
outcome-based reimbursement model. Under such models any extra costs associ-
ated with failing to identify these patients early will, at least in part, be borne by the
practice. Early detection of increased risk might help avoid expensive complica-
tions, or at least delay their development.
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