Effectiveness of Medication Reconciliation by Using IPD Paperless System in Sainoi Hospital

Abstract

Background: The transition of medication reconciliation from a paper-based system to an IPD paperless system has presented several challenges, including increased prescribing errors and process delays.

Objective: To evaluate the effectiveness of medication reconciliation and to identify problems, obstacles, and solutions associated with the implementation of an IPD paperless system.

Methods: This mixed-methods study comprised qualitative and quantitative components. The qualitative phase explored solutions through in-depth interviews with six healthcare professionals, including two physicians, two pharmacists, and two registered nurses. The quantitative phase compared data before and after system improvements, including prescribing errors (analyzed using the Chi-square test) and the time required to compare medication lists (analyzed using the Mann–Whitney U test).

Results: Based on the identified problems, the following solutions were implemented: (1) adding a feature to display medications for comparison on the same page; (2) developing a system to alert physicians to review patients’ previous medications; (3) revising the documentation form to ensure completeness; and (4) establishing standardized guidelines for patient history taking and medication reconciliation. A total of 548 and 558 participants were included before and after the improvement, respectively. Prescribing errors decreased from 8.39% to 4.84%, representing a statistically significant difference (p-value = 0.017). The percentage of patients who received medication reconciliation within 24 hours of admission increased from 73.36% to 86.02%. The time required to compare medication lists significantly decreased (p-value < 0.001).

Conclusion: Improvements in the medication reconciliation process reduced prescribing errors. Additionally, streamlined preparation of the medication reconciliation form, together with a physician notification system, enhanced the timeliness of medication reconciliation.