Background: Medication errors occur frequently at transitions of care and lead to significant patient harm. Robust medication reconciliation practices can mitigate these errors, but this process is complex and time-consuming. One of the conclusions of the first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) was that pharmacist team involvement in medication reconciliation is a key [...]

Background: Medication reconciliation programs are a well-recognized important tool in reducing medication discrepancies and subsequently decreasing patient harm, particularly at transitions of care. Medication reconciliation programs have demonstrated error reductions upward of 66% [1-4]. 39% of prescription medication history errors have the potential to cause moderate or severe discomfort or deterioration in a patient’s condition [...]

Background: The electronic health record has grown and advanced in the last decade and in recent years, basic interoperability has been successfully adopted. Organizations are able to see data from other organizations. Prescriptions are no longer hand written and are sent electronically to pharmacies. One major barrier that continues to exist, however, is electronic communication [...]