Our client, an academic medical center and national leader in patient safety, identified a need to create custom reporting metrics for Ambulatory Medication Reconciliation. Having completed a recent EHR implementation, the customer determined the out-of-the-box Medication Reconciliation reports were not adequate to meet established unique data requirements. The design of the EHR standard reports failed to capture the Medication Reconciliation workflow and also lacked the proper data elements to calculate custom provider metrics. With nearly $500,000 in departmental funding at stake it was imperative a custom report be developed to satisfy the Medication Reconciliation reporting needs. With an already stretched-thin reporting team, the ability to create such a report seemed an uphill climb.
HSi provided a site manager and a seasoned data developer, with a focus in the specific EHR system, to work in close collaboration with the client’s Physician Champion and Director of Clinical Quality. Utilizing the business knowledge of the clinical staff and partnering it with the extensive EHR system knowledge of the HSi team, the report specification was quickly completed and development started. Custom coding was developed to properly capture the unique Medication Reconciliation Metrics. Changes included limiting the report to only medication orders that were ordered by the encounter provider, determining if the provider took an action on the medication, and noting if and when the marked-as-reviewed button was clicked during the encounter. Once the development was completed, a series of detailed data validation sessions were conducted and revisions were made as needed. Upon completing data validation, the final report was presented to the full Medication Reconciliation committee for final sign-off.
With the new report now available for staff to review, the client identified a Medication Reconciliation process compliance rate of 60%; well below the pre-EHR implementation percentage. This was an expected result, which validated the accuracy of the report as additional provider workflow training was yet to be accomplished. The new Medication Reconciliation report was utilized by administration to identify gaps in workflows and training opportunities for clinical staff in order to increase the Medication Reconciliation percentage back to the pre-Go-Live rate of 85%. In addition, the client decided to extract the data in the custom report to their nationally-recognized web-based reporting system so the data could be reviewed and analyzed with other organizational metrics.
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