Download eMM Key Concepts and Definitions

Electronic Medication
Management (eMM)
Concepts and Definitions
Dr Stephen Chu
eMM Key Concepts and Definitions

Medication List
• A record of prescribed and dispensed medications for an individual
• Can be unreconciled or reconciled
• Unreconciled Medication List
 A list of prescribed and dispensed medications for an individual
that is automatically generated
 A raw list that has not undergone [human] clinical review,
validation and reconciliation processing
• Reconciled Medication List
 A list of all medications that an individual known to be taking
 The list is the outcome of comprehensive and authoritative
clinical review, validation and reconciliation
 Omissions, inconsistencies, e.g. duplicates, are identified and
rectified
eMM Key Concepts and Definitions
 Medication List
• A record of prescribed and dispensed medications for an
individual
• Can be unreconciled or reconciled
• Medication History List
 A record of previously prescribed and dispensed medications
(may include over-the-counter medications) for an individual
 It is retrospective in nature
 Can be automatically [system] generated by queries performed
against databases of ePrescription and eDispense records
• Current Medication List
 A list of all medications (prescribed and over-the-counter) that an
individual should be/known to be currently taking as identified at
the time of review
eMM Key Concepts and Definitions
 Medication List
• A record of prescribed and dispensed medications for an
individual
• Can be unreconciled or reconciled
• Medication History List
• Current Medication List
•
 A list of all medications (prescribed and over-the-counter) that an
individual should be/known to be currently taking as identified at
the time of review
The concepts of “Current or Past Medication List” is temporal and
contextual in nature.
 They present significant challenges in information management
and pose serious clinical safety risks especially when merging
data from such lists automatically into clinical information
system or EHR/EMR repositories]
eMM Key Concepts and Definitions
 Medication Profile
•
Comprehensive list of medications taken by a patient
with information on indications, actions, use patterns,
and may include
 precautions, side effects, contraindications, and known allergy,
intolerance histories where applicable
 Managed contraindications
 Failed therapy
 Patient preferences
•
•
May include diagnosis and pre-existing conditions to
allow contra-indication (may include supporting clinical
evidences such as diagnostic results) checks
(may include genetic profile in future)
eMM Key Concepts and Definitions

Medication Management Plan

A structured, formally defined scheme of patient medication
management strategies and actions, including:
 Patient’s demographics, problems/diagnoses and pre-existing
conditions (including allergies and intolerances)
 List of medications
 Indications, actions, contraindications, precautions and
managed contraindications where applicable
 Patient preferences; failed therapy
 Medication [supply and administration] schedules where
applicable/necessary
 Ongoing medication management strategies/recommendations
 Next review due

May be stand alone or part of comprehensive care plan

Shared with other authorised health care providers
eMM Key Concepts and Definitions
 Medication Review
•
•
A process of systematic evaluation of a person’s
complete medication regimen and management of the
medications*1
Includes
 a comprehensive, accurate medication history of the patient
 careful examination of the purposes and actual use of
individual medications
 issues identified (including indications, actions, uses, effects
and side effects), and
 medication management recommendations
eMM Key Concepts and Definitions
 Medication Review Record
•
•
Comprehensive and authoritative reviewed list of all
medications (prescribe and over-the-counter) that a
patient is current taking
Includes recommendations regarding proposed
changes and ongoing medication management where
applicable/required
eMM Key Concepts and Definitions
 Medication Documentation
•
•
•
An IHE pharmacy white paper
Identify the information requirements and structure from the
various information sources on
 known prescription, dispenses and administration
Identify a standardised reference structure and semantics for
harmonized medication data documentation to support
 procuring, representing and viewing medication data from
various sources
 Clinical consultation and patient medication management
 Medication review and reconciliation
 Secondary uses: clinical effectiveness and cost effectiveness
analysis; epidemiological and bio-surveillance analysis;
management and executive decision analysis
eMM Key Concepts and Definitions
 Medication Reconciliation
•
Medication reconciliation is a formal process of obtaining and
verifying a complete and accurate list of each patient’s current
medicines. Matching the medicines the patient should be prescribed
to those they are actually prescribed. Where there are
discrepancies, these are discussed with the prescriber and reasons
for changes to therapy are documented. When care is transferred
(e.g. between wards, hospitals or home), a current and accurate list
of medicines, including reasons for change is provided to the person
taking over the patient’s care. Points of transition that require
special attention are*2
 Admission to hospital
 Transfers within hospital (e.g. ED to ward; ICU to ward, etc)
 From the hospital to home, residential aged care facilities or to
another hospital
eMM Key Concepts and Definitions
 Medication Reconciliation
•
The process of comparing various medications lists to
avoid errors such as transcription, omission, duplication
of therapy, drug-drug and drug-disease interactions*3
 Based on this definition, the medication reconciliation processes
include comparing and rectifying discrepancies as well as review
of medication management therapy
•
It refers to the process of reviewing the patient’s
complete medication regimen on admission, at transfer
and discharge, comparing it with the regimen being
considered for the new care setting. The process aims at
avoiding inadvertent inconsistencies in medication
regimen across transition in care*4