On FOCUS

by Michelle Schneider

Many of you know me as a self-proclaimed Medication Reconciliation geek. I wear that title with pride as I feel Medication Reconciliation is one of the most worthwhile initiatives we’ve seen from the Joint Commission ever. It’s about the patient, it’s about safety and it’s about making people better. It’s common sense. It’s not about insurance or money or any other tertiary benefit. Its simplicity is what makes it so worthwhile. For years I have immersed myself in the Joint Commission standards and have made it my business to ensure that we are doing all we can to automate the process.

Accreditation Canada has also recently posted their medication reconciliation requirement. While the underlying goal is of course the same, the methods, nomenclature and details differ from those set forth by the Joint Commission. I felt great pride in knowing that our product is flexible enough to handle these unique differences.

There could be no other way, really. With over 100 sites using our medication reconciliation product, there are over 100 ways to perform medication reconciliation. This is due to so many factors, including administration buy-in, the presence of physician champions, the use of physician extenders, pharmacy structure and resources as well as nursing participation and staffing levels. There is certainly more than one way to skin this cat! We must be able to move with grace and speed from one model to the other.

With MEDITECH’s varied platforms, it’s best to be prepared as you consider the move to 6.x. I was excited to get in there and get blown away. While I was pleased with the user interface and the hierarchical nature of the routines, I found myself frustrated by the fact that MEDITECH has decided how we will conduct care. There seems to be an underlying assumption that there is only one way to accomplish certain tasks. Medication reconciliation is one of those tasks. They have very specific routines that are designed for specific user types and it seems we have lost the option to be unique. There is no room for the hospitals that just need to do things a little differently. There is no room for the hospital whose administrators feel they must kowtow to the loudest benefactor, or the physicians who are threatened by technology or the pharmacy that is hanging by a thread just to fill med carts. Sometimes, we have to be creative to get the job done. Nobody puts MedRec in a box.

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