Any medication, when used incorrectly, can be dangerous. Mobile Integrated Healthcare-Community Paramedicine (MIH-CP) teams are working to implement medication reconciliation, a process that improves care and safety for patients and their families. Medication reconciliation in MIH-CP is like balancing a checkbook or conducting a store inventory. It involves a thorough review of a person’s medication history to determine which medications they are currently taking, when they were prescribed, and whether the patient is taking any drugs that may not be documented in their health record.
Reconciling medications is critical for patient safety. It not only ensures that physicians aren’t accidentally prescribing a drug a person shouldn’t take, but it also gives them confidence in developing a treatment plan that won’t be undermined.
Why Medication Reconciliation is So Important (And How Mobile Integrated Healthcare Can Help)
In the medical field, physicians are trained to look out for Adverse Drug Events (ADEs). These ADEs can occur for many reasons, but one of them is a lack of organization and understanding around a medication. These are preventable conditions, which is why it’s so critical that health teams take care when reconciling medication history.
To illustrate how things can go wrong, consider the following scenario: A woman named Mary has been taking pain medications for many years to manage back pain. However, her doctor recently retired, and she’s now looking for a new physician.
Eventually, she finds a new doctor. During her first appointment, she tells her physician about all her conditions and the medications she’s taking. However, she fails to mention that she still has a prescription for pain medication from her last physician. As a result, her new doctor prescribes additional pain medication and instructs her to take it in the morning.
When Mary goes home, she realizes she still has an entire bottle of her old pain medication, which her previous doctor instructed her to take at night. Should she take both?
Situations like this can become very dangerous very quickly. In the next few sections, we’ll discuss more dangers associated with loose medications and outline how MIH-CP can be a force for proper medication reconciliation.
How MIH-CP programs help medication reconciliation and safety:
- Ensuring Medications are Easily Accessible (And that Hardship Doesn’t Prevent Access)
- Providing a Platform for Medication History
- Documenting any Non-Prescription Home Medications or Substances
- Ensuring Medications are Properly Stored (Refrigeration, Securely Locked, etc.)
Note: One of the main reasons medication management can get out of hand is that healthcare providers don’t always communicate with each other. This is a problem MIH seeks to solve. In the future, the hope is that a patient would never be prescribed a medication without their provider having a full picture of what they’re already taking.
MIH-CP Medication Reconciliation: Closing the Gap Between the Home and the Office
Even when patients try to be entirely truthful with providers, there can often be a significant gap between what’s happening at home and what they report to their doctors. Sometimes, this is as simple as a slip of the memory. Other times, people forget to account for others who have access to their medications.
MIH-CP tries to bridge this gap with common-sense medication reconciliation. When an MIH-CP enters a person’s home, they cannot only interview the patient but also take the time to perform a sweep of the home and document their findings. Often, these home visits yield many helpful tidbits of information.
As an example, say a patient lives with a roommate who also takes medications; the community paramedic can determine whether all meds are stored separately and whether they ever share (or could accidentally take) each other’s medications.
In this way, MIH-CP teams serve as the physician’s eyes and ears, closing the gap between the office and home and ensuring the utmost safety.
Mobile Integrated Health Teams Improve Pharmaceutical Safety by Ensuring the Medications are Easily Accessible (And that Hardship Doesn’t Prevent Access)
Whether it’s ensuring older adults won’t fall, equipping them with a button they can press to call 911, or ensuring easy access to their medications, MIH-CP teams seek to improve their patients’ lives wherever possible.
When it comes to medication reconciliation, one side of the coin is documentation (knowing what meds they are taking and what’s been prescribed), but the other side is easy access. What do we mean when we say this?
First, we mean the ability to safely access their medications. Are the meds stored in an upper cabinet in a room that poses a trip hazard? Does the patient have reliable transportation to get their prescriptions filled? These are the kinds of “small” things that are often overlooked.
Second, MIH-CP teams will ask who else has access to the patient’s medications. While this isn’t common, there are instances where someone close to the patient (perhaps a friend or family member) may take the patient’s meds.
This isn’t always nefarious (though it can be); sometimes the patient may want to share with a family member. It’s important that medications are documented and organized so any deviation in their use is noticed. MIH-CP teams will often ask patients directly about anyone else who may have access to their meds to determine whether there is any danger to the supply.
Finally, when we talk about access to medications, MIH-CP teams also consider accidents. For example, an older husband and wife both take similar medications and store them in similar containers on the same nightstand. Is there any possibility the medications could be mixed up? If so, the MIH-CP team might suggest storing medications in different containers and separate locations to avoid a mix-up.
Providing a Platform for an Easily Accessible Medication History: How Software Plays a Role In Medication Safety
When a physician decides to prescribe a new medication, they will consider what the patient is currently taking and what they’ve taken in the past. The physician will only know what the patient tells them and what is in the patient’s available health record.
MIH-CP teams seek to use robust software that allows them to track and document all medications a patient might be taking. One thing that sets MIH-CP teams apart is their use of an interoperable platform that will allow anyone who needs access to see the patient’s history.
Systems like this ensure that physicians have the most information possible when making decisions about which medications to prescribe.
Documenting any Non-Prescription Home Medications or Substances: They Often Go Unreported
Many people take substances that are not prescribed or reported. The community paramedic and their team will seek to reconcile all medications, not just those prescribed.
In some cases, this is as simple as checking how often a patient takes over-the-counter medications, such as ibuprofen, aspirin, and Tylenol. Other times, this is about making sure that any non-traditional substances are listed, including herbal remedies, specialized supplements, and any recreational drugs.
All of this information will influence a person’s health. For the best chance at living a healthy life, MIH-CP teams seek to reconcile all medications a patient may be taking, not just the ones they’ve been prescribed.
Mobile Integrated Health Paramedics Improve Safety by Ensuring Medications are Properly Stored
Medication storage is different from access. While these two things overlap, it’s important that MIH-CP teams understand the difference during medication reconciliation. When we talk about access, we’re referring to how easily the patient or others can physically reach their medications.
However, when we talk about medication storage, we’re referring to the specific requirements of that medication. For example, a medication like Nitro often needs to be stored in a light-blocking container. If the patient has been moving these meds into a plastic bag and storing them in broad daylight, the medication could lose its potency and fail to work properly.
Furthermore, some medications require refrigeration. If the medication is left out for too long, it could lose its effectiveness and lead to a negative outcome.
MIH-CP teams will assess how a patient stores their medications and ensure the environment meets the unique needs of the medications. Even small steps like this can make a big difference in improving medication efficacy and safety.
The Wrap Up: Why Medication Reconciliation is Such an Important Element of Mobile Integrated Healthcare
Medications are part of our lives. For this reason, it can be easy to become numb to the nuanced needs of different medications and how they should be taken. MIH-CP teams are working harder to ensure medication reconciliation becomes part of every patient’s care plan.
When medications are properly reconciled, physicians can be confident that their patients and their communities are as safe as possible.
Contact Julota to uncover how their software tools can help your MIH-CP team better track patient medications, improve safety, and reduce risk.
