TABLE 3.

Multistakeholder Medication Expert Interview Key Themes

Theme	Quotes
Time constraints	“Even though we should do [medication reconciliation], I try to do it for every single patient, but it's not being done as thoroughly as we'd like because of the time crunch.” (Expert 2) “I think one of the barriers perhaps to medication safety is just the volume of prescriptions that are being processed at the pharmacy level. So, again, just not having that time to really talk to the patient.” (Expert 3)
Limited communication among clinicians, pharmacists, and insurance companies	“In some cases, the pharmacist can communicate to us [through the EHR] but we can't communicate directly back to the pharmacist. Even when I can communicate directly back to the pharmacist, I'm never assured that segment actually works. So, I don't feel like we have a two-way communication with the pharmacy.” (Expert 1) “I think the biggest one really that stands out is just the [communication] delays between the pharmacy and the doctor's office and even between the insurance company and us. For some of the medications that aren't covered, the patient will decide to pay out of pocket, but if that's not an option, then they'll just be without their medications for a couple of days while we wait to hear back from their insurance company.” (Expert 3)
Issues with EHR design	“You'll get a warning for basically any medicine you prescribe. There's definitely a warning for anything and then you just can't read them all. I think that's the problem any EHR-based thing.” (Expert 5) “The pull-down field in our EHR is so poorly designed that I think it probably actually leads to delays in treatment in some cases. It's not designed in a way to help the clinician get to the most generic and widely available type of that medication that's most likely to be covered by all insurance types. So, I think we're constantly putting in a weird form of medication that then goes to the pharmacy, it gets bounced back to us, it takes a while for us to figure out what happened, we don't know what's wrong with it. I think that there's probably a lot of delays in getting the patient the right medications, in part because of some of the flaws of our EHR.” (Expert 1)