Table 2.
Description of the Context, System, Implementation and Presence of Ideal Features of eMedRec Tools
| e-Tool | Author, country, year | Context |
Tool |
Implementation/Evaluation |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Description criteriaa | Description criteriab | Integrated into the workflow? | Linked to other electronic systems?c | Automatic highlighting of discrepancies? | Reason for stopping medication written? | Different possibilities for organizing medication lists? | Description criteriad | eMedRec process with reminder or mandatory?e | Other specific features associated?f | Use of different prototypes? | Usability evaluated? | Routine use? | Evaluation of users’ compliance with eMedRec? | ||
| The PAML Builder | Poon, USA, 20061 | >3 | >3 | + | • | – | ≥2 | + | + | + | + | + | |||
| Turchin, USA, 20082,7 | >3 | >3 | + | ≥2 | + | + | + | ||||||||
| Schnipper, USA, 20092,8 | >3 | >3 | + | • | – | ≥2 | – | + | + | ||||||
| A tool within the EMR for MedRec after hospital discharge | Schnipper, USA, 201132 | >3 | 2 | + | ◉ | + | ≥2 | ◉ | + | + | + | + | + | ||
| MedRec after hospital discharge | Tamblyn, Canada, 20127 | >3 | >3 | + | • | + | + | ≥1 | + | – | – | – | – | ||
| MedRec application | Cadwallader, USA, 20132 | 2 | >3 | – | • | + | + | NA | + | + | + | – | – | ||
| Twinlist | Markowitz, USA, 20111,2 | 0/1 | 2 | – | ○ | + | NA | + | + | – | – | ||||
| Plaisant, USA, 20139 | 2 | 2 | – | ○ | + | + | NA | + | + | – | – | ||||
| APHID | Lesselroth, USA, 20092,4 | >3 | 2 | + | • | – | ≥2 | + | + | + | + | ||||
| Lesselroth, USA, 200911 | > 3 | > 3 | + | ◉ | – | ≥2 | – | + | + | ||||||
| Lesselroth, USA, 20112,5 | > 3 | 0/1 | + | • | – | + | + | + | – | ||||||
| Lesselroth, USA, 201210 | > 3 | 0/1 | + | • | – | – | + | – | |||||||
| Lesselroth, USA, 20142,6 (patent) | NA | >3 | NA | • | + | + | NA | + | NA | NA | NA | NA | |||
| A MedRec view within the EHR displaying two columns | Vawdrey, USA, 20102,9 | >3 | 2 | • | • | + | – | + | + | ||||||
| MedRec application launched from within the EHR | Bails, USA, 200830 | >3 | 2 | + | • | – | ≥2 | • | + | – | + | – | |||
| Electronic pathway for MedRec | Lovins, USA, 201131 | >3 | NA | + | •/◉ | + | + | NA | ◉ | + | + | + | + | ||
| The Discharge Instruction element | Sherer, USA, 201133 | >3 | 2 | + | •/◉ | + | + | ≥1 | ○ | – | + | + | + | ||
| Interactive Patient Med List | Tripoli, USA, 20143,4 | NA | >3 | NA | • | + | + | + | NA | + | NA | NA | NA | NA | |
APHID, Automated Patient History Intake Device; CPOE, computerized provider order entry; e-tool, electronic tool; EHR, electronic health record; eMedRec, electronic medication reconciliation; EMR, electronic medical record; IT, information technology; MedRec, medication reconciliation; NA, not applicable. PAML = PreAdmission Medication List Builder.
+ = YES; – = NO (as reported by the authors). An empty box = not reported by the authors.
aDescription of the context: >3 criteria, 2 criteria, 0/1 criteria: Size, location, or academic status; Financial status, or past IT experience; Information about culture, teamwork, and leadership; Existing external factors: for example, regulatory requirements, presence in the external environment of payments or penalties, such as pay-for-performance or public reporting.
bDescription of the tool: >3 criteria, 2 criteria, 0/1 criteria: different functionalities included; what/how the tool interfaces with the EMR; what is required for the consumer to operate it. Description items had to be sufficiently detailed so that it could be “replicated.”
cLinked to ≥3 other systems = •; Linked to 1 or 2 other systems = ◉; Not linked to any other systems = ○ (eg, CPOE, EMR, pharmacy claim).
dDescription of the implementation: number of components beyond “staff education”: ≥2, ≥1, 0. Possible components are: description of barriers and facilitators, audit and feedback, presence of “champions” (quality improvement leaders) responsible for implementation, assessment of impact on workflow, and tailoring/change management.
eMandatory = •; Reminder = ◉; Nothing = ○.
fOther specific features associated: review appropriateness of medication, post-discharge communication with patient, and or with other healthcare provider (by e-mail/printed list), possibility to reconcile only part of the medication list, decision support functionality (not specifically related to medication reconciliation), existing of different way of presenting medication regimen to the different users according to the needs of each (physician, patient, pharmacist), section for drug event report via e-mail.