Medication Reconciliation
Physician/Provider Workflow
3/7/13
On Admission
• The Pre-Admit Medication List (PAML)
information may be collected by the nurse or
provider
• All areas of entry to hospital use same PAML
tool
– Emergency Department
– pre-op
– direct admit
• Provider electronically stamps signature in HEO
that list has been “acknowledged”
Provider acknowledgement screen
choose
one of
the
three
options
Pre-Admit Med List
• Accessible to providers in multiple
applications
– StarPanel
– HEO
– StarNotes
• Allows importing of PAML data into other
electronic documents
• Can be modified/updated at any time by
provider or nurse
Click the
arrow to
add to
Pre-admit
Med List
(right side)
–
Click Done
to save
PAML list
In HEO you can click on PAML in the upper left window and
view details of what the patient has reported as home
medications. You can also modify at any time.
During admission
• Orders for medications are entered in
HEO
• Upon transfer to another unit or level of
care medications are reviewed and
updated as needed
• HEO is the most up to date record of
current medications
At Discharge
• Physician/Provider responsibility to
reconcile medications
– Use Discharge Process to compose patient
letter, and comply with all discharge
requirements
– Compare home meds next to current inpatient
medications
• Indicate those to continue, stop and start
• Create prescriptions in RxStar
Review the Take Medications list imported from StarPanel Patient
Summary (right side). Add medications to the list from the
medication lists currently in HEO/Wiz & PAML (left side). To Stop
a medication click the red button. To add medication from HEO or
PAML list to home medication list, click the green button.
Once “Take Medication list” complete – Click Mark
DMR Done to save new list to StarPanel patient
Summary.
Click RxStar tab to complete new prescriptions for patient.
Tips for Providers Regarding
Medication Reconciliation
• Having the PAML be as accurate as
possible at the beginning (admission)
saves documentation steps at discharge
• PAML can be completed by physicians
and MUST be acknowledged electronically
• The final step at discharge is the MARK
DMR DONE – which saves the new
patient medication list to StarPanel
Questions?
• Please call the Help Desk at 3-HELP or
343-4357 with any questions or concerns.