Interact J Med Res. 2016 May 16;5(2):e14. doi: 10.2196/ijmr.5462.

An Observational Study to Evaluate the Usability and Intent to Adopt an Artificial Intelligence-Powered Medication Reconciliation Tool.

Interactive journal of medical research

Ju Long, Michael Juntao Yuan, Robina Poonawala

PMID: 27185210 PMCID: PMC4904823 DOI: 10.2196/ijmr.5462

Abstract

BACKGROUND: Medication reconciliation (the process of creating an accurate list of all medications a patient is taking) is a widely practiced procedure to reduce medication errors. It is mandated by the Joint Commission and reimbursed by Medicare. Yet, in practice, medication reconciliation is often not effective owing to knowledge gaps in the team. A promising approach to improve medication reconciliation is to incorporate artificial intelligence (AI) decision support tools into the process to engage patients and bridge the knowledge gap.

OBJECTIVE: The aim of this study was to improve the accuracy and efficiency of medication reconciliation by engaging the patient, the nurse, and the physician as a team via an iPad tool. With assistance from the AI agent, the patient will review his or her own medication list from the electronic medical record (EMR) and annotate changes, before reviewing together with the physician and making decisions on the shared iPad screen.

METHODS: In this study, we developed iPad-based software tools, with AI decision support, to engage patients to "self-service" medication reconciliation and then share the annotated reconciled list with the physician. To evaluate the software tool's user interface and workflow, a small number of patients (10) in a primary care clinic were recruited, and they were observed through the whole process during a pilot study. The patients are surveyed for the tool's usability afterward.

RESULTS: All patients were able to complete the medication reconciliation process correctly. Every patient found at least one error or other issues with their EMR medication lists. All of them reported that the tool was easy to use, and 8 of 10 patients reported that they will use the tool in the future. However, few patients interacted with the learning modules in the tool. The physician and nurses reported the tool to be easy-to-use, easy to integrate into existing workflow, and potentially time-saving.

CONCLUSIONS: We have developed a promising tool for a new approach to medication reconciliation. It has the potential to create more accurate medication lists faster, while better informing the patients about their medications and reducing burden on clinicians.

Keywords: adverse drug event; decision making, shared; medication adherence; medication errors; medication reconciliation; patient medication knowledge

References

1. J Hosp Med. 2012 May-Jun;7(5):396-401 - PubMed
2. J Am Med Inform Assoc. 2009 May-Jun;16(3):300-4 - PubMed
3. J Grad Med Educ. 2015 Sep;7(3):407-11 - PubMed
4. J Am Med Inform Assoc. 2014 Feb;21(e1):e157-62 - PubMed
5. J Biomed Inform. 2012 Aug;45(4):613-25 - PubMed
6. Ann Pharmacother. 2009 Oct;43(10):1667-75 - PubMed
7. Arch Intern Med. 2012 Jul 23;172(14):1057-69 - PubMed
8. Ann Intern Med. 2013 Mar 5;158(5 Pt 2):397-403 - PubMed
9. JMIR Res Protoc. 2015 Oct 19;4(4):e116 - PubMed
10. Ann Fam Med. 2010 Sep-Oct;8(5):410-7 - PubMed
11. Nurse Educ Today. 2014 Feb;34(2):185-90 - PubMed
12. Int J Qual Health Care. 2015 Dec;27(6):424-42 - PubMed
13. AMIA Annu Symp Proc. 2013 Nov 16;2013:1150-9 - PubMed
14. Ann Intern Med. 2012 Sep 18;157(6):417-28 - PubMed
15. BMC Health Serv Res. 2012 Jun 21;12:170 - PubMed
16. JAMA. 1997 Jan 22-29;277(4):307-11 - PubMed
17. Basic Clin Pharmacol Toxicol. 2013 Jun;112(6):359-73 - PubMed
18. Am J Respir Crit Care Med. 2010 Mar 15;181(6):566-77 - PubMed
19. Qual Saf Health Care. 2009 Oct;18(5):402-7 - PubMed
20. P T. 2013 Jun;38(6):305 - PubMed
21. AMIA Annu Symp Proc. 2011;2011:1252-60 - PubMed

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• Journal Article