The Portland VA Creates Patient Safety Center of Inquiry

The Portland VA's medical technology team is testing the kiosk based Automated Patient History Intake Device (APHID) system in six of its locations.

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(PORTLAND, Ore.) - The Portland VA Medical Center will receive funding over the next two years to establish a Patient Safety Center of Inquiry (PSCI) to develop, implement and disseminate a medication reconciliation system to improve patient safety.

The Joint Commission, the health system accreditation body, adopted medication reconciliation as part of its National Patient Safety Goals in 2007. "Medication reconciliation is key to patient safety," said Dr. Sherrie Schuldheis, director of Portland's PSCI.

"Patients may be receiving medications from several healthcare providers for various conditions and we need to develop a system that can track that to ensure patient safety."

Simply stated; medication reconciliation allows a medical provider to have a complete list of medications a patient is taking. Many VA patients are co-managed or seasonally itinerant and receiving medications from multiple VA sites as well as Department of Defense hospitals and private facilities.

A complete list of medications will assist the healthcare provider in preventing adverse drug events associated with medication discrepancies. The PVAMC Patient Safety Committee Medication Reconciliation workgroup has already conducted a series of Health Failure Mode Effects Analysis to identify locations where medication reconciliation traditionally occurs. Typically, the reconciliation occurs when a patient is admitted, discharged, receives ambulatory care or transfers to another facility.

Dr. Blake Lesselroth, clinical informaticist at PVAMC, will lead the team developing and installing software tools directed at enhancing reconciliation activities.

"New technology solutions will be used that capitalize on the pre-existent health record infrastructure supported by the VA Vista/CPRS," Lesselroth said.

The VA Puget Sound Health Care System Informatics group will work with PVAMC developers to enhance existing software to include inter-facility messaging. This will allow medication list retrieval for patients irrespective of origin and allow reconciliation at the time a patient encounters a health care provider.

Portland VA's medical technology team developed "My HealtheVet," in 2005. It allows VA patients to access their own electronic health records online and designate others access as well. In addition, the team is testing the kiosk based Automated Patient History Intake Device (APHID) system in six of its locations. Patients use the kiosks to check in for medical visits, and verify their medications by viewing pictures of medications and medication names.

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