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Electronic medication records could save billions in health care costs - and lives | COMMENTARY

One of the scariest things patients say in the pharmacy is, “I don’t know what medications I’m taking or what they’re for. My doctor prescribed them, so I just take them.”

Of course, patients’ records are in the pharmacy system, but only for medications dispensed at that chain. If a patient gets some medications at Walgreens and some at CVS, there is no way for the staff at Walgreens to know what the patient gets at CVS, and vice versa unless the patient is able to tell them.

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And what if the patient also received a medication from the emergency room? The staff at the hospital has no way of knowing what patients are taking at home unless the patient tells them, or they spend a lot of time they do not have on the phone with various pharmacies. And what if the patient gets the medication wrong?

According to the U.S. Department of Health and Human Services, adverse drug events account for over 3.5 million physician office visits, 1 million emergency department visits and 125,000 hospital admissions each year. Adverse drug events include anything from harmful drug and allergic reactions, and overdoses in patients to medication errors made by medical professionals. According to a study published by the American Medical Informatics Association, all of those visits and admissions cost between approximately $1.6 and $5.6 billion dollars each year.

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With health care costs increasingly in the forefront of people’s minds, wasting billions of dollars for something completely preventable seems ridiculous. One solution? An electronic medication record that all medical professionals can access to see what patients have been prescribed and when.

There is already precedent for this type of record. Maryland has the Prescription Drug Monitoring Program (PDMP), which is used to monitor all “controlled dangerous substances” that are dispensed, including commonly abused drugs like Oxycodone, Percocet, Xanax and Adderall. Prescribers are required to report information about which drug was dispensed and in what quantity, what patient it was dispensed to, and the prescriber’s Drug Enforcement Administration registration number. PDMP was set up to identify and prevent prescription drug abuse, but pharmacies also use the information to determine if there are interactions between medications patients are taking that can cause serious side effects or even death.

PDMP is a great tool that pharmacies, hospitals and primary care physicians alike have access to, but only if the patient is taking medications considered “controlled dangerous substances.” What about medications for heart disease, diabetes or cholesterol? They aren’t on there. And yes, there can be interactions between those types of medications too.

Enter a universal electronic medication record.

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Say Mr. Smith gets Amlodipine from CVS and Zoloft from Walgreens? The pharmacists at both locations can see both medications on the record. Mr. Miller’s primary care physician changes the strength of his medication while she monitors his thyroid levels? The pharmacy can see which of the three strengths on his profile is most current even though he reordered the incorrect one. Ms. Jones goes to the emergency room because her blood sugar is high? The doctor can see what type and dosage of insulin she typically takes, and her primary care physician can see anything prescribed by the emergency room doctor and talk to her about ways of managing her levels more appropriately — and in a less expensive way.

And, perhaps most importantly, Mr. Taylor is complaining of pain. He is taking a blood thinner regularly, but forgets to tell the urgent care doctor. Thanks to the universal electronic medication record, the doctor knows not to prescribe him aspirin or ibuprofen because the interaction between the medications could kill him.

While PDMP is extremely useful for preventing prescription drug abuse and monitoring potential deadly drug interactions, it’s incomplete. According to the Kaiser Family Foundation, almost 4 billion prescriptions were dispensed in the U.S. in 2019. At last count, 24% of Americans are taking three or more prescription drugs and 13% are taking five or more, so we are expecting a lot of patients to remember the exact names, strengths, and dosages of their medications.

With a universal electronic medication record, the guesswork can be removed, many of the adverse drug events can be prevented, lives can be saved, and potentially billions of dollars can be allocated to more important uses each year.

Kristin DiNoto (kdinoto09@gmail.com) is a pharmacy technician.

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