Taiwan's National Health Insurance Administration PharmaCloud provides cross-institutional medication access to reimbursed medication records to support best possible medication history (BPMH) compilation. However, its utility among internal medicine inpatients, who typically present with complex regimens and frequent medication changes, remains understudied. This study aims to evaluate the impact of PharmaCloud integration on pharmacist-led medication reconciliation (MedRec) efficiency and error detection among internal medicine inpatients at both admission and discharge. The non-randomized, single-center study was conducted from May to November 2024 at the Far Eastern Memorial Hospital in Taiwan. Internal medicine inpatients taking at least one pre-admission chronic medication were enrolled and assigned to standard medication reconciliation protocol (control) or PharmaCloud-integrated medication reconciliation (experimental). Best possible medication history compilation time was recorded across two stages: preparation and interview. Medication discrepancies were identified at admission and discharge and classified as intentional or unintentional.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
93
The intervention entailed supplementing in-house electronic medical record with data from PharmaCloud, a platform launched by Taiwan's National Health Insurance Administration to enable cross-institutional access to reimbursed medication records.
Far Eastern Memorial Hospital
New Taipei City, Taiwan
Best possible medication history compilation efficiency
The first outcome measure was best possible medication history (BPMH) compilation efficiency, which was measured in minutes as three metrics: preparation time (stage 1), measured from the start of electronic medical record (EMR) and PharmaCloud review to the completion of the preliminary BPMH; interview time (stage 2), measured from the start to the end of the face-to-face interview; and total BPMH compilation time, the sum of stage 1 and 2.
Time frame: From patient's time of hospital admission to 72 hours post-admission.
Medication error detection rate
Medication error detection rate was defined as the proportion of participants with at least one identified unintentional discrepancy at either admission or discharge. All identified discrepancies were categorized as either intentional or unintentional, depending on whether or not the medication changes were consciously made by the prescribers, respectively.
Time frame: Admission: Unintentional discrepancies identified from patient's time of admission to 72 hours post-admission. Discharge: Unintentional discrepancies identified immediately prior to patient's departure from the facility.
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