QUESTION: Do your MAs do medication reconciliation?

Hi there -
We are re-examining some of our MA workflows as we transition our EMR from NextGen to Epic. Some of our sites have MAs doing some medication reconciliation or medication review but many of our sites have concerns about MAs taking this on. I wonder whether this is the most efficient use of MA time given the range of skill level among our MA team members and the fact that providers will generally be reviewing this again during the visit.

What are other organizations doing?

thanks!
Tanya

Hi Tanya,

Our MA’s (at Axis) were initially tasked with reconciling medications, however, shortly after starting they were running into complex scenarios and therefore, we reassigned the task to providers and nurses.

Another comment I wanted to make on a separate/relative topic is that we did not reconcile medications that were inactive (this is only relevant if you plan to do the same). With our HealthPAC deadline coming up, this has created a challenge for our QI team because our report identifies patients who had a positive Hepatitis C result, but is unable to identify those same patients who completed medication treatment in the past (many of which whose respective medication is inactive).

If your list of patients with positive Hep-C results is low, then we can suggest what we are planning to do to avoid this gap in reporting. However, if you do have a long list of patients with positive results AND completed treatment/has inactive medication in NextGen, then you may want to consider a solution for this.

Hope this helps,
Afsheen

Thanks, Afsheen! I’m not sure how we are reporting on treatment of our Hep-C positive patients, but I will let our QI team know that you are a potential resource if they run into reporting trouble!

We were just talking about this in a meeting today! At Salud Para la Gente, our MAs will add on any reported medications but we’ve had long discussions around whether MAs should remove medications. (We are on Greenway Intergy EHR.) We have come to a compromise with MAs being allowed to remove exact duplicate meds and any antibiotics >1 yr old (so that providers can see what has been rx’d in the past). At my prior clinic (which was on Epic), MAs did perform med rec and would make notes as needed in relevant medications that would then show up in the provider view as highlighted in yellow so that providers could easily view comments (e.g. taking every other day, taking 1/2 dose, not taking, etc) and then providers would be responsible to change/delete medications off the med list.

Good luck with the transition!

Mai

Greetings,

At the LA LGBT Center, any Medication Reconciliation that requires entering the medication in the EMR is done by an RN or PCP (MD, DO, PA, APRN) ; this is done for new patients before their first provider visit or when they are transitioning care i.e., hospital discharge.

We’ve piloted MAs reviewing the active medication list in the EMR when “rooming” the patient. The MA reviews the medication by clicking on it and the medication is then added to the visit encounter but the provider still completes the process by clicking on the “RECONCILE” tab in the EMR.

We have not implemented this with all care team MAs and have recently put the pilot on hold due to our care team restructure.

Here is a MR resource: http://www.ihi.org/Topics/ADEsMedicationReconciliation/Pages/default.aspx

Best of luck!

Louis

We did have the MAs doing the medication reconciliation, but many of the providers were ended up doing it again themselves because they’re the only ones that can discontinue medications that are no longer relevant or the patient is no longer taking. We are starting to have the providers do it as part of their workflow.