Covenant Medical Center in Saginaw, MI, recently used artificial intelligence (AI)-driven technology to protect staff and improve the quality of care for patients in its emergency care unit, completely automating the medication reconciliation process.
Previously, medication reconciliation required a pharmacy technician to interview patients face to face about their medication history, explains Rebecca Sulfridge, PharmD, clinical pharmacist specialist in emergency medicine at the hospital. That process became more difficult with COVID-19, as it was not practical for a pharmacy technician to interact closely with so many patients — sometimes dozens per day.
“My technicians typically are not trained on the use of personal protective equipment [PPE], and we had a shortage of that gear, too. At first, when COVID-19 hit, it was hard to tease out the people who might be sick and at highest risk of exposing our technicians. We had to wear PPE in every room with every patient,” Sulfridge shares. “That created a real barrier for our technicians to be able to do their jobs the way they did it prior to COVID-19.” The pharmacy technicians also relied on calling physician offices and pharmacies to gather information about a patient’s medications. Still, face-to-face interviews were a vital component that could not be skipped without replacing it with another way to gather data.
Sulfridge and other hospital leaders studied ways to change the workflow for medication reconciliation. They decided to integrate a software solution into its electronic health record. (Covenant Medical Center used technology from DrFirst, headquartered in Rockville, MD, but similar products are available from other manufacturers.) The software solution gathers information on medications during the intake process, using AI to probe for the most complete information, and compiles it in the electronic health record (EHR), asking many of the same questions that the pharmacy technicians would ask but eliminating the need for another employee to be exposed to the sick patient.
“We had the technology available to us prior to COVID-19, but we had not implemented it on any scale for medication reconciliation,” Sulfridge says. “By implementing it as the primary way we do medication reconciliation, our technicians were able to see more patients, and we were still able to offer this important service to the medical center.”
The technology solution has provided medication reconciliation results consistent with the previous face-to-face interviews, Sulfridge adds. In addition to reducing the exposure to patients during the pandemic, the technology has saved staff 10 minutes or more per patient, Sulfridge reports. Even if the hospital returns to some level of face-to-face medication reconciliation when the virus risk is lower, the success of the technology probably will result in some workflow changes to make the process more efficient.
“Changing workflows is always scary. When you have an established workflow that works, it’s not always easy to ... make that change, to say we’re going to do something different to try to get the same result,” Sulfridge says. “We did that, and we’re happy with the results. I’d suggest people not be afraid to use technology to your advantage to reduce how much time you’re spending in a patient room.”
- Rebecca Sulfridge, PharmD, Clinical Pharmacist Specialist, Emergency Medicine, Covenant Medical Center, Saginaw, MI. Phone: (989) 583-0000.