Reconciling Medications For Admission

This chapter describes how to reconcile your patients’ home medications when you are evaluating a course of treatment for admission to a hospital. These medications are typically pulled from a third-party system. Once you start the admission medication reconciliation process, you can reconcile your patient’s medications in one of the following ways:

• Reconciling with No Home Medications
• Reconciling with Home Medications
• Reconciling Home Medications after Completing Admission Medication Reconciliation

You can also view both previously reconciled and existing hospital medications. See Viewing Orders within Admission Medication Reconciliation.

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Starting Admission Medication Reconciliation

To begin the process of reconciling a patient’s home medications with your plan of care, you need to review the list to ensure its accuracy as follows:

• From the Patient List tab
• From the unreconciled home meds link
• From the Patient Search tab

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Reconciling Home Medications from the Patient List tab

1. Select the patient from your Patient List tab.
2. Start the Admission Medication Reconciliation using one of the following ways:
   • Selecting the Actions drop-down at the top right corner of the window, and then selecting Admission Med Rec under the Medication Reconciliation heading
   • Clicking the Home Meds link in the center column, and then clicking the Adm Med Rec button; or
   • Clicking the Orders link in the center column, and then clicking the Adm Med Rec button.
   The Admission Medication Reconciliation window opens and displays any home medications. The most recent visit is selected in the Med Rec for Visit field. If any discharge actions have been started, you will received a pop-up warning. Click the Yes button to continue with Admission Medication Reconciliation. If you click No, you will exit the Admission Medication Reconciliation window.
   If the patient has a finalized discharge plan in MEDITECH, you cannot access the Admission Medication Reconciliation window. A pop-up message will display saying there is a finalized discharge plan and Admission Medication Reconciliation is not available.
3. Review the list of medications under the Home Medications column and choose one of the following actions:
   • If the patient has no home medications, proceed to Reconciling with No Home Medications.
   • If the patient has home medications, proceed to Reconciling with Home Medications.

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Reconciling Home Medications from the Unreconciled Home Meds Alert

If you have any patients with unreconciled home medications on your patient list, you will see an alert at the top of your screen that displays the unreconciled home meds link.

1. Click the unreconciled home meds link next to the alert You have unfinished item(s): at the top of the screen. A pop-up dialog window displays with a list of patients with unreconciled home medications. You can also see a list of unreconciled home medications and the visit description for each patient.
2. Click the Admission Med Rec button under the Action column for a patient visit. The Admission Medication Reconciliation window opens and displays any home medications. The most recent visit is selected in the Med Rec for Visit field.
3. Review the list of medications under the Home Medications column, as well as any CDS alerts that display. Then, choose one of the following actions:
   • If the patient has no home medications, proceed to Reconciling with No Home Medications.
   • If the patient has home medications, proceed to Reconciling with Home Medications.

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Reconciling Home Medications from the Patient Search tab

If the patient is not on your patient list, you can search for the patient and then start the reconciliation process.

1. Select the Patient Search tab, enter the name of the patient and any other search criteria, and then click the Search for Visit button.
2. Select the patient from the search results.
3. Select the Actions drop-down at the top right corner of the search results pane, and then select Admission Med Rec under the Medication Reconciliation heading. The Admission Medication Reconciliation window opens and displays any home medications. The most recent visit is selected in the Med Rec for Visit field. If any discharge actions have been started, you will received a pop-up warning. Click the Yes button to continue with Admission Medication Reconciliation. If you click No, you will exit the Admission Medication Reconciliation window.
   If the patient has a finalized discharge plan in MEDITECH, you cannot access the Admission Medication Reconciliation window. A pop-up message will display saying there is a finalized discharge plan and Admission Medication Reconciliation is not available.
4. Review the list of medications under the Home Medications column, as well as any CDS alerts that display. Then, choose one of the following actions:
   • If the patient has no home medications, proceed to Reconciling with No Home Medications.
   • If the patient has home medications, proceed to Reconciling with Home Medications.

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Reconciling with No Home Medications

If the patient is not taking any medications, you can reconcile the patient as either having no known home medications or as unable to obtain the home medications from the Admissions Medication Reconciliation window as follows:

• Unable to obtain home medications - this comes into the system preselected located below the Home Med to Reconcile column if your system is configured for this. Click the Reconcile and Submit button to complete the reconciliation.
  You cannot deselect Unable to obtain home medications. To make a change, click the here link to add a home medication.
• No known home medications - you select the checkbox if it is not already preselected, and then click the Reconcile and Submit button to complete the reconciliation.
  If No known home medications is preselected, you cannot deselect it. To make a change, click the here link to add a home medication.

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Reconciling with Home Medications

If your patient is taking medications prior to admission, you must reconcile all these medications before admitting the patient unless your facility allows partial medication reconciliation (check with your administrator). You need to complete the following procedure to reconcile the medications:

1. Choose a course of action for each home medication (See Choosing a Course of Action for Hospitalization). If you are doing a partial medication reconciliation, only select a course of action for the home medications that you wish to reconcile.
   During any of the following actions, you must review and address any CDS alerts that display.
   While you decide the course of action for each home medication, you can also choose to do the following:
   • (Optional) Make changes to the Home Medications list if needed. See Changing the Home Medications List.
   • (Optional) Click the Existing Hospital Meds tab to review the patient’s list of existing hospital medications. See Reviewing a Patient’s List of Existing Hospital Medications.
   • (Optional) Click the Show Clinical Data button to review any lab results, test results, or other patient data without exiting the Medication Reconciliation process. See _Displaying Patient Information_in the Physician Portal User’s Guide for more information on all the available display options except for Home Medications and Discharge Orders. For information on the Home Medications link, see Viewing Home Medications in the Patient Data Display. For more information on the Discharge Orders link, see Reviewing Discharge Orders in the Patient Data Display.
   Click the Return to Med Rec button to return to the list of home medications.
   • (Optional) Discontinue an active existing order. See Discontinuing an Existing Order.
   • (Optional) Add a new hospital order. See Adding a Hospital Order.
   • (Optional) Delete a new hospital order. See Deleting a New Hospital Order.
   • (Optional) Modify a new or existing hospital order. See Modifying a New Hospital Order.
2. Review and resolve any medication interaction warnings and alerts. See Reviewing Medication Interaction Pop-up Warnings and Inline Alerts.
3. Reconcile and submit the medication(s) and any hospital orders. See Reconciling New Hospital Orders.

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Choosing a Course of Action for Hospitalization

For each home medication you need to decide to either stop, continue, or change it for admission. You cannot complete the reconciliation process until every home medication has a course of action unless your facility allows you to submit a partial medication reconciliation (check with your administrator). The Action for Hospitalization column displays a red highlighted background to indicate an action is required. Any home medication that you choose to continue or change will become a hospital order when you complete the reconciliation. If the home medication has an existing hospital order of the same therapeutic class, you will see different actions to choose from the standard Stop and Continue/Change (see Choosing an Action for a Therapeutic Class Match).

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Stopping a Home Medication for Admission

If you determine that a home medication is no longer required for admission, you can choose to stop it upon admission. Review and address any CDS alerts that display.

• Click Stop under the Action for Hospitalization column for the home medication. The red highlight in the Action for Hospitalization section is removed and the word Stop displays, and Stopped displays in the Hospital Orders column. If you stopped a home medication in error, you can undo the Stop order action as long as you do so prior to submission for reconciliation. You can undo the Stop order action in one of the following ways:
  • Hover over the Action For Hospitalization until radio buttons for Stop and Continue/Change appear and then select either select the radio button for Continue (see Continuing a Home Medication for Admission) or click the Change link (see Changing a Home Medication for Admission).
  • Click Edit next to the home medication to display the menu of options, and then select Undo Stop to return the home medication to its original state.

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Continuing a Home Medication for Admission

You can continue the home medication as a hospital order if there are no changes required.

1. Click the radio button next to Continue/Change under the Action for Hospitalization column next to the home medication. The medication order displays under the Hospital Orders column with the prefix New:. The order is then ready for reconciliation unless a warning or non-critical alert needs resolution.
   • If either the Order Search window or Order Details window displays, proceed to the next step.
   • If a home medication is a duplicate of an active existing order, the active existing order is continued by default and displays in the Hospital Orders column with the prefix Existing:. If you want to continue a home medication that has an active existing order, you must discontinue the existing active order (see Discontinuing an Existing Order), and then continue the home medication.
   If a home medication has a corresponding existing hospital order already placed in the Commure Pro system, the existing hospital order displays in italics to denote this along with the name of the ordering provider and the date/time it was placed.
2. If the Order Search window displays, your order does not have a valid route or a matching order. You must select the correct medication in the search results and complete any required fields in the Order Details window, and then click OK. If only the Order Details window appears, you have missing required information. Complete any highlighted required information, and then click OK.

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Changing a Home Medication for Admission

You can modify the home medication or choose a different medication for inclusion to the list of Hospital Orders upon admission. Review and address any CDS alerts that display.

1. Click the Change link in Continue/Change under the Action for Hospitalization column next to the home medication. The Order Search window displays any possible matching Formulary (including matching medications in the same therapeutic class) and Non-Formulary (if enabled) medications. You now have the ability to either change to a different medication in the same therapeutic class or modify the existing medication.
   If the search comes back with “No matches,” and you have the ability to add a medication order as custom “free text” order, then see Using Free Text to Add an Order; otherwise, see your system administrator.
2. (Optional) Select the Weight Based Medications Only checkbox if you only want to see this type of medication order.
   The Weight Based Medications Only checkbox only displays if your facility has weight based dosing functionality enabled.
3. Select the desired medication, using one of the following ways:
   • To modify one or more of the details of the existing home medication, select the same medication with the desired changes from the list of search results; or
   • To change to a medication in the same therapeutic class, select the desired new medication from the list of medications.
   If you choose a non-formulary medication, you may see a pop-up window requiring a reason for using a non-formulary medication. Select the reason and click Continue.
   If you select a medication that has all the required information completed, it is added to the Hospital Orders list with the prefix New: and a Delta icon displays to signify a change was made to the home medication order. If the Order Details window displays, proceed to the next step to complete your changes.
4. Enter any changed or new information into the Order Details window, and then click OK. For weight based dosing medication order changes, see Modifying the Order Details of a Weight Based Dosing Medication Order.

The medication order displays under the Hospital Orders column with the prefix New: and a Delta icon displays to signify a change was made to the home medication order.

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Choosing an Action for a Therapeutic Class Match

If there are no NDC, medication, brand, or generic matches between a home medication and the patient’s existing hospital medications, the system will determine if there are any therapeutic class matches. If a therapeutic class match exists between a home medication and an existing order for the patient, the Stop and Continue/Change radio buttons under Action for Hospitalization will change to Substitute w/Existing Order and Not Therapeutic Equivalents. Choose one of the following appropriate actions:

• Choose Substitute w/Existing Order to continue the home medication as the existing order.
• Choose Not Therapeutic Equivalents to unlink the home medication with the matched hospital order. A dialog box displays asking The system has linked this hospital medication to the home med as an equivalent drug. Do you want to permanently unlink these medications on the med rec screen? Click Yes to remove the link and switch back the Action for Hospitalization to the standard radio buttons of Stop and Continue/Change.
  Click No to cancel out of the action.

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Changing the Home Medications List

It is important to have an accurate list of home medications for an accurate reconciliation. If you determine that any medication is missing, incorrect, or mistakenly added, you can make changes to the patient’s list of home medications by either adding, correcting, or deleting a home medication.

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Adding a Home Medication

If you determine that the list of home medications is missing a home medication, you can add a new home medication as follows.

1. Click the Add button next to the Home Medications heading. If no home medications are listed, click the Click here to add a home med link. The Search for order window displays.
2. Enter the name of the medication in the Search field or select a medication from your Favorites list. If you choose a medication from your Favorites list, the medication is added to the list of home medications. If you enter a medication in the search box, continue to the next step.
   To keep the Search for order window open to add more medication orders, check Keep Window Open in the upper right corner of the Search for order window.
3. Select the correct medication from the list of medications.
4. Review and address any CDS alerts that display.
5. If the Order Details window displays, make changes as needed to the order and complete any incomplete required information (highlighted in red), and then click Done to add the medication. The medication is added to the bottom of the list of home medications with a prefix of New:.
   If you entered a new home medication in error and need to remove it, click Edit next to the home medication order, and then select Delete home med entered in error from the pop-up.

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Correcting a Home Medication

If you determine that some home medication information is not correct, you can modify it as follows:

1. Select the home medication under the Home Medications column or click Edit next to the home medication order, and then select Correct this home medication from the pop-up. The Order Details window displays with the current medication information.
2. Make the desired changes to the Order Details window, and then click Done.
   • If you edit a home medication that came from a third-party system, the original home medication gets crossed out and the revised medication is displayed under the original medication order.
   If you made an error and need to undo your changes to the home medication that came from a third-party, click Edit next to the home medication order, and then select Undo Modifications from the pop-up.
   You cannot permanently delete any home medication order that came from a third-party system from within Commure Pro. You must go to the third-party software and delete the medication.
   • If you revise an order that you added within Commure Pro Medication Reconciliation, the home medication order updates to display any changes.
   If you made a mistake and need to remove the home medication that you added, click Edit next to the home medication order, and then select Delete from the pop-up.

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Deleting a Home Medication Entered in Error

If you discover that a home medication was incorrectly entered, you can remove it as follows:

• Click Edit next to the home medication order, and then select Delete home medication entered in error from the pop-up.

The medication is removed from the Home Medications list.

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Discontinuing an Existing Order

If your patient’s home medication matches an existing order, you will see the existing order under the list of Hospital Orders with the prefix Existing:. No action is needed unless you wish to discontinue the existing order. You can choose to discontinue that order as follows:

1. Click Edit next to the Existing: order to display a pop-up.
2. Select Discontinue from the pop-up. The order displays as crossed-out with a prefix Discontinued:.
   If you discontinued the an order in error, click Edit next to the Discontinued: order and select Undo DC from the pop-up. The order is returned to its original state.

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Adding a Hospital Order

You can add more medication orders to your patient’s list of hospital orders. You may also add new non-medication orders or order sets. You can add a new order, repeat an existing order using the Order Again feature, or use free text to add an order that isn’t found using the search function.

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Adding a New Order

To add any type of new order to the list of Hospital Orders:

1. Click the Add button next to Hospital Orders column heading. The Search For Order window displays. You can choose one of the following ways to add an order:
   • Using the Favorites list, continue to Step 2.
   • Using the Search field, continue to Step 3.
   • Creating a free text order if you cannot find the order you want on the Favorites list or by searching, see Using Free Text to Add an Order.
   All new orders that you add will be listed in a new section called Additional New Hospital Orders, designated by a gray bar and displayed below the list of Hospital Orders. Each order will have a New: prefix.
   To keep the Search For Order window open to add more hospital orders, check the Keep Window Open checkbox in the upper right corner of the Search For Order window.
2. If you are adding an order or order set from the list of Favorites, select the appropriate category under Favorites and then the desired order or order set. One of the following actions occurs:
   • The order is added to the Additional New Hospital Orders section. The order is ready for reconciliation unless a warning or an alert needs resolution.
   • The Order Details window displays. Complete any required information, and then click Done to add the order to the Additional New Hospital Orders section.
   • The order set form displays if you choose an order set from your Favorites. Check the desired orders (may need to scroll to see complete form), including any highlighted required orders to create the desired set of orders, and then click Done with Order Set.
   The new orders display in the Additional New Hospital Orders section. The orders are ready for reconciliation unless a warning or an alert needs resolution.
   You may also see either the Order search triggered or additional orders added when you check an order in the order set form, depending on the requirements set up within the form. You can also modify an order on the form by selecting the order and making changes to the Order Details window.
3. If you are using the Search field to add an order, enter the name of the desired order or order set. As you enter the order into the Add Order search field1, a list of possible matches displays.
   If no matches are found, you may create a custom order using the Add as free text button if it is available. See Using Free Text to Add an Order; otherwise see your system administrator.
   1. (Optional) Select a tab for the desired category to narrow the search results if desired.
   2. (Optional) Select the Weight Based Medications Only checkbox if you only want to see this type of medication order.
   The Weight Based Medications Only checkbox only displays if your facility has weight based dosing functionality enabled.
   3. Select the order or order set from the search results. If the Order Details window displays with required information highlighted go to Step d, or if the order set form displays go to Step e.
   4. If the Order Details window displays, complete the required information (highlighted in red) and any other requirements, and then click Done.
   The order is added to the Additional New Hospital Orders section. The order is ready for reconciliation unless a warning or an alert needs resolution.
   5. If the order set form displays, check the desired orders, including any highlighted required orders to create the desired set of orders, and then click Done with Order Set.
   You may also see the Order search triggered or additional orders added when you check an order in the order set form, depending on the requirements set up within the form. You can also modify an order on the form by selecting the order and making changes to the Order Details window.
   The orders are added to the Additional New Hospital Orders section. The orders are ready for reconciliation unless a warning or an alert needs resolution.

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Repeating an Existing Order

You can repeat an existing lab or test when you check their results from within the Admission Medication Reconciliation window:

1. Click the Show Clinical Data button in the upper right corner of the Admission Medication Reconciliation window to view the results of a completed lab or test order.
   Click the Return to Med Rec button if you want to return to the Admission Medication Reconciliation window or click the Admission Med Rec button found in the Orders screen.
2. Click either Lab Results or Test Results in the center column, and then select the desired lab or test result.
3. Click Order Again and choose one of the following actions, depending on your choice of order:
   • If you choose to repeat a test, you have the following choices:
   • Order Details window displays. Complete any required information and click Done.
   • Test is added, no further action is required.
   Search For Order window displays if the order cannot be found. Choose the desired order, and complete any required information for the Order Details window, and then click OK if prompted.
   You are returned to the Admission Medication Reconciliation window, and the new order is added to the Additional New Hospital Orders section.
   • If you choose to repeat a lab, the Order Again window displays. Choose to repeat the entire panel or specific components, and then click OK.
   You are returned to the Admission Medication Reconciliation window, and the new order is added to the Additional New Hospital Orders section.

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Using Free Text to Add an Order

If you do not find any matches for your order using the Search function, you can create a free text order.

1. Click Add as free text in the search window. A dialog box appears with the possible order types available for custom orders.
2. Select the correct order type, such as Medications. A blank Order Details window displays.
3. Enter the name of the order in the Description field, complete the rest of the order details including any required information, and then click Done. The new order is added to a new section called Additional New Hospital Orders, designated by a gray bar and displayed below the list of Hospital Orders. The order will have a New: prefix.

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Deleting a New Hospital Order

If you decide you no longer need a new hospital order (prior to submitting it), you can delete the new order as follows:

• Click Edit next to the New: hospital order, and then select Delete from the pop-up.

The hospital order is removed. If the hospital order was an action for a home medication, you will need to provide a another course of action for that home medication.

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Modifying a New Hospital Order

If you need to change any of the unsubmitted new hospital orders, you can modify the order as follows:

1. Select the order listed under either the Hospital Orders or Additional New Hospital Orders column in one of the following ways:
   • Click on the new hospital order that you wish to modify, or
   • Click Edit next to the hospital order, and then select Modify from the pop-up.
   The Order Details window displays.
2. Make any desired changes, and then click Done.
   For weight based dosing medication order changes, see Modifying the Order Details of a Weight Based Dosing Medication Order.
   The modified New: order displays under either the Hospital Orders (for continued or changed home medications) or Additional New Hospital Orders (for new orders that were not a home medication) column. If there was a change to a New: hospital order that was a home medication order, the Delta icon displays to signify a change was made. The order is ready for reconciliation unless a warning or an alert needs resolution.

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Reviewing Medication Interaction Pop-up Warnings and Inline Alerts

Whenever you add a medication hospital order, such as continuing or changing a home medication or adding a new order, you may see an immediate warning pop-up or an alert appear next to the hospital order. You must resolve any pop-up warnings when they occur, and you should review all alerts for possible further action especially if the interaction is labeled Severe.

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Resolving Medication Interaction Pop-up Warnings

Clinical Decision Support (CDS) warnings typically appear when the medication order triggers a severe interaction such as drug-allergy interaction or drug-drug interaction but could also appear for moderate interactions depending on how your Commure Pro system is configured. You must resolve any pop-up warnings as follows:

1. Review the CDS warning(s).
   When a CDS warning displays to alert providers of one or more interactions (either drug-drug or drug-allergy) on the right-hand side of the screen, the order list on the left automatically scrolls to display the first of the medication orders identified in the interaction.
2. Decide if you want to continue with the order or cancel the order.
   If you need to view the patient’s clinical data, such as a lab result, click the Show Clinical Data button in the upper right corner of the window to exit the Interaction window and enter the Patient Data Display screen. When you are done with reviewing the patient’s clinical data, click the Return to Med Rec button in the upper right corner of the Patient Data Display screen to return to the Medication Reconciliation window.
   • Click Don’t Order at the bottom of the window if you want to cancel the new order.
   The Warning window closes and you are returned to the Medication Reconciliation window.
   • If you wish to continue with the new order, you must resolve all the issues listed in the left column using one of the following actions as is appropriate:
   • Click the DC icon to discontinue an interacting existing medication, or click Delete New Order to delete the interacting new order, and then click OK.
   You can restore a discontinued order by clicking Undo
   • Select Provide an override reason, then choose a reason from the list, and then click OK.
   • Complete the Order Details window if there are missing required fields, and then click OK.
   If an Info pop-up displays, click OK to continue. When all the issues are resolved, the order is added as a new order.

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Resolving Medication Interaction Inline Alerts

Medication interaction inline alerts generally indicate moderate interactions and duplications, however, your Commure Pro system may be configured to show all interactions - moderate and severe as an inline alert. Therefore, you should review all alerts to determine if further action is required as follows:

1. Click the inline alert link to display the complete text of the alert.
2. After reviewing the alerts, decide if you need to make any changes or if you want to proceed with no changes.
   • If no changes are required, click Close. No further action is required to resolve the alerts.
   • If changes are required, click Close and then proceed to the next step.
3. If the order needs to change, determine if you need to modify or delete the order. After you resolve all inline alerts, you are ready to complete the reconciliation process.

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Reconciling New Hospital Orders

After you have decided upon an action for home medications, added any new hospital orders, and resolved any interaction alerts, you are ready to complete the reconciliation process.

1. Click Reconcile and Submit at the bottom of the Admission Medication Reconciliation window to reconcile the medication orders and submit all the hospital orders for routing.
   If you click Cancel at the bottom of the Admission Medication Reconciliation window, the window closes, and none of your changes are saved.
   If your facility allows you to submit a partial medication reconciliation and you have chosen to do this, you will see a warning message display when you select Reconcile and Submit. Click the Submit Partial Med Rec button if you wish to submit a partial medication reconciliation with only the medication orders that have a course of action selected. Click the Go Back button if your submission was done in error. If your facility requires you to enter an additional electronic signature and/or if Co-Signature is implemented, you will see a Signature dialog display. Proceed to the next step; otherwise the Admission Medication Reconciliation window closes and you are returned to the Patient Data Display window. All orders including continued or changed home medications are then routed to appropriate destination (for example, a printer for future action) and also added to the patient’s Existing orders for the current visit list (click on the Orders link display).
2. Enter one of the following depending on what Signature dialog displays:
   • Enter your password or PIN, and then click OK.
   The Admission Medication Reconciliation window closes and you are returned to the Patient Data Display window. All orders including continued or changed home medications are then routed to appropriate destination (for example, a printer for future action) and also added to the patient’s Existing orders for the current visit list (click on the Orders link display).
   • Enter the name of the provider who can co-sign the orders for you (using either the Search field or Recently Selected link), and then click OK.
   If only one provider can co-sign orders for you, this name will automatically populate in the co-signing field. You cannot search for another provider.
   The Admission Medication Reconciliation window closes and you are returned to the Patient Data Display window. All orders including continued or changed home medications are then routed to appropriate destination (for example, a printer for future action) and also added to the patient’s Existing orders for the current visit list (click on the Orders link display). All medication orders submitted in Commure Pro will display in_italics_ when viewing a printout or existing orders in the Commure Pro system.
   • Enter your password or PIN, enter the name of the co-signing provider (using either the Search field or Recently Selected link), and then click OK.
   If only one provider can co-sign orders for you, this name will automatically populate in the co-signing field. You cannot search for another provider.
   The Admission Medication Reconciliation window closes and you are returned to the Patient Data Display window. All orders including continued or changed home medications are then routed to appropriate destination (for example, a printer for future action) and also added to the patient’s Existing orders for the current visit list (click on the Orders link display).
   When orders are routed to a co-signing provider, they are routed as either a printed order sheet or made available in whatever system your facility uses for managing order deficiencies depending on how your system is configured.
   A record of all your submitted orders for admissions may be routed to a printer (determined by your administrator) and the printed form will display a list of the patient’s home medications and any associated hospital order, a separate list of any discontinued home medications, and a list of new hospital orders. Each list will display an electronic signature of the ordering physician.

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Reconciling Home Medications after Completing Admission Medication Reconciliation

If your patient should have home medications added after you submitted and reconciled them for admission or only a partial medication reconciliation was completed, you can return to the Admission Medication Reconciliation window and reconcile these home medications as follows:

1. Start the Admission Medication Reconciliation process as described in Starting Admission Medication Reconciliation.
2. Reconcile any new or existing home medication as described in Reconciling with Home Medications.

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Saving as a Draft in Admission Medication Reconciliation

If you should need to stop and save any work done in Admission Medication Reconciliation, you can click the Save as Draft button. Once you click the Save as Draft button, you will exit the Admission Medication Reconciliation window and return to the Patient Data Display. To return to your saved work, select the patient and then select Admin Med Rec from the Actions menu in the Patient Data Display or click on the unfinished orders link and click the Continue button for the patient. If you log out with draft orders saved, you can choose any of the following actions:

• Click Continue Ordering to return to the Order Entry window to either complete (Sign/Submit) the draft orders or remove (Cancel) the draft orders. To resume Admission Medication Reconciliation, select the patient from the patient list and then select Admin Med Rec from the Actions menu in the Patient Data Display to enter the Admission Medication Reconciliation window with the saved unsubmitted orders.
• Click Keep Orders and Exit Commure Pro to keep the orders saved as drafts for a later order session. Log back in to resume Admission Medication Reconciliation for this patient, select the patient from the patient list and then select Admin Med Rec from the Actions menu in the Patient Data Display to enter the Admission Medication Reconciliation window with the saved unsubmitted orders.
• Click Discard Orders and Exit Commure Pro if you do not wish to keep the orders for a future session.

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Viewing Orders within Admission Medication Reconciliation

You can review any existing hospital medication orders or previously reconciled medication orders within the Admission Medication Reconciliation window.

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Reviewing a Patient’s List of Existing Hospital Medications

If your patient has existing hospital medications, for example, from an emergency room visit, you can review this list from within the Admissions Med Rec window as follows:

1. Click the Existing Hospital Meds tab next to the Home Meds to Reconcile tab in the upper left corner of the window. The screen displays the Existing orders list along with the Start date and time and the Status.
   Any medication orders submitted in Commure Pro will display as italicized.
2. Click Back, or click the Home Meds to Reconcile tab, to return to the main screen. The tab changes to the Home Meds to Reconcile tab.

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Reviewing Previously Reconciled Home Medications

While reconciling home medications added after the initial reconciliation for admission, you can review all the previously reconciled home medications and their submitted action as follows:

1. Click the Previously Reconciled tab in the Admission Medication Reconciliation window, located between the Home Meds to Reconcile tab and the Existing Hospital Meds tab. Depending on how the home medications were reconciled, you will see a list of reconciled home medications or an entry stating either No known home medications or Unable to obtain home medications. Any home medication that was deleted will also display with a strike-through and Action for Hospitalization will be blank. You cannot make any changes to submitted home medications. You can restart a discontinued home medication using the Continue Home Medications feature. See Restarting a Discontinued Home Medication for more information.
2. Click Back, or click the Home Meds to Reconcile tab to return to the Home Meds to Reconcile screen.