An effort to improve electronic health record medication list accuracy between visits: patients' and physicians' response

Int J Med Inform. 2008 Mar;77(3):153-60. doi: 10.1016/j.ijmedinf.2007.03.001. Epub 2007 Apr 16.


Objective: To evaluate the efficacy of a secure web-based patient portal called Patient Gateway (PG) in producing more accurate medication lists in the electronic health record (EHR), and whether sending primary care physicians (PCPs) a clinical message updating them on the information their patients provided caused physicians to update the EHR medication list.

Methods: We compared the medication list accuracy of 84 patients using PG with that of 79 who were not. Patient-reported medication discrepancies were noted in the EHR in a clinical note by research staff and a message was sent to the participants' PCPs notifying them of the updated information.

Results: Participants were taking 665 medications according to the EHR, and reported 273 additional medications. A lower percentage of PG users' drug regimens (54% versus 61%, p=0.07) were reported to be correct than those of PG non-users, although PG users took significantly more medications than their non-user counterparts (5.0 versus 3.1 medications, p=0.0001). Providing patient-reported information in a clinical note and sending a clinical message to the primary care doctor did not result in PCPs updating their patients' EHR medication lists.

Conclusions: Medication lists in EHRs were frequently inaccurate and most frequently overlooked over-the-counter (OTC) and non-prescription drugs. Patients using a secure portal had just as many discrepancies between medication lists and self-report as those who did not, and notifying physicians of discrepancies via e-mail had no effect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Drug Information Services / standards*
  • Drug Prescriptions / statistics & numerical data
  • Drug Utilization Review*
  • Female
  • Humans
  • Male
  • Medical Records Systems, Computerized / standards*
  • Middle Aged
  • Physician-Patient Relations
  • Polypharmacy*
  • Primary Health Care / standards
  • Quality of Health Care