Best Possible Medication History (BPMH)

In Meditech Expanse: Acute vs. AMB
 

Meditech allows the entering of a patient’s home medications into the system using a special Home Medications overlay. These overlays, while created with similar intent, differ slightly in both the Acute and Ambulatory environments in look, functionality and access.

Accessing the Home Medications Overlay

Acute

The Home Medications overlay can be accessed via several different points in the patient’s acute chart:

• Clicking on the Home Medications reference region of the acute eChart

• PCS status board - BPMH Status link in chart overview area

• Clinical Data routine from the Menu button in the patient’s acute eChart

Clicking on these links will launch the Acute Home Medications Overlay.

*** NOTE that the home medications overlay in an Acute module is titled “Home Meds” ***

AMB

The Home Medications overlay can also be reached via several access points in the Ambulatory module:

• Clicking on the Home Medications reference region of the ambulatory eChart, then clicking on the RED Reconcile button in the Orders section of the patient’s visit.
• Clicking on the Home Medications section within a document in the patient’s visit.
• Clicking on these links will launch the Ambulatory Home Medications/Reconcile Medications Overlay.Ambulatory module is titled “Reconcile Medications” ***

*** NOTE that “reconciling” medications in the Ambulatory module differs from an Acute module in that the user that is reconciling is NOT ordering medications, but rather compiling a medication history.***

Confirming Home Medications

Acute

When accessing the Home Medications overlay, the user will be presented with any existing home medication information collected on the patient in the past. Note that if the patient’s home medication information has NEVER been collected, it will show up as blank. In the event that the patient reports taking no home medications, or home medication information is unable to be collected, users may select “No Known Home Meds” or “Unobtainable” at that time.

When collecting home medication information, the user must indicate the sources of information used for collecting the patient’s home medication information by clicking on all of the applicable sources in the top section of the overlay (see RED box). Then each medication should be confirmed by selecting either the “taking” or “not taking” option for every medication listed (see PURPLE box). The last taken information should also be updated for each medication (see PINK box). Once all of the medications have been addressed, the user must then save the information by clicking on the SAVE button at the top right corner of the overlay.

AMB

When accessing the Home Medications overlay, the user will be presented with any existing home medication information collected on the patient in the past. Note that if the patient’s home medication information has NEVER been collected, it will show up as blank. In the event that the patient reports taking no home medications, or home medication information is unable to be collected, users may select “No Known Medications” or “Unobtainable” at that time (see RED box below).When home medications have previously been reported on a patient, they will appear in the Active Med List, with options to confirm whether or not the patient is still taking the medications. In the top right corner of the Active Med List box, there is an option to select “Confirm All” (see PURPLE box below), otherwise each medication can be addressed individually by clicking either the “Confirm” or “Stop” box in each medication field (see PINK box below). Note that when stopping a medication, the user must enter a reason. There is also a text box between the Confirm and Stop buttons that allows the user to enter a free text comment, as well as the last taken information for each medication (see RED box below). Once all of the medications have been addressed, the option to save the information becomes available where the “Back” button is located on the picture below.Adding Home Medications

Acute

Adding a home medication to a patient’s list begins by typing in the medication name in the Search field at the top of the Home Meds overlay. This will bring up a look-ahead list of possible matches, and the medication is selected by clicking on the correct option.

Once a medication has been selected, the medication order string overlay is opened. The user then clicks on the arrow next to the desired medication, revealing potential order string choices.The user then clicks on the box next to the closest order string, which then brings up the home medication entry screen, where the order string can be modified to reflect how the patient is taking the medication (if different from the selected order string), where any pertinent patient comments can be entered, and the last taken information entered. Once the user has inputted all of the relevant information, the user then clicks “Queue” to proceed to the next entry, or clicks “Queue & Exit” to return to the Home Meds overlay, where the new entries have been added.The user then clicks on the “Save” button when the home medication list is complete.

AMB

Adding a home medication to a patient’s list begins by clicking on the “Search Meds” button in the Active Med List section when in the Reconcile overlay of the patient’s Orders.Note that when the overlay is accessed via the Home Medications section of a document, the overlay will look slightly different, but functions in exactly the same way.This will open up the medication order string search overlay. The mediation name should be typed into the “Search Meds” box, then options will display once the user has hit the “enter” key on the keyboard. To view the potential medication order strings, click on the desired medication and a drop-down of order strings will appear.The user should then choose the closest order string to how the patient takes the medication, opening the medication order string overlay, similar to what is seen in the Acute module. The user can then modify the string as needed, enter pertinent patient comments, and document the Last Taken information. The user should then click on the “Queue” button to enter an additional medication, or click on the “Queue & Exit” button if they are done adding medications to the home meds list.Once all new medications have been added to the patient’s home medication list, and the user deems that the list is now complete, the user then clicks on the “Save” button to finalize the updated home medication list.The Manage Medications portion of the Orders Section of the patient’s chart will then be updated, and the reconcile button will now longer appear in a BLACK font.