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Charting a Patient’s Medication Journey in Epic


If you ever needed to convince yourself of the benefits of switching from paper charting to an electronic medical record (EMR), try writing a complete discharge medication script for a patient who has been in hospital for two months with an ICU stay. You will need the patient’s full chart, a home medication list (hopefully it’s accurate) and the patient’s current medication administration record (MAR). Finding all of these orders in a paper chart can feel like a scavenger hunt.


I recently had a conversation with my father about EMRs and he was surprised to learn we still use paper charting at HHS. Having worked in the banking industry for decades, he could not help but compare how inefficient banking would be if all transactions were not fully documented electronically. Our patients may go through multiple medication changes during their hospital stay. Imagine if your bank had to dig through binders of paper charting to track your cash flow!


With Epic, documenting a patient’s medication history will be easier for physicians and safer for patients. If I do a great job of documenting a complete home medication history, it will save my colleagues from having to re-enter the entire list again when they see the patient at another visit. Epic will also standardize medication reconciliation across all specialties and sites, enabling physicians to easily keep track of home medications, dose changes, new medications, and stopped or held medications, and medication reconciliation will be part of all important points of transition of care for patients, such as transfer from the ICU to a ward.


Physicians will be able to efficiently do medication reconciliation and script at time of discharge. Just as we get a copy of our bank account statements so that we can understand our money’s journey, patients will get a copy of their discharge medications as part of their after-visit summary (AVS) so all changes in their medications are communicated to them.


Go-live is less than 6 months and away, and I can’t wait to use Epic to promote medication safety and improve how we communicate with patients about their medications.


Article written by Dr. Amna Ahmed, an internal medicine physician at Hamilton Health Sciences (HHS), member-at-large for HHS Medical Staff Association, and an associate chief medical officer working on Project Odyssey, You may also read this article published Dec 23, 2021 via HHS Hub on improving communication and workflows by eliminating paper.

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