As part of our CQI with Medication Reconciliation, I wanted to focus on medications that are to be communicated during discharge from an acute care setting that should be discontinued. An example would be an NSAID that was on a home med hx after an acute HF episode.

NPSG.03.06.01 EP5 mentions that there should be a plan to have the patient do this, but falls short of requiring documentation that acute care hospitals should do this. I personally feel as if discharge med rec has just as much if not more to do with readmission than getting the admission med rec correct (though both are pivotal).

Could you answer the following questions:
1. Does your EMR have discontinued home meds as part of the standard discharge paperwork (next to the listing of the current med list)? Alternatively, does the EMR allow the provider to mention specific medications to permanently discontinue during discharge med rec?
2. If so, what table or fields does your EMR pull this information from?
3. What EMR do you use?
4. Can I contact you or someone in your IT department for further questions?

Thank you for your assistance,