Personal Medication Record Discussion Guide

SOS Rx Subcommittee Meeting Agenda

Carnegie Endowment for International Peace

Choate Room, First Floor, 1779 Massachusetts Avenue NW

June 3^rd, 2004 from 10 AM to 3 PM

INTRODUCTIONS (10:00 – 10:15)

MEETING OVERVIEW & GROUND RULES (10:15 – 10:30)

REVIEW & DISCUSSION OF SOME EXISTING PMR EFFORTS (10:30 – 11:15)

4. SOS Rx MISSION FOR PMR (11:15 – 11:30)

The goals of this SOS Rx subcommittee are threefold: 1) to create one or more templates that patients could use to manage their medications, first using a paper based process to set down the basic construct, but fully acknowledging the possibility that many patients could eventually transition to an electronic system 2) to charge stakeholders (e.g., health care providers, insurers, etc…) to promote use of standardized personal medication templates, and 3) to educate consumers about their roles, responsibilities, and benefits that accrue with maintenance of an accurate personal medication record.

5. CONTEXT (11:30 – 12:00)

Several agencies and research institutions are promoting or adopting systems that support the transition of patient medical records from a paper-based environment to an electronic-based system. There is much promise in this field, for patient safety, systems efficiency, and containing health care costs.

Despite the perceived benefits, there are numerous barriers to immediate and widespread adoption of these systems. As illustrated in the recent eHealth Initiative report on electronic prescribing and other publications, factors such as high start-up costs, infrastructure development, and provider behavior modification pose barriers to immediate adoption in most communities.

To realize the full benefit, the ultimate objective is a complete electronic medical record system that can be accessed both by patients and providers. The eHealth Initiative report suggests that independent providers and larger institutions can build up to this goal in a stepwise fashion – initiating with basic electronic prescribing and progressing along a continuum that leads to a fully automated health record system. Other initiatives are using a medication and other core data record model as the foundation.

The concept of the personal medication record is viewed as an initial step in this progression toward system change. The primary difference being that electronic prescribing must be implemented by the physician practice, whereas personal medication records can be largely managed by patients – with periodic caregiver consultation. In taking this initial step, patients and providers can achieve great value well in advance of a fully integrated electronic provider-patient interaction. This type of action could empower patients to take a more active role in managing their health, and could ultimately help convince providers to adopt technology that would facilitate exchange of this type of information.

What this Effort Excludes

Numerous organizations, government agencies, and institutions are working together to develop technology and content standards that will support the transition from our current paper-based system to the envisioned electronic medical record system. As the SOS Rx coalition has no desire to duplicate or complicate these ongoing efforts, we wish to remain focused on the objectives that will 1) retain the consumer focus, and 2) facilitate action in the right direction. To stay on course, we plan to focus solely on the objectives stated in the “mission” section above. In addition, we propose moving forward with development of a template that likely will be paper based initially for many patients. Of course, the idea would be to transition the data elements to an electronic medium at some point in the future.

Notes & Comments

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BREAK FOR LUNCH (12:00 – 12:30)

DISCUSSION OF PMR TEMPLATE (12:30 – 2:30)

General Questions for the Group to Consider

In developing a template for use as a personal medication record, there are a number of important factors to consider:

1. Who should use one?

2. What are the critical components?

3. How can it be designed to maximize likelihood of adoption?

4. When (at what intervals) should it be updated?

5. Where should it be kept/maintained?

6. Why is it important?

7. How should it be evaluated?

Specific Questions for the Group to Consider

The following questions should help this group start to address these factors for consideration.

1. Would it be appropriate to develop one or multiple template versions to account for factors such as patient age, patient gender, and number/severity of chronic conditions?

a. If yes, would it make sense, given the SOS Rx mission, to start with templates geared toward a senior population?

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2. What types of demographic data fields should be included?

Possibilities include, but are not limited to:

a. Name/phone number

b. Age,

c. Weight,

d. Number of prescribing providers,

e. Primary care provider name,

f. Blood type,

g. Emergency contact name and number.

3. What types of experience data fields should be included? Possibilities include, but are not limited to:

a. Prior conditions,

b. Current chronic conditions

c. Immunizations

4. What types of medication data fields should be included?

Possibilities include, but are not limited to:

a. Current prescription medications,

b. Current OTC medications

c. Current vitamins, herbals or other supplements

d. Allergies (foods, medications)

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5. What level of detail should be recorded for prescription medications?

a. Dose

b. Frequency

c. Route of administration

d. Pill color/shape (if applicable)

e. Reason for taking medication

f. Prescriber name/type

g. Duration of medication use

6. What level of detail should be recorded for OTC medications and supplements?

a. Dose

b. Frequency

c. Reason for taking medication

d. Duration of medication use

7. How should the template be laid out (A-D assume a paper-based template whereas E-G assume an electronic component)?

a. Wallet size folding card

b. Pamphlet

c. Paper-size form

d. Daily planner insert

e. PDA software tool

f. Computer spreadsheet or program

g. Patient/Provider electronic medical records hub

8. How often should patients review and update their personal medication records? Physicians?

DISCUSSION OF NEXT STEPS (2:30 – 3:00)

ADJOURN