According to Joint Commission data, medication discrepancies occur in over 50% of hospital admissions when formal reconciliation processes are absent. AI-assisted reconciliation tables create clear documentation preventing omissions, duplications, and dosing errors.
3-Column Reconciliation Template
| Home Medication | Hospital/Current | Action |
|---|---|---|
| Lisinopril 10mg daily | Lisinopril 20mg daily | Increased for BP control |
| Metformin 500mg BID | Metformin 500mg BID | Continued |
| Aspirin 81mg daily | — | Held for procedure; restart 2/20 |
| — | Furosemide 20mg daily | NEW: Added for edema |
Allergy Documentation Format
| Element | Example |
|---|---|
| Allergen | Penicillin |
| Reaction type | Anaphylaxis (throat swelling) |
| Severity | Life-threatening |
| Date | 2015, treated with epinephrine in ER |
Key distinction: True allergy (anaphylaxis, rash) vs. intolerance (nausea, GI upset). Document "Codeine intolerance: nausea" not "codeine allergy."
Common Reconciliation Errors
| Error Type | Example | Prevention |
|---|---|---|
| Omission | Home BP med not restarted | Address every home med explicitly |
| Duplication | Lisinopril + enalapril (both ACE-I) | Check for same-class duplicates |
| Dosing | 25mg BID becomes 25mg daily | Compare doses explicitly |
High-Risk Medications Checklist
- Anticoagulants: Dose, indication, INR, hold/restart plan
- Insulin: Type, dose, timing, target glucose
- Opioids: Home dose, hospital changes, taper plan at discharge
- Immunosuppressants: Exact dose, timing critical
FAQ
When should reconciliation happen?
Every transition: admission, transfer, discharge. Each handoff is opportunity for error.
What if patient doesn't know medications?
Brown bag review. Ask patient to bring all medication bottles. Bottles show drug, dose, frequency, prescriber.
Can AI help with med rec?
Yes, River's Med Rec Generator creates 3-column reconciliation tables from home and current medication lists, flagging discrepancies automatically.