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.