Medication reconciliation

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The Centers for Medicare & Medicaid Services (CMS) has defined medication reconciliation as “the process of identifying the most accurate list of all medications that the patient is taking, including name, dosage, frequency, and route, by comparing the medical record to an external list of medications obtained from a patient, hospital, or other provider.” [1] [2]


The Institute for Healthcare Improvement cites that "poor communication of medical information at transition points is responsible for as many as 50 percent of all medication errors and up to 20 percent of adverse drug events in the hospital." [3]

Historical Foresight

In 2006, the Institute of Medicine in their report, “Preventing medication errors”, calls upon consumers, providers, and the federal government to take action to improve medication safety by way of maintaining accurate medication lists, reconciling discrepancies in medications taken by patients at transitions in care, and improving quality of pharmacy information available to the public. Citing handoffs as being "fraught with errors," the IOM encouraged providers to reconcile medication lists between transition points within and between care settings. [4]

Part of Meaningful Use Criteria

On November 7, 2010, CMS issued a statement identifying medication reconciliation as a one of the Menu Set measures for Stage I Meaningful Use Criteria for the Medicare and Medicaid EHR Incentive Programs--for both Eligible Professionals (EP) and Eligible Hospitals and Critical Access Hospitals (CAH).

To count medication reconciliation as one of five Menu Set measures toward the Incentive Programs, the EP or Eligible Hospital and CAH must attest that medication reconciliation was completed in greater than 50% of all transitions of care to the EP, eligible hospital or CAH (defined by “the movement of a patient from one setting of another." [1] [2]

Despite the definition for medication reconciliation (above), the measure as pertinent to the attestation “does not dictate what information must be included in medication reconciliation." [1] [2]

Future Meaningful Use Criteria

At present (May 2011), Stage 2 Criteria have been proposed and published by the Health Information Technology Policy Committee for the purposes of soliciting public feedback before recommending the criteria for the years 2013 and 2014. At the time of this publication, the proposed Stage 2 measure for the reconciliation of medication at transitions of care would be 80%, and the Stage 3 measure would be 90%. [5]

Related Papers


  1. 1.0 1.1 1.2, "Eligible Hospital and Critical Access Hospital Meaningful Use Menu Set Measures, Measure 6, Stage 1"
  2. 2.0 2.1 2.2, "Eligible Professional Meaningful Use Menu Set Measures, Measure 7 of 10, Stage 1".
  3. Institute for Healthcare Improvement, "Reconcile Medications at All Transition Points"
  4. Institute of Medicine, Preventing medication errors. Washington, DC: National Academies Press; 2006. (pp 2, 8, and 14)
  5. HIT Policy Committee, “Meaningful Use Workgroup Request for Comments Regarding Meaningful Use Stage 2”, Jan 12, 2011; [Online, cited May 22, 2011]