Brief Observation on “Med Reconciliation”

Patient is seen by her nephrologist and there is documentation in her Plan of Treatment: AVOID ALL NSAIDs. The physician never noticed in the med list that the patient is taking an NSAID (and has been for years). The only reason I picked up on it was because the patient told me she hadn’t been able to get her Celebrex approved by insurance so the orthopedist changed her to meloxicam. Having read the nephrologist’s note right before the patient came in, we have the following exchange:

Me:”But you’re not supposed to take an NSAID like meloxicam”

Patient: “I’ve been taking celebrex for years. Nobody told me to stop”

Me: “OK, I’m telling you to stop”

Patient: “So I can use advil every once in a while for pain? Tylenol doesn’t help”

We have an extended conversation about what NSAIDs are.

What IS it about EHRs that make straight-forward information difficult to see?

 

 

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