Chazli, I think it is documented, but in a different spot. An EMR can handle medication changes in different ways. I am not sure if the way AC does it is right or wrong; it is a matter of what people prefer. If most people truly prefer to do it differently, then we should suggest that AC change it.
When you open the note, the medication list and the note itself is designed to reflect the meds the patient came in on. In fact, at the conclusion of the note, if you print it as a SOAP note, for the medication section of the note it says "reported medications". Any changes are reflected in the plan section, where it says "Prescribed" or "discontinued" followed by the name of the medication.
The note (and the medication list) therefore reflects medications at the onset of the visit, with changes recorded at the end of the note. This is pretty clear, so long as you understand how it works. I am not saying it is necessarily the best way, though. What do people think?
