Home Forums Discussions Problems Historical List of Medications

Does anyone know how to construct a timeline of a patient?s medication history on AC? I often see patients who are on multiple classes of medications (and maybe multiple meds within classes). Frequently, I?d like to be able to glance at a list and be able to determine (for example): ?Hmm. On 5/26/2009 we discontinued Wellbutrin XL 150 mg because of insomnia, but at that time you were also taking 10 mg of Focalin XL and 40 mg of Prozac. Currently, you are only taking 15 mg of Remeron, so maybe we should retry the Wellbutrin and you might not experience the insomnia.?

I was using an EMR written over ten years ago that tracked each medication change and listed the changes chronologically so I could easily make such determinations.

In AC, if I open a patient?s chart, click on PAST ENCOUNTERS >FILTER BY MEDICATIONS, I get a list of every medication they were on for each and every visit; several visits might have passed without any information so it?s a bunch of repeating information.

Alternatively, if I go SUMMARY SHEET>FILE>PRINT>SUMMARY SHEET, I get a list of current medications, then a list of inactive medications. The list of inactive meds has the reasons why they were stopped, but the dates aren?t accurate nor are they chronological.

Or, I can open SUMMARY SHEET, double click on MEDS, choose ALL in the ?Current Medications? drop down box, and see a list of active and inactive meds, but they are listed alphabetically, making it impossible to quickly determine which meds they were taking when, per the example above, Wellbutrin XL was discontinued on 5/26/09.

Having trained in Internal Medicine as well as Psychiatry, I can imagine a number of scenarios where a physician would want to be able to track medication changes in the setting of polypharmacy. I can?t imagine that I?m the first who has struggled with this issue in AC, but I haven?t found any solutions.

Have you tried going to the medication writer and clicking a medication and then clicking "History"? This will not give you a full picture of what all they were taking on a particular date but it will tell you when a drug was prescribed and refilled.

Leslie: I've figured out how to quickly determine what's happened with a specific medication at a specific dose by following steps such as you've suggested. I haven't been able to track changes to a specific medication in relation to one or more concurrently prescribed medications. Whether in treating depression or in following metrics such as BP when treating HTN, lipid profiles in treating dyslipidemias, serum GLU in treating diabetes, the ability to track responses or side effects to changes in concurrently prescribed medications could be extremely helpful in guiding the use of medications. I haven't been able to find such information in AC.

Another way of describing the type of information I seek is a "Medication Flow Sheet"

I think Medication Tracking is another major defficieny in this program.

Ideally, Medication History Button (in Past Encounters page) should document the following:

1."Current Medication list" present at each visit

2. Chronological List of ANY medication ever prescribed by provider

3. List of Discontinued medications (and the comment of why they were dicontinued) - this is suppied the program when we double left click medication list and then check off 'patient is no longer taking this medication' and 'comment'

I've made some of these suggestions to AC months ago, but I'm pessimistic things will ever change.

Finally - I've tried listing medication experiences in "allergies" section (eg. Inderal -> made bradycardic 7/12/2011)) , but because there is no formatting available, becuase the thin red print is so hard to read, and because of overobfuscation with documentation (ie who made the entry and when) I'm having limited success.

I find myself becomming prgressively frustrated with this progam.

Bruce Morgenstern, (Neurology)
Denver, CO