Medication reconciliation transformation: Enhancing safety across the care continuum

Author: Brian Simpkins

Geisinger has launched a multi-phase initiative to improve medication reconciliation processes across the system, with a focus on strengthening patient safety and care continuity from admission through discharge. The effort addresses longstanding challenges related to medication accuracy, workflow consistency and system integration.

The initial phase targets transitions from the Emergency Department to inpatient care.

Key issues identified include incomplete or inaccurate medication histories, limited availability of medication history technicians (MHTs) and inconsistent use of Epic tools. To address these gaps, Geisinger implemented the Surescripts module to improve medication data integration and secured support to expand the MHT workforce. A notable advancement is the establishment of a virtual medication history team, comprising 5.5 full-time equivalents, designed to support campuses without in-person coverage and yield timely, accurate histories for high-risk patients.

To promote consistency in practice, educational resources — including fast-fact sheets, posters and video walkthroughs — have been developed and distributed across disciplines.

These materials are intended to reinforce standardized workflows and support staff in adopting best practices.

Financial modeling associated with this phase projects significant cost avoidance, with potential annual savings exceeding $11 million through reductions in medication errors, adverse drug events and hospital readmissions.

The second phase of the initiative focuses on optimizing discharge medication reconciliation. Persistent challenges include premature printing of the After-Visit Summary (AVS), limited integration with skilled nursing facility (SNF) systems and inconsistent delivery of medication education. In response, Geisinger is implementing a hard stop for AVS printing until pharmacist signoff is complete, expanding multi-language support and introducing concise 1-page medication lists tailored for SNFs. These changes aim to improve communication between care teams and patients, reduce medication-related confusion and support safer transitions of care.

Other efforts include evaluating preauthorization workflows for discharge medications and clarifying roles and terminology to support standardized practices. These measures are designed to reduce delays in medication access, improve documentation accuracy and be sure patients receive clear, actionable information about their medications at discharge.

Together, these phases underscore the importance of accurate medication history as the foundation for safe and effective reconciliation. The initiative is guided by continuous improvement methodology and supported by a governance structure led by Brian Simpkins and Kelly Guza. Through a combination of technology enhancements, workforce development and process redesign, Geisinger’s transformation offers a scalable model for health systems seeking to elevate medication safety and operational performance across the patient journey.