Closing the loop of patient care--a clinical trial of a computerized discharge medication program.

A frustrating time for hospitalized patients and their primary care providers is after discharge from the hospital, because of changes in patients' medications. We developed a computer program to improve the discharge process, by providing guidance to the physician writing the prescriptions, offering educational material to the patients, and providing electronic notification of medication changes to the primary care providers. During a one-year clinical evaluation of this system, in which use of the program was voluntary, 1000 patients were discharged through the program. House officers tended to use the program more often for patients who were older and in the hospital longer. Both house officers and primary care physicians found the program extremely useful, and the process took no longer than the manual method of creating discharge medication lists. Patients who were discharged using this program may have had better adherence to medication regimens. We conclude that computer-assisted compilation of a discharge medication list is a useful method for improving the discharge process.