Medication Reconciliation

Medication reconciliation is a structured clinical process that ensures a patient’s medication list is accurate, complete, and up to date across all points of care. Its primary goal is to prevent medication errors such as omissions, duplications, dosing mistakes, or harmful drug interactions—particularly during transitions of care, like hospital admissions, discharges, or changes in healthcare providers.

In H2H DigitalRx, medication reconciliation is integrated into the Medication History module. Prescribers can review a consolidated list of the patient’s current and previously prescribed medications, reconcile them against the patient’s current medication list, and initiate a CancelRx request from the same interface, without manual communication with the pharmacy.

Medication Reconciliation also warns prescribers about duplicate medications before a prescription is sent to the pharmacy. When a drug on the RX Pad matches a drug already on the patient’s active medication list, or another drug on the same RX Pad, a Duplicate Medications popup appears on the RX Summary screen.

• Soft validation: the check never blocks the prescription. The prescriber decides whether to remove the new drug, cancel the existing one, or continue as is.
• Matched on drug name: the same drug at a different strength (for example, Ferrous Sulfate 325 mg and 75 mg) is still flagged as a duplicate.

How Medication Reconciliation Works

Step 1 – Access Medication History

• Navigate to the patient’s profile and open the Medication History tab.
• View both current and previously prescribed medications, including dosage, frequency, and prescribing provider.

Step 2 – Select Medications for Reconciliation

• From the Medication History view, select one or more medications that require reconciliation.
• This may include medications that are no longer clinically appropriate, have been replaced by alternative therapies, or were prescribed in error.

Step 3 – Reconcile Medications and Initiate CancelRx

• Reconcile the selected medications directly within the interface.
• Initiate a CancelRx request for discontinued or incorrect medications without the need for manual communication with the pharmacy.

Step 4 – CancelRx Transmission

• When a CancelRx request is submitted, H2H DigitalRx electronically transmits the cancellation to the designated pharmacy in accordance with NCPDP SCRIPT standards.
• This ensures that discontinued medications are promptly removed from the pharmacy’s active dispensing queue, reducing the risk of unintended dispensing and improving patient safety.

Step 5 – Confirm and Document

• Verify that the reconciled medication list accurately reflects all updates.
• Document any changes and rationale for reconciliation to maintain a complete audit trail.

Before You Begin

The Duplicate Medications popup appears only when the patient has an active medication that matches a drug on an RX Pad, or when the same drug at a different strength is on two RX Pads. A patient with no active medications will show no duplicates.

To review a patient’s active medications

Step 1 – Login to the Application

• The prescriber logs in to the DigitalRx application using valid credentials.
• After successful authentication, the prescriber is presented with the patient and prescription management interface.

Step 2 – Search and Select the Patient

1. The prescriber searches for and selects the intended patient.
2. Once the patient is selected, the patient’s demographic information, allergies, active medications, and other relevant clinical information are displayed.
3. The prescriber proceeds to the New Rx Pad.
4. Select Medication History from available tabs.
5. Apply the Active Medications filter (an Inactive Medications filter is also available), or open Complete History.

 

 

 

 

 

Figure 1: Medication History with the Active Medications filter applied

 

 

How to Review Duplicate Medications

Step 1 – Add the medication on the RX Pad

Open the RX Pad and add the medication you want to prescribe. If the same drug is already active for the patient, it is flagged even at a different strength.

 

Figure 2: RX Pad with a medication that already exists in active medications

Step 2 – Open the RX Summary and review the popup

Click Confirm Prescription to open the RX Summary screen. The Duplicate Medications popup opens automatically. It lists two groups:

• Current Prescription: drugs on any RX Pad (RX Pad 1, RX Pad 2, and so on) that duplicate an active medication or a drug on another RX Pad.
• Active Medications: drugs in the patient’s medication history that match the current prescription.

 

Figure 3: Duplicate Medications popup on the RX Summary screen

 

Step 3 – Choose an action

Select a medication in the popup to enable its action button.

If you select	Button enabled	Result
A drug under Current Prescription	Remove	The drug is removed from the RX Pad. The remaining RX Pads renumber (RX Pad 2 becomes RX Pad 1).
A drug under Active Medications	Cancel	A cancellation (CancelRx) is sent to the pharmacy for the existing prescription.
Nothing	Close the popup	No change. You can continue and send the prescription.

 

 

Figure 4: Current prescription selected with the Remove option

 

 

Figure 5: Active medication selected with the Cancel option

 

Step 4 – Reopen the duplicate information if needed

After closing the popup, you can still view the duplicate details from the RX Summary screen using View duplicate medications.

 

 

 

 

 

Figure 6: Duplicate medication info on the RX Summary screen after the popup is closed

 

 

Few Examples

Example 1: The same drug at a different strength

The patient has Clarithromycin Oral Tablet 250 mg as an active medication. You add Clarithromycin Oral Tablet 500 mg on the RX Pad. The popup flags it as a duplicate because the drug name matches, even though the strength differs.

Select the new drug and click Remove to take it off the RX Pad, or select the active medication and click Cancel to cancel it at the pharmacy.

 

Figure 7: New prescription at a different strength flagged against the active medication

 

Figure 8: Page after the duplicate is removed or cancelled

Example 2: The same drug on two RX Pads

RX Pad 1 has Clarithromycin Oral Tablet 500 MG and RX Pad 2 has Clarithromycin Oral Tablet 250 MG. The popup flags both RX Pads as duplicates of each other and of the active medication.

 

 

 

 

Rx 1

 

 

 

Rx 2

 

 

 

 

Figure 9: RX Pad 1 and RX Pad 2 with the same drug, both flagged in the popup

 

If you remove RX Pad 1, RX Pad 2 moves up to become RX Pad 1. The current prescription no longer shows a duplicate, but the active medication match is still listed.

Figure 10: Popup after the RX Pad is removed

 

 

Key Points

• The check is a warning only. You can send the prescription to the pharmacy without taking any action.
• Duplicates are matched on drug name, so different strengths of the same drug are flagged.
• A single RX Pad will flag the same drug twice: a different strength or the same drug at the same strength is flagged but not restricted.
• A prescription can have multiple RX Pads (RX Pad 1, RX Pad 2, and so on). The same drug at a different strength can be added on separate RX Pads and is flagged as a duplicate. The same drug at the same strength is never allowed, on any RX Pad.
• Remove applies only to the current prescription; Cancel applies only to an existing active medication already with the pharmacy.
• No popup appears when the patient has no active medications and no drug repeats across RX Pads.

Benefits

• Enhanced Patient Safety – Minimizes adverse drug events caused by medication errors or omissions.
• Comprehensive Medication Management – Provides a consolidated view of current and past medications for better clinical decision-making.
• Streamlined Workflow – Reconcile medications and submit CancelRx requests directly from the Medication History module.
• Improved Care Coordination – Ensures all care team members have access to accurate and updated medication lists.
• Efficiency & Time Savings – Reduces manual communication with pharmacies and repetitive data entry.
• Regulatory Compliance – Supports NCPDP SCRIPT standards for electronic prescription cancellations.
• Clinical Confidence – Provides prescribers with a complete medication context to make informed decisions.