1. Design and implementation of a web-based patient portal linked to an electronic health record designed to improve medication safety: the Patient Gateway medications module Informatics in Primary Care 2008

2. Outline Introduction Introduction Study setting Study setting Discussion Discussion Long-term evaluation plan Long-term evaluation plan Conclusion Conclusion

3. Introduction The causes of ambulatory ADEs and undertreatment The causes of ambulatory ADEs and undertreatment Medication discrepancies Medication discrepancies Non-adherence Non-adherence Inadequate monitoring and follow-up Inadequate monitoring and follow-up A Portal linked to an EHR has the potential to help address many medication safety and quality issues. A Portal linked to an EHR has the potential to help address many medication safety and quality issues.

4. Study setting

5. The type, duration and confidence in the symptom being related to that medication are elicited. The type, duration and confidence in the symptom being related to that medication are elicited.

6. For physician view For physician view Medications Module fit into workflow. Medications Module fit into workflow. Concise overview of the information. Concise overview of the information. Patient ’ s medication journal is displayed in medications screen. Patient ’ s medication journal is displayed in medications screen. Medication Module also allows for verification of allergy information. Medication Module also allows for verification of allergy information.

7. Short-term evaluation

9. Discussion 20% of eligible patients consented to be in the study. 20% of eligible patients consented to be in the study. Users tended to be white and less impoverished Users tended to be white and less impoverished Important lessons Important lessons Mix of free text, structured data fields within patient interface. Mix of free text, structured data fields within patient interface. Integrating the application with clinicians ’ workflow. Integrating the application with clinicians ’ workflow. Document medication and allergy within one application. Document medication and allergy within one application.

10. Long-term evaluation plan Studying the impact of the Medications Module on patient outcomes. Studying the impact of the Medications Module on patient outcomes. Clinical outcomes to be evaluated include Clinical outcomes to be evaluated include ADEs ADEs Medication list accuracy Medication list accuracy Self-reported medication adherence Self-reported medication adherence

11. Conclusion Integration of this kind of intervention into a patient portal represents a novel and potentially powerful way to reduce ADEs and medication discrepancies. Integration of this kind of intervention into a patient portal represents a novel and potentially powerful way to reduce ADEs and medication discrepancies.