Whether it’s prescribing a routine antibiotic or managing a complex specialty therapy, the accuracy of a patient’s medication list is non-negotiable. Even the smallest discrepancy can have serious consequences. These errors not only put patient safety at risk but also lead to costly complications, hospital readmissions, and declines in quality performance measures.
Unfortunately, the path to accurate medication reconciliation is rarely straightforward. Fragmented health records, communication gaps between providers, and reliance on manual processes all contribute to incomplete or inaccurate medication histories. In some cases, critical details are scattered across multiple systems or never documented at all, leaving pharmacists and care teams without the full picture they need to make informed decisions.
This is where modern pharmacy technology is transforming the process. By replacing a patchwork of manual processes with technology-enabled workflows, health plans and pharmacists can move from reactive problem-solving to proactive medication safety. The result is more accurate reconciliation, stronger adherence, and optimized treatment plans.
The prevalence of medication errors in healthcare
Medication errors remain one of the most persistent threats to patient safety in the U.S. healthcare system. These errors can occur at any point in the medication use process, from prescribing and dispensing to administration and monitoring, and their impact can be serious, even life-threatening.
Alarmingly, poor dispensing practices alone lead to medical error rates as high as 55%, underscoring the critical importance of accuracy and quality control throughout the entire medication journey. Beyond the numbers, these errors translate into real-world harm, including preventable adverse drug events, hospital readmissions, and in some cases, long-term health complications.
For patients, the risk is far from hypothetical. One in five Americans has experienced a medication error while receiving healthcare, whether through incorrect dosage, wrong medication, or overlooked drug interactions. Each incident not only jeopardizes the individual’s health but also erodes trust in the care system.
Given the frequency and severity of these events, reducing medication errors must be a top priority for health plans, providers, and pharmacists alike. This is where medication reconciliation, a structured, pharmacist-led process for reviewing and verifying a patient’s complete medication list, can have an immediate, measurable impact on safety.
6 common challenges in medication reconciliation practices
The goal of medication reconciliation is simple: create an accurate, up-to-date list of every medication a patient is taking to prevent errors and adverse drug events. In practice, achieving this goal can be complex. Systemic barriers often undermine reconciliation efforts, introducing the very risks the process is designed to eliminate.
By understanding the most common challenges, health plans and pharmacists can proactively address these vulnerabilities, ultimately strengthening their medication management programs and improving patient safety at every stage of care.
1. Manual processes
Despite advancements in health IT, many organizations still rely on manual, paper-based workflows or outdated EHR systems not optimized for medication reconciliation. These methods are slow, resource-intensive, and inherently prone to human error. The problem becomes more prevalent in high-volume environments or during critical transitions of care, when speed and precision are essential. Without automation or structured digital workflows, maintaining accuracy becomes a constant challenge.
2. Fragmented patient data
One of the most significant obstacles is the lack of a single, unified patient record. Medication information is often scattered across different providers, hospitals, pharmacies, and insurance systems. This fragmentation can result in missing, incomplete, or conflicting data, especially during care transitions. Without real-time access to a complete medication history, compiling an accurate list is not only time-consuming but also dangerously unreliable.
3. Ordering vulnerabilities
The ordering process, selecting and prescribing medications, presents another potential point of failure. Errors in dosage, frequency, or recognition of drug-drug interactions can easily occur without robust verification protocols. When these errors are not intercepted early, they can cascade through the care process, leading to inappropriate prescriptions and avoidable harm. Integrating technology-enabled decision support is critical for catching issues before they reach the patient.
4. Communication gaps
Successful medication reconciliation depends on seamless communication between all members of the care team, including physicians, nurses, and pharmacists. When these teams aren't aligned or lack real-time communication tools, critical information can be lost. Misunderstandings about a patient’s medication regimen can lead to conflicting instructions, delayed care, or incorrect prescriptions.
5. Pharmacist burnout
Pharmacists are on the front lines of medication reconciliation, but they often face immense time constraints and high-volume workloads. The burden of manual processes, coupled with the pressure to manage a growing number of complex cases, contributes to burnout. This not only impacts job satisfaction but can also increase the risk of errors as professionals are stretched thin.
6. Patient engagement challenges
Accurate reconciliation requires patients to share their medication history, but that’s not always straightforward. Patients may forget medication names or dosages, misunderstand instructions, or withhold over-the-counter or supplement use. Barriers such as low health literacy, language differences, and a lack of awareness about the importance of disclosure make it harder for pharmacists to gather complete information. Without patient engagement strategies, such as simplified education materials, language support, or telepharmacy outreach, gaps in the medication list are inevitable.
How medication reconciliation prevents adverse outcomes
Despite these challenges, the ability to perform accurate and thorough medication reconciliation is a powerful preventative measure against adverse outcomes. When executed effectively, medication reconciliation transforms a potential point of risk into a critical safeguard for patient safety. It serves as a systematic check and balance that helps identify and resolve discrepancies before they can cause harm.
Pharmacists, in particular, are uniquely positioned to leverage this process to prevent a range of adverse events:
- Catching medication errors before they occur: By systematically comparing a patient's current medication list with the medications they were taking previously, pharmacists can spot inconsistencies, such as duplicate therapies, incorrect dosages, or potential drug-drug interactions. This proactive verification process is essential in preventing prescribing or dispensing errors from reaching the patient.
- Reducing readmissions: Transitions of care, such as hospital discharge, are high-risk periods for medication errors. A comprehensive medication reconciliation at this stage ensures that the patient leaves the hospital with a clear, updated medication list that aligns with their discharge plan. This reduces the risk of post-discharge complications that could lead to preventable hospital readmissions.
- Improving patient adherence and understanding: The medication reconciliation process provides a crucial opportunity for patient education. By reviewing each medication with the patient, pharmacists can clarify instructions, explain the purpose of each drug, and answer questions. This direct engagement empowers patients, improving their understanding and adherence, which is vital for managing chronic conditions and avoiding negative health events.
- Ensuring regulatory compliance: Accurate medication lists are a cornerstone of several quality and regulatory programs, including CMS Star Ratings and HEDIS measures. By diligently performing medication reconciliation, health plans can support their compliance efforts, avoid financial penalties, and demonstrate a commitment to high-quality care.
By emphasizing medication reconciliation, health plans and care teams can move beyond a reactive approach to risk management and build a proactive framework that significantly enhances patient safety, improves outcomes, and drives long-term success.
Leveraging pharmacy technology for enhanced medication reconciliation
From fragmented data and manual processes to pharmacist burnout and patient engagement, there are many obstacles in the way of effective medication reconciliation and ongoing medication management. Overcoming these barriers is essential to improving patient safety, and modern pharmacy SaaS solutions are proving to be a critical driver of better outcomes at scale. Medication reconciliation has the potential to “significantly reduce unforeseen medication discrepancies by 45%” with the help of modern pharmacy technology.
Pharmacy technology has transformed medication reconciliation from a time-consuming, error-prone process into a streamlined, data-driven safeguard for patient safety. Many modern MTM platforms provide pharmacists and care teams with a unified, real-time view of a patient’s complete medication history. This eliminates the guesswork and record-chasing that often leads to discrepancies, allowing care teams to identify potential drug interactions, therapeutic duplications, and dosage errors before they reach the patient.
Further, these solutions enhance the efficiency and scope of medication management programs. Built-in decision support tools flag high-risk scenarios such as polypharmacy in older adults, adherence gaps in chronic disease management, or contraindications with specialty medications that require precise dosing and monitoring. Specialty medications in particular often come with complex administration schedules, high costs, and a narrow margin for error. Technology ensures these therapies are prescribed, dispensed, and administered according to the latest clinical guidelines, while providing alerts if follow-up interventions are needed.
At Aspen RxHealth, we know that the future of patient care involves innovation, flexibility, and, of course, pharmacist-led care, which is why we built two delivery models designed to help health plans and healthcare organizations tailor their approach based on their specific needs.
- Alliance by Aspen RxHealth: A SaaS medication management platform built for organizations that want to maintain full control over their strategy while strengthening internal infrastructure. This solution empowers in-house care teams with a scalable, compliant, and efficient platform that streamlines every step of MTM delivery.
- The Aspen RxHealth Pharmacist Community: For health plans and organizations that need to deliver medication management and MTM services, as well as reach out to specific patient populations, the Aspen RxHealth pharmacist network provides an outsourced care delivery model, powered by our BeWell platform.
Both solutions are purpose-built to improve medication adherence, close care gaps, and elevate Star Ratings. The right fit for your organization depends on your internal resources, clinical priorities, and vision for scaling care.
By giving pharmacists the right tools, health plans can shift from reactive, error-prone reconciliation to a proactive, technology-enabled approach that improves safety and supports quality metrics, including Star Ratings and HEDIS measures.
Ready to strengthen your medication reconciliation process and enhance patient outcomes? Connect with Aspen RxHealth to learn how our technology and pharmacist-led solutions can help you enhance patient safety and improve outcomes.
