Medication Historian

Medication historian (MH) serves as collaboration between the Pharmacy and Emergency Department Team. The MH provides a medication reconciliation service to patients pending admission to a floor within the facility. It is the MH’s responsibility to accurately obtain a comprehensive list of medications and other relevant information a patient is taking prior to presentation. This information includes but is not limited to:

• Prescribed, over the counter, herbal, and/or illicit medications:
  • Dosage
  • Frequency and typical administration time of medications when relevant 
  • Last doses of medication
  • Recent changes to medications prior to admission
  • Pertinent labs for medications when required (e.g., most recent INR, lithium level)
• Allergies and/or reactions to medications

The list of the above information is obtained via interviewing of patients’ outpatient prescribers offices and/or care facilities, retail pharmacies, patient and/or their caregiver’s interviews, and any other relevant sources when available. All information gathered is to be accurately documented within a patient’s electronic health record to guide treatment while they are admitted.