The BPMH must be conducted before proceeding with Admission Medication Reconciliation in the CST Cerner.

For the current admission, the BPMH is updated based on:

Review the patient’s PharmaNet profile

Interview with the patient and/or family

Review other reliable sources of information (e.g. Facility MAR, community pharmacy, and local records)

Review any medications that appear on the Document Medications by History page from a previous encounter.

The BPMH must be completed prior performing Admission Medication Reconciliation.

ED Physicians and Nurses can signal the BPMH technician to perform a BPMH by inserting the capsule icon into the events section of the tracking shell. Please do this at the earliest possible sign that a patient is likely to be admitted. The BPMH technician will remove the capsule icon and insert a comment “BPMH in progress” while they are working on the BPMH interview and Cerner entry, then change the comment to “BPMH done” or “BPMH complete” when it is finished. The green checkmark will also appear on the patient’s chart.

For more information on how to request BPMH – please see Request a Best Possible Medication History (BPMH) in the LGH Emergency Department (ED Nurses), Request a Best Possible Medication History (BPMH) in the LGH Emergency Department (ED Providers)) or on a unit with a Direct Admit patient.

In Newborn Encounters, the BPMH will automatically complete with no medications upon registration of the encounter.

To complete the BPMH, PharmaNet should be reviewed whenever available (BC residents) and verified by interviewing the patient and/or family/caregiver who can speak on the patient’s behalf. The goal of the BPMH is to document the patient’s own reality of how they take their medication. Medication that meets the following criteria should then be documented in CST Cerner:

The patient takes the medication actively (including intermittent and cyclical medication), OR

The medication has been placed on temporary hold by the patient’s provider, OR

The patient has stopped taking the medication without seeking provider direction

Ask about medications on the External Rx History (PharmaNet) List as well as over-the-counter medications, vitamins, natural health products, HIV/AIDS medications, recreational drugs, topicals, and samples. Document this information into CST Cerner.

If patient says “No longer taking”, ask “Why did you stop?” 

If the prescriber advised the patient to stop taking a medication: Do not enter the medication into CST Cerner.

If the patient decided to stop taking a medication without the prescriber's advice: Enter the medication into CST Cerner, with an explanation on the Compliance tab.

When the patient is unable to participate in an interview (for example, due to low level of consciousness), and there is no other person who can be interviewed to verify the medication on the PharmaNet profile, BPMH and Admission MedRec may be postponed and completed retroactively after the patient has already been admitted to an inpatient bed.

To proceed with entering the Admission Medication Orders PowerPlan without completing the BPMH and MedRec at admission, providers can review the patient’s PharmaNet profile, either through Excelleris or the CST Cerner External Rx History (PharmaNet Profile), and decide what medications they want to order right away.

Access to a patient’s PharmaNet profile may only occur:

In support of providing patient care (and not more than 5 days before/after a clinical encounter with the patient).

Browsing is not permitted.

PharmaNet  data must be kept confidential and must not be used or disclosed for any purpose other than to provide care or to provide the patient with a copy of their own profile.

The printed or distributed copy of the medication profile must either be maintained on the patient’s medical chart or it must be appropriately destroyed.

 PharmaNet must NOT be accessed from outside of Canada.

Best Possible Medication History Overview

Step One: Open CST Cerner BPMH (Document Medications) Page

Step Two: Import PharmaNet Profile Medications (Pharmacy, Nursing, and Provider)

Step Three: Update CST Cerner Using the PharmaNet Profile (Pharmacy, Nursing, and Provider)

Document No Known Home_Medications in BPMH

Add Medications to CST Cerner

Modify Medications on BPMH_List

Remove Medications from the BPMH_List

Document Medications not found on PharmaNet in CST Cerner BPMH

Finish Documenting the BPMH

Not Able to Complete the BPMH

Unable to Verify Medication History

Remove Duplicate Entries from the Best Possible Medication History (BPMH)

Document BPMH Viewing Options

Document BPMH with PharmaNet using the Scroll Button in Add As Column

PharmaNet Integration Additional Information

PharmaNet FAQ/Troubleshooting Tips

Medication Reconciliation Overview

Ambulatory Medication Reconciliation

Admission Medication Reconciliation

Transfer Medication Reconciliation

Discharge Medication Reconciliation

Printer Selection - Discharge Medication Reconciliation

Medication Reconciliation Icons