Using timeline displays to improve medication reconciliation

Objective: To explore approaches for integrating and visualizing time-oriented medication data in narrative and structured formats and to address related issues on handling temporal abstraction, granularity, and uncertainty. The ultimate goal is to improve medication reconciliation by providing clinicians with more accurate medication information in patient care. Methods: An event taxonomy was generated to capture different combinations of clinical and temporal uncertainties. A prototype of a temporal visualization system was implemented using an open source software package called Timeline. Medications were parsed and mapped to the event taxonomy, and then represented in Timelines. Seventy-five medications from narrative discharge summary reports and seventy-nine medications from structured orders were used as data input for temporal visualization. Five physicians served as domain experts and answered ten proof-of-concept survey questions. Results: Overall positive feedback from experts suggested the potential value of the proposed timeline visualization method. Challenges were also identified, and future work will include reconciliation of medications from various sources based on temporal attributes and medication classification.