Issuing 'Medication Passports' for Patients

It began as one patient's request for a list of his medications.

It has since evolved into a medication awareness program for patients and the health care professionals who treat them.

It's what Dr. Arnold Jay Simon calls a “medication passport.”

The idea came to Dr. Simon after that initial patient inquiry in 1990. “I was putting my notes on a word-processing program at the time. So I programmed a shortcut key that would allow me to print out a copy for any given patient along with a billing list,” said Dr. Simon, a solo-practice internist specializing in geriatrics in Palm Springs, Fla.

That effort evolved into a simple record-keeping system using WordPerfect that Dr. Simon updates during each patient's visit. The medication history is recorded in each patient's chart along with other information such as medical history, physical exam findings, laboratory results, and vital signs.

“With the help of multiple macro keys, or a shortcut key combination, I can automate the process of printing out a personalized medication sheet,” Dr. Simon explained. “I can easily include the purpose of each medication and, in the case of the visually impaired, enlarge the font.”

When a patient has an accurate list of his medications—including dosages and frequency of administration—this improves communication and meets an important goal of good patient care, he said.

“Instilling in each patient an awareness of his or her medications in terms of their names and functions is an important educational goal for every primary care physician,” Dr. Simon added.

Physicians seeking to provide such information can use a variety of methods to maintain each patient's medication list and share it with the patient, he noted.

The medication passports have gotten favorable responses from doctors and nurses—and especially from emergency room nurses. “ER nurses are ecstatic when one of my patients comes in and has everything written down. In a geriatric practice, if you know the patient's medications, you know 90% of what's going on,” he said.

His patients take it seriously when Dr. Simon reminds them to keep their medication lists with them at all times.

“Several weeks ago, a patient came in with a tattered and discolored medication sheet. It turned out that she was a patient I had seen 3 years ago when I was covering for a colleague, and that was the original sheet I had printed out for her,” Dr. Simon recalled in an interview. The woman had crossed out the medications that she was no longer taking, and had added new ones.

“When her doctor retired and she came back to me with that old list, my jaw dropped,” he said.