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Primary Care MedRec Guide

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Appendix 9: Glossary of Terms
Actual Medication Use

Actual Medication Use refers to how a person is routinely taking their medications regardless of the instructions from a healthcare professional or directions on the medication label.

Adverse Drug Event

Adverse Drug Event is an injury from a medicine or lack of an intended medicine. Includes adverse drug reactions and harm from medication incidents.

(ISMP Canada)

Ambulatory Care Sensitive Conditions (ASCS)

Ambulatory Care Sensitive Conditions (ASCS) conditions are medical conditions for which a substantial proportion of cases should not advance to the point where hospitalization is needed if they are treated in a timely fashion with adequate primary care and managed properly on an outpatient basis.


bestPATH is an initiative that facilitates more coordinated, person-centered care for seniors and others with complex chronic illnesses. It is designed to be an integral support to Health Link communities as they work to smooth the gaps between sectors, improve access to care, reduce avoidable emergency room visits and hospital re-admissions, and improve the experiences of patients as they make their way through the health system.


Best Possible Medication Discharge Plan (BPMDP)

Best Possible Medication Discharge Plan (BPMDP) is the most appropriate and accurate list of medications the patient should be taking after discharge from a medical facility. This should be completed by a qualified staff member from the discharging facility

Ref: ISMP Canada. Medication Reconciliation in Home Care: Getting Started Kit. 2010

Best Possible Medication History (BPMH)

Best Possible Medication History (BPMH) is a history created using 1) a systematic process of interviewing the patient/family; and 2) a review of at least one other reliable source of information to obtain and verify all of a patient's medication use (prescribed and non-prescribed). 3) Complete documentation includes medication name, dosage, route and frequency. The BPMH is more comprehensive than a routine primary medication history which may not include multiple sources of information.

Ref: ISMP Canada. Medication Reconciliation in Acute Care: Getting Started Kit. 2011


Discrepancy is an identified difference between what the patient is actually taking versus the information obtained from other source of information (e.g., community pharmacy profile, hospital discharge summary etc.)

Ref: ISMP Canada. Medication Reconciliation in Home Care: Getting Started Kit. 2010

Electronic Health Records (EHRs)

Electronic Health Records (EHRs) contain individual information registered with healthcare providers (e.g., family doctor, specialist, healthcare team) and the provincial healthcare plan.

Electronic Medical Records (EMRs)

Electronic Medical Records (EMRs) computer software used by primary care providers to collect, manage and store patient's health records.

Health Links

Health Links is a program sponsored by the Ontario Ministry of Health and Long-Term Care that delivers a new model of care at the clinical level where all providers — including primary care, hospital and community care — are charged with coordinating plans at the patient level. The initial focus is on improving patient care and outcomes for people with complex health conditions, while delivering better value for investment.

High Alert Medications

High Alert Medications are medications that bear a heightened risk of causing significant patient harm when used in error.


Intentional Discrepancies

Intentional Discrepancies occurs when a prescriber makes a deliberate decision to add, change or discontinue a medication that the patient was taking in the prior healthcare setting.

Medication Management

Medication Management is defined as patient-centred care to optimize safe, effective and appropriate drug therapy. Care is provided through collaboration with patients and their healthcare teams.

Ref: Developed collaboratively by the Canadian Pharmacists Association, Canadian Society of Hospital Pharmacists, Institute for Safe Medication Practices Canada, and University of Toronto Faculty of Pharmacy, 2012.

Medication Reconciliation (MedRec)

Medication Reconciliation (MedRec) is a formal process in which healthcare providers partner with patients to ensure accurate and complete medication information transfer at interfaces of care. It involves a systematic process for obtaining a medication history, and using that information to compare to medication orders in order to identify and resolve discrepancies. It is designed to prevent potential medication errors and adverse drug events. The process starts and ends with the patient. The end result is the reconciled medication list which is verified with the patient in a manner to support clear understanding by the patient/family and/or caregivers.

Ref: ISMP Canada. Medication Reconciliation in Home Care: Getting Started Kit. 2010

Medication Review

Medication Review addressing issues relating to the patient's use of medication in the context of their clinical condition in order to improve health outcomes.



MedsCheck program is a one-on-one interview between the community pharmacist and the patient to review the patient's prescription and nonprescription medications. The MedsCheck medication review will encourage patients to better understand their medication therapy and help to ensure their medications are taken as prescribed and that patients are getting the most benefit from their medications. MedsCheck should be available to all eligible patients in any community pharmacy in Ontario.


Ontario Drug Benefits Drug Profile Viewer

Ontario Drug Benefits Drug Profile Viewer is a secure, web-enabled application that provides healthcare providers with patient prescription drug information for Ontario Drug Benefit and Trillium Drug program recipients.


Prescribed Medication Use

Prescribed Medication Use assumes the patient is taking their medications as instructed by their healthcare professional or directions on the medication label.

Rapid Response Nurses

Rapid Response Nurses care for patients with complicated health needs in consultation with care coordinators, community nurses and other community health providers by providing care at home within the first 24 hours after the patient is discharged home from the hospital.

Reconciled Medication List

Reconciled Medication List is the reconciled BPMH and is the end of the MedRec process where are all discrepancies are identified and resolved. It is the most up to date accurate medication list for the patient.

Ref: ISMP Canada. Medication Reconciliation in Home Care: Getting Started Kit. 2010

Sources of Information

Sources of Information refers to the various resources that may house or have knowledge of a patient's medication information, including the patient themselves.

Unintentional discrepancies

Unintentional discrepancies occur when a prescriber unintentionally adds, changes or discontinues a medication that a patient was taking prior to admission. This type of discrepancy can potentially lead to adverse drug events and cause harm.