How to use MedRec 2.0
- Start with your trusted medication list. Use the last known good medication list you believe is correct. This may be a current facility list, pharmacy list, patient portal list, discharge list already reviewed by a provider, or another list your care team trusts. This is your source of truth.
- Enter that list first. Paste the trusted baseline list into MedRec 2.0 as the medication list before the change.
- Enter the new list second. When you receive a new hospital discharge, pharmacy, portal, provider, or paper medication list, paste it as the new medication list.
- Review the comparison report. MedRec 2.0 highlights possible added, removed, changed, and unchanged medications, along with selected safety cautions for human review.
- Take changes to a trusted professional. If the report shows changes, bring or share it with your trusted provider, pharmacist, nurse, or care team before making medication decisions.
- Keep the reviewed report. After your care team confirms the correct medication list, save or print the report. Over time, keeping these reports can help create a history of medication changes.
- Use the confirmed list next time. Once a provider or care team confirms the current list, use that updated list as your new source of truth for the next comparison.
Medication orders only: do not enter names, dates of birth, medical record numbers, addresses, phone numbers, or other patient identifiers.
Compare hospital discharge medications with facility orders
Long-term care and skilled nursing teams often receive medication information from hospital discharge summaries, prior facility orders, pharmacy lists, portal tables, paper records, and caregiver reports. The same medication may be written in different ways across systems, and clinically meaningful changes can be easy to miss when a resident has a long medication list.
MedRec is a free browser-based medication reconciliation tool that supports the comparison step. It helps organize likely added, removed, changed, unchanged, duplicate-review, and therapeutic-caution items so the nurse, provider, pharmacist, or care team can review each item according to facility policy.
Why medication reconciliation is difficult after a hospital stay
When a resident returns from acute care, the discharge medication list may not match the facility medication list word-for-word. One source may use a brand name while the other uses a generic name. One list may say “twice daily,” while another says “BID.” A hospital document may separate medications into START, STOP, CHANGE, and CONTINUE sections. Older records may include inactive, discontinued, completed, or hospital-only medications.
MedRec is designed for this messy comparison step. It does not decide which medication should be continued, stopped, changed, or held. It makes the differences easier to see.
How MedRec fits into the medication reconciliation workflow
MedRec works best when the user compares the new medication list against a reliable baseline medication list. This baseline is often called a source-of-truth medication list. It should be the best available list at the time of comparison, not a guessed list or an old medication history.
For individuals and caregivers, the source-of-truth list may be a typed medication list or computer file that reflects the medication regimen the person understands and has been doing well on. Keep that list current after provider visits, pharmacy changes, hospital stays, or medication changes. After a hospital discharge or new medication instruction, compare the new list against the saved list and bring any differences to the appropriate clinician.
For long-term care, skilled nursing, and post-acute teams, the workflow should be more formal. Assign a person or role responsible for the medication reconciliation process. When a resident transfers to acute care, keep a copy of the current facility medication list from that time. Store that list according to facility policy, such as in the chart, a secure computer location, or a paper file labeled with the resident name and date created.
When the resident returns from the hospital, compare the hospital discharge medication list against the saved source-of-truth facility list. If MedRec shows added, removed, changed, duplicate-review, or therapeutic-caution items, the team should contact the appropriate provider, pharmacist, or facility process for disposition. Final medication orders still need to be verified and signed through the facility’s normal workflow.
MedRec does not store source-of-truth medication lists. If a facility stores a medication list with a resident name or date, that storage happens outside MedRec and must follow facility policy, privacy requirements, and applicable agreements. Users should copy medication orders only into MedRec unless their organization has approved another process.
What MedRec can help compare
MedRec can support review of common medication-list differences such as:
- Medications added on hospital discharge
- Medications removed or listed under STOP / Discontinued sections
- Dose changes
- Route or formulation changes
- Frequency and schedule changes
- PRN versus scheduled changes
- End-date and stop-date changes
- Hold-parameter changes
- Brand and generic wording differences
- Duplicate same-medication regimens
- Ophthalmic and otic laterality changes
- Sliding-scale insulin instruction changes
- Hospital-only, completed, inactive, and history-only medication noise
- Differences between a saved source-of-truth list and a new discharge medication list
Example: facility orders compared with hospital discharge medications
The table below is a static example. It is not live clinical output and does not contain patient information.
| Facility / Current Order | Hospital Discharge Medication | Likely Review Category | Why the item needs review |
|---|---|---|---|
| Warfarin 5 mg by mouth every evening | N/A | Removed | Anticoagulant removal should be checked against indication, bleeding risk, discharge plan, and any replacement therapy. |
| N/A | Apixaban 5 mg by mouth twice daily | Added | A newly added anticoagulant may require renal-dose review, bleeding-risk monitoring, and provider verification. |
| Lisinopril 10 mg by mouth daily | Lisinopril 20 mg by mouth daily | Dose changed | Dose changes should be verified before final facility orders are signed. |
| Insulin glargine 20 units subcutaneously at bedtime | Insulin glargine 25 units subcutaneously at bedtime | Dose changed | Insulin changes carry hypoglycemia and hyperglycemia risk and need careful review. |
| Acetaminophen 500 mg, two tablets every 8 hours scheduled | Acetaminophen 500 mg, two tablets every 8 hours as needed | PRN changed | A scheduled-to-PRN change can affect pain control and duplicate acetaminophen exposure. |
| Ciprofloxacin ear drops, right ear, end date 05/22/2026 | Ciprofloxacin ear drops, left ear, end date 05/29/2026 | Laterality changed and End Date changed | Otic laterality and stop dates are clinically meaningful and should be verified. |
| Prednisone taper, 40 mg daily for 3 days, then 20 mg daily for 3 days, then stop | Prednisone 20 mg daily | Dose, quantity, or duration changed | A taper and a flat daily dose are not the same order and need provider disposition. |
| Lisinopril 20 mg daily and hydrochlorothiazide 12.5 mg daily as separate orders | Zestoretic 20 mg-12.5 mg daily | Removed components plus Added combination product | A fixed-dose combination product should remain reviewable because it changes dose flexibility, formulary handling, and hold-order options. |
Why this matters for nursing homes and post-acute care
Hospital discharge medication review is often time-sensitive. A resident may arrive with new orders, changed doses, missing medications, discontinued medications, and instructions that do not match the prior facility record. Long lists increase the chance of missed differences, especially when medication names, directions, and formatting vary across systems.
MedRec helps reduce line-by-line scanning burden by placing the two lists into a structured comparison view. The final clinical decision still belongs to the nurse, provider, pharmacist, or facility process.
Free, browser-based, and designed for privacy-conscious workflows
MedRec is free to use. It does not require a login or account. It does not request patient identifiers. Medication lists are compared in the browser and are not stored by MedRec 2.0.
Users should copy medication orders only and avoid names, dates of birth, medical record numbers, addresses, phone numbers, or other patient identifiers unless approved by their organization’s policy and applicable agreements.
What MedRec does not do
MedRec is a support tool, not a final medication reconciliation decision-maker. It does not:
- Replace clinical judgment
- Replace provider verification
- Replace pharmacist review
- Replace facility medication reconciliation policy
- Decide whether a medication should be continued, stopped, changed, or held
- Verify renal dosing, indication appropriateness, or every possible drug interaction
- Confirm that the source lists are complete or correct
- Store, maintain, or retrieve a facility’s source-of-truth medication list
The output should be used as a discrepancy screen. Each item still needs human review and final disposition.