A hospital has stopped amlodipine. The clinical decision is correct, but the loop is still open because GP, pharmacy and care workflows have not all caught up. CareGrid tracks the change from signed decision to confirmed downstream reconciliation.
Authorised by: hospital prescriber
Reason: fictional adverse-effect review
Effective: today, 14:30
Follow-up: GP medication review within 7 days
4 service workflow(s) still need action. A notification alone is not closure.
The hospital record says STOPPED while this service still has the medicine active. CareGrid shows both sources and requires an accountable reconciliation rather than silently overwriting one with the other.
CareGrid keeps this action visible and owned until the responsible service resolves it.
Every service has its own role and permissions. CareGrid records provenance, ownership, acknowledgement and resolution.
The published evidence supports the problem or intervention mechanism. A Sitora pilot must establish the local effect.
An England-wide study covering 1,454 patients and 10,038 medicines across 43 CCGs found that 12.5% of patients still had medicine changes not acted on within 7 days of discharge information arriving. Reasons were documented for only 57% of stopped medicines and 39% of dose changes. A UK randomised trial also found fewer post-discharge discrepancies when community pharmacists received discharge medication information as well as GPs.
A cross-organisation medication-change event with provenance, an accountable recipient, explicit acknowledgement, visible conflict and a defined closed state across GP, pharmacy, hospital, care-home and community workflows.
Whether CareGrid reduces unresolved discrepancies and time-to-reconciliation; prevents obsolete or duplicate supply; improves downstream acknowledgement; avoids missed essential medicines; and does so without creating disproportionate workload.