Accurate information on prescribed medication remains central to safe patient care, particularly during transitions between services. Discrepancies between medication records can contribute to inappropriate prescribing, medication errors and discontinuity of therapy. Several countries have developed digital systems that aggregate current medication information and make it accessible across provider organisations.
A scoping review published in the International Journal of Medical Informatics maps evidence on digitally shared medication lists across healthcare organisations. The evidence covers 24 primary research studies on 11 systems in eight countries, including national centralised medication lists, shared electronic health record systems and complementary or temporary solutions. The overall picture is mixed: shared medication lists can improve access to medication information and support reconciliation, but data quality, usability and accountability continue to limit their value.
Medication Lists Across Care Settings
Digitally shared medication lists bring together information on patients’ current medications or prescriptions and make it available across provider organisations, care levels and IT systems. The list must be accessible in clinical practice and physicians must be able to change its content. Systems limited to one-to-one transfer, patient-only access, pharmacist-only access, historical dispensing data or research-only use fall outside this definition.
Three system types shape current implementation. National centralised medication lists or databases create a single information source that authorised personnel can access, with local electronic health records exchanging information with the central list. Denmark’s Shared Medication Record, Finland’s Kanta services, Norway’s Patient Medication List, Austria’s e-Medikation and Sweden’s National Medication List fall into this category. Shared electronic health record systems create a regional medication list within a common record used by multiple providers and care levels, including examples from Sweden and the United States. Complementary or temporary solutions add specific functions or interim support, including Swiss shared electronic medication plans, patient health records in the Netherlands and MyGeisinger in the United States.
National systems offer wide geographical access, patient portals and better control of high-risk drugs. Shared electronic health record systems can support real-time error reduction, interprofessional work and smoother workflows. Both models face challenges, including outdated information, technical rigidity, privacy concerns, information overload and unclear responsibility.
Medication Safety and Discrepancies
Medication safety is the main goal of digitally shared medication lists. The systems aim to give healthcare professionals more accurate and up-to-date medication information, enable automated safety checks, reduce discrepancies and improve coordination. Additional aims include support for medication reconciliation, workflow efficiency and patient engagement.
Must Read: Digital Scribe Validation Remains at an Early Stage
Discrepancies remain a persistent problem after implementation. Danish Shared Medication Record data from 412 admitted patients aged 50 years or older contained 1,004 discrepancies, with a mean of 2.4 medication discrepancies per patient. More than half of patients had one or more medications listed that they did not administer, and 12.6% used medications that did not appear in the Shared Medication Record. Duplicate prescriptions affected 9.5% of patients. Another Danish dataset of 260 patients contained 925 discrepancies, with a median of three discrepancies per patient. Health system factors caused 53% of discrepancies, patient factors caused 32% and 15% could not be assessed.
The Norwegian e-Multidose implementation showed a reduction in discrepancies from 389 to 122 in the intervention group, while the control group changed from 521 to 503. Mutual prescription items increased from 77 to 94%. Missing prescriptions for psycholeptics, analgesics and dietary supplements fell the most. These results sit alongside recurring concerns about incomplete updates, unclear maintenance responsibility and integration barriers with existing electronic health record systems.
Patient and Professional Use
Patient access can support medication management, but engagement varies. Some patients are familiar with shared medication list services and use them to view prescriptions, health data, healthcare visits, laboratory results and imaging results. Finnish My Kanta users commonly valued access to health data, prescriptions and prescription renewal. Most users in one Finnish questionnaire were satisfied overall, found the service easy to log into and found the recorded information easy to understand. Problems included missing health data, difficult navigation, delays before health data appeared and interest in more guidance. Some users worried that unauthorised people might view their information or that saved prescription and health information might disappear.
Healthcare professionals recognise the potential of shared medication lists but raise practical concerns. Physicians point to workflow, responsibility, time use and data security. Pharmacists tend to view the systems more positively and see practical benefits for medication reconciliation and workflow, despite usability issues. Professional experience across systems includes better overview of medication use, more accessible information and improved communication.
Implementation barriers remain substantial. Technical problems and usability concerns can make workflows complicated and time-consuming. Organisational barriers include unclear responsibility for maintaining medication lists. Wider obstacles include voluntary participation and insufficient financial incentives. Implementation strategies include more training, technical improvements, stronger integration across the medication management chain, clearer role definitions and feedback from healthcare professionals and patients.
Digitally shared medication lists can improve access to medication information across care settings and support medication reconciliation, prescribing and follow-up. Current systems differ in functionality, technical design, information content, implementation and adoption. The most important challenges sit at the intersection of technology, workflow and governance. Medication lists need reliable updates, clear accountability, better integration with existing systems and consistent use across organisations and professions. Evidence on clinical outcomes remains limited, while patient engagement and long-term effects on safety require further evaluation.
Source: International Journal of Medical Informatics
Image Credit: iStock
References:
Josendal AV, Bergmo TS, Clausen SS et al. (2026) Digitally shared medication lists – A scoping review. International Journal of Medical Informatics, 215: 106443.
