In today's health care system, no one person may be not even you know exactly what drugs you're taking. No health care provider knows how the patient takes your medications and at what doses.

A 2016 study at the Johns Hopkins University School of Medicine suggested that medical errors are the third leading cause of death in the United States. Many of these deaths are directly related to errors associated with medications. The Centers for Disease Control and Prevention estimates 1 million visits to emergency rooms each year stem from adverse medication events.

Also, thousands of people are harmed by suboptimal medication management, or because they don't take their medications as directed. And millions of health care dollars are wasted each year in the form of duplicated or unneeded drugs and medication-related hospital readmissions.

As dean of the UCSF School of Pharmacy, a school defined by science, as well as a researcher who has strived to improve the effectiveness and safety of medications, "I think the key to solving these problems is to expand the role of pharmacists. My position on this point is based on accumulating evidence."

Investigating the problem

In a 2015-2016 project, UCSF School of Pharmacy pharmacists compared the accuracy of the medication lists of 135 newly discharged patients with the medications the patients ended up taking.

Not one of these lists completely reflected medication use at home, even though each patient had been recently discharged from a controlled hospital environment.

Common errors included:

1. Duplication of therapy (either getting two of the same medication or two drugs in the same class)

2. Omitted but necessary medications

3. Unreported use of herbals or dietary supplements

In a previous project in 2014, as part of a new transition of care program, patients received an automated phone call 48 hours after leaving the hospital. Any reported issues resulted in an immediate phone call by a nurse and pharmacists addressed any medical issues.

Let pharmacists do their best work

Ensuring an accurate, managed medication list for each patient would require a radical change in the business of health care. The current community pharmacy business model is based upon the volume of drugs dispensed.

In a new patient-centered model, pharmacists would be reimbursed for dispensing their advice to patients, just as they are for dispensing drugs. In this model, the pharmacist is a critical member of the patient's healthcare team.

A tectonic shift in business models might seem like a lot to ask, but empowering pharmacists with the ability to apply their extensive medication knowledge fully is an obvious next step toward ensuring patients receive the safest, most effective drug therapy.

Couple the power of an accurate medication list with the medical expertise and management of the pharmacist, and I see patient health improving, adverse drug events falling and health care dollars being saved in the process.