At Brigham and Women's Hospital, we also leverage the use of the multiple outpatient electronic medical records and inpatient CPOE systems to facilitate the process of medication reconciliation before, during, and after the hospital stay. This system aggregates medication data from electronic medical records (EMR) and CPOE systems so that clinicians can efficiently generate an accurate pre-admission medication list. Information collected with the use of this application subsequently supports the writing of admission and discharge orders by physicians, performance of admission assessment by nurses, and reconciliation of inpatient orders by pharmacists. Medication histories are thus seamlessly transferred during transition of care from inpatient admission to discharge to home, rehabilitation, or skilled nursing facilities. This efficient system will allow us to carefully document the use or omission of thromboprophylaxis orders. Furthermore, for 90 day follow-up, we will be able to track thromboprophylaxis prescriptions after hospital discharge by using a combination of the Brigham and Women's Hospital's pharmacy's electronic outpatient prescription reconciliation program and Partners' internally developed EMR, the Longitudinal Medical Record.