Health system developed method to track medical marijuana use in patient records | Research

The takeaway

A Pennsylvania health system's structured documentation tool for medical marijuana captured certifying conditions and products well (93% and 93%) but dosage information poorly (31%), highlighting a gap in clinical cannabis documentation.

Health system administrators, medical cannabis clinicians, health informatics researchers

Only 31% had dosage documented

What the researchers found

Smart data elements for medical marijuana documentation had high completion for certifying conditions (93.6%), product (92.9%), dispensary (87.8%), and active ingredient (83.3%), but low completion for certifying provider (61.5%) and dosage (30.8%). Documentation was primarily done by nurses/medical assistants (88.5%) in primary care settings (68.6%).

Why it matters

Without systematic documentation of medical cannabis in health records, clinicians cannot track patient use, assess drug interactions, or evaluate treatment outcomes. The 31% dosage documentation rate is a significant safety gap.

The numbers in context

156 records analyzed. Interrater reliability kappa=0.966. Condition documented: 93.6%. Product: 92.9%. Dispensary: 87.8%. Active ingredient: 83.3%. Certifying provider: 61.5%. Dosage: 30.8%.

How the study worked

Retrospective analysis of 156 medical records with MMJ documentation at Geisinger health system (Pennsylvania). Protocol developed for consistent data extraction with high interrater reliability (kappa=0.966).

What this study cannot tell us

Single health system in Pennsylvania. Only captures documented use, not actual use patterns. Retrospective design. Smart data elements are voluntary and dependent on clinical staff completing them.

How to read the evidence

Single-system retrospective analysis with high data extraction reliability, but limited to one institution and one documentation approach.

When this study was published

2024 analysis of Geisinger health system MMJ documentation (2019-2022)

The bigger picture

The lack of integration between state MMJ registries and health records means clinicians cannot easily identify patients using medical cannabis, unlike other scheduled medications visible through prescription monitoring programs.

Questions still open

Would mandatory EHR integration of MMJ registry data improve documentation? Can improved documentation reduce adverse drug interactions for medical cannabis patients?

Common questions

Do doctors know when patients use medical marijuana?

Not consistently. No integration exists between Pennsylvania's MMJ registry and health records. This study's structured documentation tool helped, but dosage information was recorded only 31% of the time.

Who documents medical marijuana use?

In this study, nurses and medical assistants (88.5%) documented MMJ use, primarily during primary care visits (68.6%), rather than the prescribing physicians themselves.

Read the original research

Medical Marijuana Documentation Practices in Patient Electronic Health Records: Retrospective Observational Study Using Smart Data Elements and a Review of Medical Records.

JMIR formative research, 8, e65957

View on PubMed ↗Publisher’s paper ↗

Citation

Beiler, Donielle; Chopra, Aanya; Gregor, Christina M; Tusing, Lorraine D; Pradhan, Apoorva M; Romagnoli, Katrina M; Kraus, Chadd K; Piper, Brian J; Wright, Eric A; Troiani, Vanessa. (2024). Medical Marijuana Documentation Practices in Patient Electronic Health Records: Retrospective Observational Study Using Smart Data Elements and a Review of Medical Records.. JMIR formative research, 8, e65957. https://doi.org/10.2196/65957