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The traditional method of medication monitoring can be improved, in particular by covering a broader patient background. The patient file should therefore include more than 'merely' medication. Especially clinically relevant chemical parameters should be included. This substantially reduces the number of unnecessary warnings and you will receive more relevant reports and fewer false positives or false negatives. This does have consequences for your standard operating procedures. Currently, doctors write prescriptions and submit lab requests simultaneously. You receive the prescription immediately, but you will not receive the lab report until several days later. Your current medication monitoring system does not account for this asynchronicity.

It is therefore necessary to supplement the current pharmacy information systems to monitor medication more purposefully. What is lacking is a secure infrastructure for the exchange of relevant patient data and a high-quality knowledge base.

Relevant alerts

Clinical Rules provides support both for the delivery of (repeat) prescriptions and the monitoring of prescribed medication, for example when lab reports become available, a patient reaches a certain age limit or when a new diagnosis is made.

This monitoring process is made possible through a collaboration with your XIS provider and/or electronic health records (in the Netherlands: Landelijk Schakelpunt, or LSP), in which anonymised data are exchanged with the centrally managed Clinical Rules Engine via the Clinical Rules Reporter. The Clinical Rules Engine detects potential problems and reports these back to the Clinical Rules Reporter.

If you are registered with LSP as the manager of an electronic patient file, after obtaining patient consent, you will receive notifications of changes to the patient file in any of six pharmaceutically relevant areas. The Clinical Rules knowledge base also checks whether any action is required on your part regarding this change, in order to filter out only relevant notifications on different alertlevels. This makes Clinical Rules a new and additional step in drug safety. As an instrument, it is quality enhancing, reliable, time-saving, efficient, more specific, more intuitive to use, easy and well-organised.

Pilot StatusScoop

In 2013 in collaboration with several community pharmacists, Z-index and eZorg a project started to unroll guidelines to support the pharmaceutical health care. The group of practising pharmacists, organised in the Stichting StatusScoop, has taken the initiative to create an infrastructure based on LSP and to integrate this with Clinical Rules.

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