The Dutch Health Care Inspectorate is urging for a large-scale implementation of medication reviews. However, the realisation of these reviews is limited by several factors: time constraints and the lack of working knowledge in order to be able to systematically and proactively interpret a broad range of clinical pictures and treatment options in relation to clinically relevant chemical lab reports and other patient data. And the lack of standardised criteria to provide uniform, reproducible advice. After all, every health care professional takes action according to their own working knowledge and experience. Furthermore, a medication review could become redundant after one day, due to a change in circumstances.
The traditional method of medication monitoring should therefore be supplemented on several levels: using relevant clinically relevant chemical parameters, a broader patient background and focus on serious problematic cases. This not only improves medication safety, it also supports a more efficient workflow for hospital pharmacists.
Clinical Rules provides this improvement and support both during 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 (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. As the analysis is automated, it requires minimal proactive time investment from health care professionals, while the review can be conducted very frequently.
This makes Clinical Rules a new, additional step in medication safety and medicines optimisation. As an instrument, it is quality enhancing, reliable, time-saving, efficient, more specific, more intuitive to use, easy and well-organised. Clinical Rules is system-independent and does not burden health care professionals with additional work. Rather, it could improve their efficiency significantly. Communication in the chain of care is improved as observations and interventions are transferred more efficiently within the treatment team.
CR Quick Scan measures impact
If your hospital wants to know what the - measurable - results could be from a possible deployment of Clinical Rules, we advise you to run the Clinical Rules Quick Scan. The Quick Scan is designed in collaboration with iCON healthcare and shows and clarifies the impact of Clinical Rules on your organisation. Over a period of 30 days it retrieves the needed data from the various systems in the hospital. This information is read into the CRR and with the use of Qlik Sense it is clear what the return on investment (ROI) of Clinical Rules would have been during those 30 days.
Currently guidelines and decision rules are being developed to support the pharmaceutical health care industry in collaboration with several hospital pharmacists. These guidelines are also being expanded and implemented as part of the project SCREEN, in collaboration with Zuyderland (formerly Orbis-MC) in Sittard/Geleen.