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13
| 3 | 2004
Klinisk Biokemi i Norden
Based on these and other studies we formulated
algorithms to determine
- whether a change in INR was significant and not
due to analytical and biological variation.
- if the dose should be altered and
- the new dose.
A contact to an IT-firm with ideas about program-
ming decision support systems for clinicians led to
an oral anticoagulation system project.
If this project became a success it might be pos-
sible to create similar systems for diseases where
treatment was decided after biochemical monitoring
of the patient, e.g. diabetes.
Some of the success criteria were that the system
should
- increase the quality of the treatment
- reduce dosage errors
- reduce the number and severity of intoxica-
tions.
- enable paramedical staff to handle dose adjust-
ment in uncomplicated cases.
- give some patients the possibility of self-care
with on-line support.
- be a dedicated electronic patient record.
- be able to generate documentation of treatment
quality.
- be time-saving
- handle all patients in oral anticoagulation treat-
ment in the county (approx. 3500) in one
system.
The system
The work-flow in the outpatient department and in
the laboratory was studied before simulating it in
the system.
The INR result is automatically transferred to the
patients record. The system rates the INR result in
relation to the patients target value and signals with
a flashing blue light if the value is very far away
from target. Indications with red, yellow and green
Figure 2.
Patient record.
(Fortsættes side 14)
Figure 3.
Dossage prescription.
