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Decision-making

The knowledge- and discipline-specific application of IT, aimed at pharmacotherapy, deserves an interdisciplinary approach and enriches the cooperation between physicians and pharmacists. Health care providers like to be involved in the decision-making process, as it increases motivation and expertise, for a focused application. Rational and transparent decision-making depends on knowledge sharing and promotes professional interaction with the health care providers concerned. With SOJA, InforMatrix, and STEPSelect, Digitalis wants to support the rational selection of medication by physicians and pharmacists.

The content of the so-called matrix productions is compiled and maintained by editorial boards of health care experts in the field. The selection models enable users to compare their own choices with those of experts, in a reproducible and transparent way. The productions are available through the web and may also be accessed interactively by groups This increases consensus and leads to more effective medication usage. This methodology constitutes both the basis for the purchasing of drugs and the starting point of effective therapy policies.

Therapy policies

Translating guidelines and formularies to the shop floor, implementation in daily practice, made as ink for the prescriber's electronic pen (EPS). Digitalis works together with knowledge partners to digitise national, regional and local formularies and therapy agreements in the shape of an Electronic Prescription System (EPS). This decreases the distance between the creation of therapy policies and their conversion into daily practice.

Therapy policies deserve a conversion into a practical implementation of the EPS, to increase the effectiveness and safety of pharmacotherapy as an integral part of individual patient care. Such policies require a degree of dynamics, of which professional knowledge management is an important component. Hence the twofold nature of the tools: an EPS for the shop floor and a so-called Wizard to create therapy agreements, and to maintain and adjust these to the effective therapy choices in health care practice. All of these knowledge tools, electronic formularies and therapy agreements are hosted in ‘the cloud’ and therefore easily accessible for health care groups, both within the EPS during surgery hours and in pharmacotherapy consultations.

Decision support

This prompts a parallel with road navigation: expertise and experience are essential, while planning the (therapeutic) routes has great practical value for effective treatment. Safe administration of medication benefits greatly from knowledge-based decision support. An EPS must be more than just a system for electronic prescription processing, and with Prescriptor, Digitalis has developed a knowledge module that links up with existing EPS systems. Decision support has become a valued component of health care IT. Its integration in patient files is the final piece of this type of knowledge navigation in medical practice. Not only the therapeutic options are important, the patient's current context also plays a part: callable from the (interoperable) Electronic Health Record (EHR), online and in real time. This allows prescribers to be supported actively, both in their rational therapy choices and in their taking an alternative route if the patient's specific situation demands a change: this can be compared to the real-time integration of traffic control in navigation systems.

Medication safety

Medication usage is increasing sharply, and with that also the associated risks. At the same time, the volume and speed of the exchange of health care information are expanding. A risk-avoiding society demands a search for solutions to the resulting medication issues and incidents.

Medication problems can be prevented proactively, but unfortunately health care providers increasingly face an information overload. In-process checks while prescribing and delivering medications require an intelligent approach to medication safety: no suggestive alerts, but relevant, specific and concrete advice. To achieve this, the available information must be filtered more specifically for relevant problems, instead of creating a plethora of alerts. Medication safety can be improved greatly by exchanging and introducing a patient's laboratory data. Clinical Rules and Prescriptor provide process support for medication safety ‘at the point of care’.