A methodology pathway to develop a Computer Drug Safety program in Primary health care setting based on clinical audit

Abstract

Objective: Medications management is an area in Primary health care (PHC) and General Practice (GP) setting where decision making is very important. Computer Decision Support program have been developed to help primary physicians in their decisions and have proved effective in improving the process of care and promising in economic issues. Methods: In order to create a Computer Drug Safety (CDS) program for managing oral anticoagulant therapy for use in PHC and GP setting with developed Information Technology (IT) System and established electronic Health Records (eHRs), we used clinical audit (a real-life practice analysis) as the methodology framework. We assumed that this method would enable a proposed CDS program to cope with clinical complexity of GP patients taking oral anticoagulants and also suggest this method as the operative framework for Quality of Care (QC) improvement and practice research. Results: By using clinical audit, we were able to identify the list of elements necessary for building up a feasible CDS program for a long-term oral anticoagulant therapy surveillance, for use in PHC and GP setting. According to this list of elements, we were able to create a paper based concept (a schemata) for this program development. This CDS program would not be a simple drug-dose calculator, but a comprehensive software support system integrated within the existing IT work applications. Conclusions: The main benefits, expected from this proposed CDS program, include: learning from work experience, oral anticoagulant QC improvement, better patients compliance to long-term treatment with the drug warfarin, practice performance follow up and practice research.