Galen eCalcs - Module: Anticoag Module

Description

The Anticoag Module is designed to help clinicians begin anticoagulant therapy for patients by estimating the necessary dosage. The tool can also be used to track a patient's therapy over an extended period of time. Due to its robust design, Anticoagulation Tracking has a separate tab in the HTB within TouchWorks. The calculator is broken into 3 sections; a collapsible flowsheet, an input form and an output table.

Flowsheet

The flow sheet within the module is a way for clinicians to view the patient's history without having to click back and forth between the module and clinical desktop. The flow sheet is collapsible for convenience. The filter option allows users to filter by 1 month, 3 months, 6 months or all visits.

Input Form

The input form is where users can enter data regarding the patient's current INR visit.

Data Fields Explained

The following table explains each data field and it's functionality.

Fields that are carried forward will contain the same value from the last visit.

Fields that are required will be bright yellow with a red asterisk next to them indicating that they must be filled out to commit the information.

Name of Field	Functionality	Carry Forward?	Required Field?
INR	A free text field to document INR value	Yes	Yes
INR Date	A date field	Yes	Yes
Goal INR	INR Value ranges that are considered healthy for the patient	Yes	Yes
INR Relative to Range	Where the patient's INR falls in comparison to their Goal INR	No	Yes
Indication of Therapy	Why the patient is receiving therapy	Yes	No
Indication Comments	Free text field for comments regarding therapy. Limit - 250 characters	Yes	No
INR Complications	Any complications the patient experienced	No	No
Treatment Duration	The length of therapy	Yes	Yes
Current Total Weekly Dose	The patient's current dosage	Yes	Yes
Anticoagulant Name	The name/type of anticoagulant	Yes	No
Tablet Strength	Multiple dosage strengths can be selected	Yes	No
Discontinue Notes	Free text field for comments regarding discontinuation. Limit - 250 characters	No	No
Change Dose	A Yes/No field indicating if change in dosage is necessary	No	Yes
Recommended New Weekly Dose	Auto-calculates the patient's new weekly dosage	No	No
Next INR Date	The patient's recommended next visit date	No	Yes
Non-Compliance Risk	Patient's level of disobedience	No	No
Bridging Indication and Comments	Check box and comments field. Limit - 250 characters	Yes	No
Comments	Free text field for any additional comments	Yes	No
Patient Instructions	Additional instructions for the patients, will be pulled into patient print out	No	No

Weekly Dosage Table

The weekly dosage table will initially display the patient's previous dosage per day. When "Change Dose" is changed to "Yes" in the input form, the weekly dosage table will allow users to manually update/enter the appropriate dosage amounts the patient should be taking daily.

Module Outputs

The Output table is a summarized version of the information entered. Towards the bottom of the output table, there are three buttons:

• Show Summary: This button can be selected at any point during data entry to view the summary of information in the output table.
• Commit: By selecting this, the information will be saved to the patient's chart and added to the flow sheet.
• Commit and Print: This button will save the information to the patient's chart and prompt the user to print out a Patient Instructions print out.

Anticoagulation Patient Instructions - Print Out

The print out is an instructive form the patient can use as a reference between visits. The print out contains the following fields:

• Date of INR Test: The date recorded in the calculator as the date of their current test
• Your INR Results: The patient’s current INR value
• Your Goal INR Range: The INR range they should fall into
• Total Dosage per Day: The amount of milligrams per day the patient should be taking.
• Patient Instructions: Any additional instructions given to the patient
• Next Lab Visit for INR: The date of their next visit.

Tasking

Tasks are generated when a patient's INR visit is past due.

Tasking Workflow

1. User enters the patient's "Next INR Date".
2. Patient's INR is not documented by this date.
3. eCalcs will search the patient's chart for an INR value within a specified date range.
4. When that value is not found, a task type "Review Results" will be generated.

Additional Resources

• Anticoagulation Module

References

http://www.pace-med-apps.com/CoumCalc.htm