Galen eCalcs - Module: Anticoag Module
The Anticoagulation Tracking calculator 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.
The flow sheet within the calculator is a way for clinicians to view the patient's history without having to click back and forth between the calculator 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.
The input form is where users can enter data regarding the patient's current INR visit.
Data Fields Explained
The following table explain 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||Calculator will calculate 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.
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.
Tasks are generated when a patient's INR visit is past due.
- User enters the patient's "Next INR Date".
- Patient's INR is not documented by this date.
- eCalcs will search the patient's chart for an INR value within a specified date range.
- When that value is not found, a task type "Review Results" will be generated.