Scientific insights and studies (such as HARM and pharmacokinetic analyses) are translated into actionable decision rules for clinical practice with the help of health care professionals. One of these important sources is the project SCREEN, which is run in collaboration with the department of Clinical Pharmacy at Zuyderland (Sittard-Geleen). Other sources are the medical and pharmaceutical decision rules (Medisch Farmaceutische Beslisregels (MFB)) in the G standard of Z-index for example. All these decision rules are used in the Clinical Rules protocols and are managed (including source references) centrally in the so-called Clinical Rules Engine.
Support for clinical practice
The Clinical Rules Engine runs on a server that is capable of analysing anonymised patient data. The Clinical Rules Engine does not store patient files. The Clinical Rules Engine activates and automatically interprets relevant protocols during this process. Clinical Rules protocols support clinical practice by incorporating the patient's personal risk profile. This is useful, for example, for medication dosage in relation to kidney functioning, electrolytes in the case of heart medication, and the choice of anticoagulants in cases of cardiac arrhythmia (CHADS2). Those who compile the data and users in clinical practice are the best to determine the value of clinical decision rules and are able to provide suggestions to improve the system based on their user experience. In this way, the structure to ensure medication safety is partly created from within clinical practice.