1. Prescriptor & Clinical Rules practice support & implementation of medicines management www.prescriptor.nl www.clinicalrules.com www.prescriptor.nl www.clinicalrules.com Rob Brenninkmeijer Digitalis

2. Prescriptor/ Clinical Rules: modular webbased architecture / infrastructure Medical record (eg GP) Prescriptor  formulary  prescriptions  Medication surveillance eKompass (Dutch BNF) Document browser  Protocolls (e.g. Nice)  Patient Info Leaflets Patient characteristics: age, sex, problem list, allergies, contra-indications, comedication eGuideline, guidance a.o. from patient characteristics: indications, treatment scenario’s, therapy choices, prescriptions Clinical Rules (webservice):  Alerts & reminders (repeat)medication  Addional guidance therapy choices  Requirements for additional (lab) tests Additional EPR-data: lab, measurements, diagnostic data, etc.

3. Installed base in NL  Interoperable with 6 major GP systems  65% of Dutch GP’s  10 elderly homes  1 hospital (policlinic, starting up)  all prisons and asylum centres  medical service dutch army  Interoperable with 2 major Pharmacy systems (Clinical Rules): 50% of Dutch Pharmacists

4. Collaborations  Dutch college of general practioners  Three most prominent regional formulary committees  Dutch college of insurance companies  Dutch ministry of defence  Involvement in academic research projects

5. Prescribing Clinical Rules Services Clinical Rules communication protocol Multilex ACID Prescriptor Medication safety alerts Patient / medical / medication Record Editorial board / local adaptations Formulary Wizard Formulary Guideline support

6. Electronic Prescribing System Local Regional formularies STEPSelect National formulary (e.g. derived from national guidelines) Formulary Management Local adjustments Reference formularies www.formularium.nl www.prescriptor.nl EPS-Pyramid