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JOHNW. WILSON, M.D., is Consultant, Division of Infectious Diseases; LANCE J. OYEN, PHARM.D., and NARITH N. OU, PHARM.D., are Pharmacotherapy Coordinators, Pharmacy Services; M. MOLLY MCMAHON, M.D., is Consultant, Division of Endocrinology, Diabetes, Metabolism, and Nutrition; RODNEY L. THOMPSON, M.D., is Consultant, Division of Infectious Diseases and Infection Control Unit; JANICE M. MANAHAN, R.N., is Infection Control Nurse; KEVIN K. GRANER, B.S.PHARM., is Pharmacotherapy Coordinator and JENNA K. LOVELY, PHARM.D., is Clinical Pharmacist, Pharmacy Services; and LYNN L. ESTES, PHARM.D., is Clinical Pharmacy Specialist, Pharmacy Services and Division of Infectious Diseases, Mayo Clinic, Rochester, MN.

Address correspondence to Dr. Wilson at the Division of Infectious Diseases, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905 (wilson.john{at}mayo.edu).

Purpose. The hospital rules-based system (HRBS) and its subsystems at a major medical center are described. Summary. The HRBS was implemented at the Mayo Clinic to rapidly identify and communicate crucial information to the clinician in order to optimize patient care. The system also enhances workload efficiency and improves documentation and communication. The system is used by the infectious-diseases division, pharmacy services, nutritional support services, infection control, and the nursing department. The six HRBS subsystems are Web-based programs that share a common structural design and integrate computerized information from multiple institutional databases. The integrated data are presented in a user-friendly format that improves the efficiency of data retrieval. Information, such as monitoring notes and intervention information, can be entered for specific patients. The subsystems use rules designed to detect suboptimal therapy or monitoring and identify opportunities for cost savings in a timely manner. Conclusion. The HRBS enhances the identification of drug-related problems while optimizing patient care and improving communication and efficiency at a major medical center. Index terms: Communication; Computers; Documentation; Economics; Errors, medication; Hospitals; Internet; Patient care; Pharmacy, institutional, hospital; Rational therapy; Toxicity; Workload; World Wide Web

 

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