DPV Rules

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All rules are available to any client free of charge and new rules created by a client become part of the rule library open to all. The VigiLanz Rule Builder allows the user with authorized privileges to build rules easily and quickly using drop down menus that show all the formulary drugs and all the Hospital's labs. The user makes drug and lab selections and fills in other required fields such as whether the lab is a high or low lab and the lab values they desire for the rule to fire. An optional value that can be specified is a Good Medical Practice Interval (GMP). This is a time period either fixed or variable that the VigiLanz system uses to reduce the number of alerts. If a rule is satisfied by a correct drug action within this period that activation of that rule will not become an alert. Thus if a physician in the normal course of rounds makes a change in the drug regime within the time period the pharmacist will not have to intervene. The use of a specified GMP interval allows time for a clinician to make the appropriate change in a non-critical situation which turns off a rule activation with this new drug order meeting the specified criteria and is key to reducing pharmacists' workload due to over alerting..

Past lab values can be made part of the rule so that not only does the current lab have to be greater or less than the cutoff value but also the previous lab values have to bare a user chosen relation to the current lab. This allows comparison to baseline values e.g. the Maximum or Minimum or Average or Median or the immediately previous lab of all the patient's previous labs has to be less/more than X% (or some distinct value you choose) of the current lab for the rule to fire.)

Filters can be chosen that restrict the scope of the rule for age, gender, weight, Unit of the Hospital or prescribing Physician. Associated drugs and/or labs can also be chosen that qualify the rule even further so that the rule will only activate if that set of additional drugs/labs are present as well as all the other parameters that are set in the rule.

Each rule directs a correct drug action chosen by the user that will satisfy the rule. This can be raise or lower the dose, discontinue the drug, change the dosing schedule etc. all through choices available through drop down menus that display the available options. If a rule is satisfied within the Good Medical Practice Interval it will not become an alert and will disappear in the warning phase from the action screens. If not satisfied in time or the drug action is incorrect it will become an alert.

The rule can be given accelerators such that very abnormal or trending labs call for faster  or slower action. 

Rules can be created, edited, put into production, taken out of production and assigned to clinical rule groups as the user wishes. Rules can also be cloned so that a rule for one drug/lab/weight range/age etc. can easily be made for a another in an instant.
  
The following are Rule Descriptions only.  All the details that make up each rule are easily seen in the Rule Builder and can be viewed as a group within the Vigilanz Report System. Here we show only the rule description that the user created.  It should give a general sense of why the rule was created. For a closer look at our rules think of calling or writing for an online demo.

DPV Rule Examples

Drug induced hyperkalemia

ACEI, ARB and K >5
Potassium supplements and K>5

Critical drug levels (low and high)

Carbamazepine, lithium, digoxin, phenobarbital,Theophylline
Digoxin level >2.0, evaluate for possible ADR or dose adjustment
Elevated theophylline >20, evaluate for possible ADR or dose adjustment
Elevated carbamazepine level >12, evaluate for possible ADR, or dose adjustment

Drug induced hypoglycemia

Anticoagulation monitoring

Drug induced thrombocytopenia

Reversal agent use i.e. ADR tracer drug alert

Drug induced hepatotoxicity

Renal Dose rules

Anticonvulsant therapy