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Choi, Hwang, Koo, Cho, Lee, Lee, Kim, Chang, Chin, Chae, Kim, and Lee: Development of Renal Dosing System at a University Hospital
Original Article

Journal of Korean Society of Medical Informatics 2008; 14(4): 373-385.

Published online: 31 December 2008

DOI: https://doi.org/10.4258/jksmi.2008.14.4.373

Development of Renal Dosing System at a University Hospital

Kyung Suk Choi, Soo Hee Hwang, Hyun Kyung Koo, Yoo Mi Cho, Eun Sook Lee, Sukhyang Lee, Hong Bin Kim, Yoon Seok Chang, Ho Jun Chin, Dong Wan Chae, Yoon Kim, Byung Koo Lee

Department of Pharmacy, Seoul National University Bundang Hospital, Korea.

Center for Interoperable Electronic Health Record, Korea, Korea.

Graduate School of Clinical Pharmacy, Sookmyung Womens's University, Korea.

Department of Internal Medicine, Seoul National University Bundang Hospital, Korea.

Department of Health Policy and Management, College of Medicine, Seoul National University, Korea.

Institute of Health Policy and Management, Seoul National University Medical Research Center, Korea, Korea.

College of Pharmacy, Ewha womans University, Korea.

bklee@ewha.ac.kr

Copyright © Korean Society of Medical Informatics

Abstract

OBJECTIVE

This report is describing the development and implementation process of the knowledge-based renal dose adjustment system at a university hospital.

METHOD

From the hospital drug formulary which included about 1500 medications, clinical pharmacists selected 243 nephrotoxic medications which require dose adjustment in patients with renal impairment. Through literature review and consultation of clinical pharmacists, nephrologist, and infectious disease specialist, we developed an accordant renal dosing knowledge-base and used them to build the rules for dosage adjustment alerts and to provide information related to alerts such as patients' age, gender, most recent weight, latest serum creatinine, calculated creatinine clearance, and recommended dosage for renal insufficiency.

STATUS REPORT

As of August 2006, the renal dosing system which monitored drug prescription and generated real-time alerting window to help physician to adjust drug doses in patients with renal impairment was implemented and has been operated well since initial implementation.

CONCLUSION

Renal dosing system based upon knowledge-based renal dosing guideline was successfully developed and implemented into a local clinical practicesetting.

Keywords: Renal Dosing System, Knowledge-base, Implementation, Dosage Adjustment Alerting

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