If patients stay in their therapeutic range, the risk of complications (stroke, bleedings) will decrease. This range is monitored on a regular basis in a timeframe between 3 and 28 days, depending on their individual stability. The dosing scheme of the medication is adapted depending on the result of a blood analysis (INR) and historical medical data.

This blood analysis is performed in one of two possible ways:

1. Within a laboratorium (for ‘regular patients’);
2. By a self measurement handheld device at home (for ‘self measurement patients’).

Objective criteria are defined by the FNT to select patients for self-measurement. These patients are trained at the TTCA to teach them the necessary skills. An Internet based e-learning module supports part of this training.

eTTCA has produced an ASP service supporting already 25% of all Dutch Anticoagulation Clinics. In this ASP service the medical treatment protocol has been automated using a HL7 Version 3 RIM based Electronic Health Record and a Workflow system. The aim of the ASP service including the embedded medical treatment protocol is to ensure and guard the exact follow up of the disease management in the most transparent and effective way. All clients relevant medical data is monitored continuously 7x24 hours and based upon the value warning signals go to the relevant medical professional.www.thrombosedienst.de und www.thrombosedienst-mainz.de