The password-protected, secure web-based system contains all basic health information, including medical facility and patient searches, patient contact information, preferred labs and physicians, dose change history, detailed visit and test result information, patient medications/interactions, and patient medical and family history. You can also keep track of the addresses and contact information for local physicians, labs and pharmacies, and patients, so you can quickly contact them, or track which ones are being used by your patients (download mailing lists to Excel or Word program). INR Pro^© also allows you to enter historical INR and protime results for each patient, so you can make the proper data-driven decisions. You can also print off a copy of the dosage change and give to each patient, so they don't forget!

CoumaCare^SM users: You can now convert to INR Pro^© without any extra setup charges! No downtime! Read about our conversion process >>>. It is a great idea to use the latest technology, in order to allow your medical organization to function as effectively as possible. For example, if you were looking to find the best mortgage deal for your house, or the best coverage on life insurance in the UK, then you would not hesitate to convert to the service which will offer you the best quality and most efficient solution. The same can be said of the conversion from CoumaCare^SM to INR Pro^©, which offers a variety of upgraded abilities and features.

INR Pro^© is an ideal solution for:

• Clinics with Point of Care testing and on-site consultations
• Clinics with patient self-testing (who have patients call into an automated phone service, call in directly to a nurse for entry, or enter test results online for review)
• Virtual clinics who review testing performed outside of the clinic (test results submitted to clinic via fax, email or mail)
• Clinics with less than 100 patients (see our pricing structure)

Two new features have been added to INR Pro^©, bridging therapy tracking with calendar printout feature, and Bleeding Risk Index calculations. More info coming soon!

INR Pro^© was developed through an AHRQ grant, focused on improving the number of readmissions related to warfarin patients. This system was a key aspect of the improvements implemented in the grant.

It also has numerous reports, including the following:

• Number of patient visits per day, and patient activity by hour in the day (notifications, faxes received, blood testing, received from lab)
• % patients within INR range (Rosendaal [% of therapeutic days in range], Cross Section [% of last visits in range], and traditional [% of visits in range]). Read why having all three calculation methods is necessary for your patient management system
• Cycle Times (test results until communicated back to patient)
• Patient Compliance rating (CAT) scores
• Pre and Post Training Scores
• % Dose Changes per visit
• Complications causing admission
• and more...

Download INR Pro Reports Handout, showing all our reports on 2 PDF pages >>>

By viewing a chart and histogram of a patient's INR values using Statistical Process Control (SPC), the analyst is able to determine whether the patient's readings are significantly higher/lower than historical results, and compare them to the expected therapeutic range. This helps prevent unnecessary dose changes to the patient.

Not every patient has the same needs, and the Patient Priority report provides you with a "Top 10" list of patients with the most Out of Range visits within a specified date range, so you can work closely with them first, without trying to provide additional education to all patients (some may not even need it).

In addition, the system has a tracking mechanism to notify the user of the following...

• which patients are scheduled today
• which patient is overdue for their visit
• which patient still needs training or re-testing
• which patient is waiting to be contacted with their results
• which patient is overdue for thier annual refresher training

The system has 4 different access options for those involved in the Warfarin management process.

1. Clinic Administrators: majority of functionality above, allows edit/add/delete of patient information and test results
2. Patients: allows access to patients to input their home-testing results online, download training materials, and view their historical INR results
3. Physicians: allows access to only their patient results and charts, and provides email functionality back to administrator (to make changes)
4. Labs: allows entering of test results with patient SS number, which will instantly notify administrator of results needing review

Scientific Evidence - Why use these charting techniques?

"Despite the finding that the INR is a weak predictor of hemorrhage overall, small INR increases within the therapeutic range may be the only sign of impending hemorrhage. The bleeding may occur quite rapidly, within a few days of a rise in INR to the upper limit of normal."
-Kucher N, Connolly S, Beckman J, Cheng L, Tsilimingras K, Fanikos J, Goldhaber S. International Normalized Ratio Increase Before Warfarin-Associated Hemorrhage. Archives of Internal Medicine. 2004;164;2176-2179

Statistical Process Control (SPC), in conjunction with trend analysis techniques (Western Electric Rules or Nelson Rules) can identify slight drifts and trends in the INR results (out of control conditions), which can prevent the onset of complications, such as hemorrhage and bleeding in certain patients.

SPC is a key tool within Six Sigma. Six Sigma is a performance improvement system that utilizes data and statistical analysis to measure and improve operational performance and practices. The development of INR Pro^© utilized Six Sigma techniques and methodology. An AHRQ paper will be published in 2008 to summarize the development of this system, and the use of Six Sigma to improve anticoagulation management. In addition, the American College of Chest Physicians (ACCP) recently conducted a study to show the benefits of a Six Sigma initiative to improve patient care. To learn more about how you can get help with Lean and Six Sigma, visit our consulting page.