An information infrastructure design to support home care of warfarin users: problems and possibilities

Abstract: The anti-coagulant warfarin is consumed by around 200 000 people in Sweden every year. There are many dose affecting factors, and if the dose is wrong the consequences can be severe. Hence patients are required to regularly have their coagulation ability tested so that the dosage can be adjusted if needed. In this study the dosage regulation processes of warfarin in Swedish home care are examined through a case study, where-after an information infrastructure design is created that could support the identified needs. The proposed design is formed through combining three separate IT-capabilities: a general purpose health care platform, a warfarin specialist software and a medication reminder application. The design was guided by the application of the information infrastructure design rules with the aim of uncovering problems and possibilities associated with this design approach. By applying the information infrastructure design rules a technical architecture could successfully be created. Additionally, information exchange specifications and important decision making points could be identified or solved successfully. However the design rules were found to assume an unlikely level of openness and to lack a focus on organizational and legal factors which make them difficult to apply in practice.