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Often patients with a long admission in the hospital are allowed a stay during the weekend at home. In the hospital system this weekend stay is not seen as a discharge.
However, during this period, the medication for the stay at home is treated as in the case of a discharge after an admission. After the weekend home stay, actions are taken as if with a new admission. 

• This means that the admission medication will be transferred to the home medication. 
• Next the home medication will be validated & uploaded to Vitalink. 

• Often, a patient friendly medication scheme will be printed for the weekend home stay.
  • Also from here it is possible to validate & upload the medication list to Vitalink (cfr. ambulant visit). 

• After the weekend, the home medication is normally not changed. However, a Vitalink sync will be done.
• Next, the home medication will be transferred again to the admission medication. 

• When having a discharge over the weekend, medication is normally not substituted. 
• When having a final discharge, the medication is re-substituted as much as possible to the original medication.

• In some cases, when having a discharge over the weekend, the admission medication is not transferred to the home medication.
• This means that no update of the medication will be available on Vitalink.
• This is only done when no mediation problems are expected. 

3. Transfer to other hospital

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In the case medication (e.g. intravenal medication, hospital specific medication) is not uploadable to Vitalink, the medication  is passed on to the receiving hospital via the transfer note.

This is because information during and related to an admission is often hospital-related and not adaptable to home medication as is the purpose of the Vitalink format.

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Automatic questioning of Vitalink

Mandatory

• When opening a patient's

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• EHR, it must be checked automatically if the registration of the informed consent is fulfilled, if there is a Vitalink medication scheme for this patient and whether the

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• EHR has the most recent version of the Vitalink medication scheme.
  
  
• This automatic questioning is done for all patients as soon as their file in the

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• EHR is opened, independent what the reason for hospital visit is (ambulant visit, emergency room visit or admission).
• An automatic questioning of the Vitalink medication scheme is crucial. The care giver should not take any action (eg no click to start a download).
  
  
• Automatic import and analysis of the information from the Vitalink medication scheme in a combined overview should take a minimum of time (preferably 4 to 6 seconds or less on average, with a maximum of 10 seconds). 
• This takes place in the background and starts immediately when the patient's medical record is opened. In the meantime, the CG can continue working in the

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• EHR.
  
  
• When the Vitalink medication scheme has been received, the CG can easily switch between his/her work screen and the medication scheme (eg through tabs or other interaction mechanisms). 
• This may not take more than one click on the screen.
  
• It is important that the vendor can monitor the performance in an active way if the automatic import and analysis of the information from the Vitalink medication schedule takes more than a pre-determined number of seconds (eg after more than 10 seconds).
• If, after an adjustable period of, for example, 60 - 120 seconds, a connection has not yet been established with Vitalink, the connection will be terminated automatically.
• The CG is hereby informed about the problem in a user-friendly and concrete way and should be able to send the error easily (ask for error report).
  
  
• The CG must be able to clearly see whether or not a Vitalink medication scheme has been created for the patient. If not, the CG must be able to indicate that he/she wants to make use of the Vitalink medication scheme for the patient in question, if applicable.
• The CG must be able to clearly see that the application is still working on importing the information from the Vitalink medication scheme.
• The CG must be able to clearly see when the import of the Vitalink medication scheme has been completed.
• The CG must be able to clearly see when the application has failed to import the Vitalink medication scheme.
• In the case of a hospital, if all

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• mandatory authorizations/mandates are set, it must be possible for a member of administrative staff to prepare the

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• EHR by importing the medication scheme for the patient in question.
   

Recommendations

• Display visually that the application is working on the Vitalink medication scheme.
  
  • This can be done, for example, by a progress indicator or an icon indicating that the Vitalink medication scheme is loading.
    
    
• Display visually that the Vitalink medication scheme has been collected.
  • This can be done, for example, by an icon indicating that all data from Vitalink has been retrieved (+ mandatory information: date & time of last download).
    
    
• If it is not possible to obtain data from the Vitalink medication scheme, also visualise it and indicate why there is a problem / what the problem is (in understandable language).

One combined overview of all active medication

Mandatory

• It is important that the care giver has one overview of the active medication of the patient. Since information about the active medication can be found both in the local EMR and on Vitalink, the CG wishes to see this information in one combined overview. 

The CG does not want to compare the information from the local EMR and the Vitalink medication scheme manually to determine what has changed. Comparing two different schemes is too time-consuming, too complex and can lead to mistakes. Methods where they can 'update' per line, 'upload' are not well understood. Rows in a table using different status icons can not be interpreted unambiguously.

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