Blood clot drug test software 'superb'

Software that helps patients taking warfarin to check their blood clotting factor at home is attracting national attention and on the way to exploring an international market.

The INRonline management system, designed by MidCentral Health consultant haematologist Paul Harper and his son, software developer Joe Harper, is one of 10 finalists in the New Zealand Focus on Health Challenge, run by New Zealand Trade and Enterprise.

Last year it won a MidCentral District Health Award for innovation, and it's already a winner with one of its first users, Palmerston North heart patient Howard Ball.

He's been on the blood-thinning drug to protect against the clots that are a risk with his irregular heart beat – the most common reason for being prescribed the drug long term – for about six years.

He found the previous methods for monitoring his condition "a bloody nuisance".

Before the INRonline system, he had to go to the laboratory every month to have a blood sample taken. The results went to his doctor, and if they weren't in the desired range, they'd have to make contact and arrange a dose change.

When he was travelling away from home, getting to a laboratory was even more of a hassle.

Dr Harper said under that system, the 40,000-plus New Zealanders taking the drug weren't getting ideal results about 58 per cent of the time. The danger was that if they took too much, they could bleed too easily, and if they didn't get enough, dangerous clots could form. In the Palmerston North trial, patients achieved a good level of management 80 per cent of the time.

The test kits are rather like a diabetic's, with sharps to draw a bead of blood from the finger, a test strip to collect the blood, and an electronic reading device.

Mr Ball knew they were available years ago, but couldn't afford one. And Dr Harper said the next step was missing – knowing what to do with the result. INRonline allows users to get online advice if a change in dose is needed.

"There are trials using internet contact between patient and doctor, but nor this sort of software that interprets the results, provides feedback to the patient, and flags irregular results to the doctor."

That allows for close medical supervision without the patient having to leave home, or alternatively, lets patients travel abroad and still have monitoring and advice on hand.

Mr Ball can carry out the test in a few minutes from home whenever it suits him, and gets an email reminder.

He runs the test, logs on, and answers a few questions about whether he's missed his pills, started taking any other medication, or has had any recent bleeding or bruising.

On the day he demonstrated, his INR (International Normalised Ratio) was 2.7 – safely within his ideal range.

The computer software responded telling him how much warfarin he should be taking – the dose was unchanged – and even produced a printable calendar showing him how many of which dose tablets he should be taking on each day.

"The convenience is absolutely superb," Mr Ball said, even at dial-up speed.

Since the system was trialled in Palmerston North about 60 patients have bought the $1000 test kit, and some can get subsidies for the test strips.

Another 70 people are on a nurse-led trial around East Cape, and a few pharmacies are offering an in-store test that links into the online programme, bringing the total number of users to around 500.

Dr Harper said gaining recognition in the health challenge awards gave him access to expert advice on business development, legal and marketing advice. And the potential market was global.

The winner of the awards will be announced next year.