TeleWarfarin – Establishment of a virtual anticoagulant clinic using an internet based expert system


This project started out as a cross over randomised controlled trial in the anticoagulant clinic at Cork University Hospital (CUH). The trial’s objective was to determine the effectiveness of an internet based expert system and compare it to the usual care clinic. The results showed that the expert based system was more effective at maintaining patient time in the therapeutic range.



Current Status

Following completion of the trial in 2008 the anticoagulant team continued to manage patients who had participated in the trial and also trained up new patients to use this system. There are currently 84 patients actively self testing their oral anticoagulant therapy (OAT) each week. This reduces the amount of time these patients spend attending clinic and has given great freedom to people on chronic OAT. It reduces their exposure to hospital infections and it reduces overcrowding in the OAT clinic.

Our objective is to improve the quality of life of patients prescribed chronic OAT, also improving the patients’ time in the therapeutic range, which in turn reduces the risk of adverse events.

Future Plans

We plan to expand the clinic to include more patients monitoring their OAT at home and to collaborate with the School of Pharmacy (UCC) to educate more healthcare professionals nationally and internationally on the benefits of this novel service.


This project was originally funded for a three year period by the Health Research Board, Roche Diagnostics and Zycare under the Building Partnership Grant award in 2005 (PA-05-16). CUH are currently funding the costs associated with running this service.

Key team members: Key members of the multidisciplinary team include Dr. Susan O’Shea (Consultant Haematologist (CUH)), Dr. Stephen Byrne (Senior Lecture in Clinical Pharmacy (UCC) and Ms. Caitriona O’Leary (Clinical Nurse Specialist (CUH))