Figure 1.

Process and modules of the transition concept as well as criteria for their use (gray); several modules (1–4) can be used in a single patient.

*¹ HIS = hospital information system; admission and discharge tools were programmed by the hospital’s IT department in SAP/i.s.h.med.

*² The criteria (gray) for the use of the modules were set prior to the start of the study by an expert panel of clinical pharmacists and physicians.

*³ Oral anticoagulants = phenprocoumon, dabigatran, rivaroxaban, apixaban; cardiac glycosides = beta-acetyldigoxin, digoxin, digitoxin

*⁴ Faxed only to verified provided fax numbers after written authorization by the recipient