The medication profiles that meet the selected criteria are printed.

The profiles are then reviewed by clinical staff specific to the exception criteria upon direction of the Clinical Manager.

After the pharmacist review, the medication profiles are returned to the Clinical Manager to:

• perform a second review to assure that the profile demonstrates that the exception has occurred and deserves further attention
• select profiles for a physician specific letter
• assure that the cover letter to the physician is specific to the current RetroDUR topic.

Physician responses are faxed to the Clinical Manager for review.

The results of the clinical reviews and physician responses are presented to the DUR Board for discussion.

The Clinical Manager responds to any further direction regarding the selected topic from the DUR Board and all cases concerning a specific intervention are moved into a cost savings tracking system.

After six months, cost savings begin to be calculated. This waiting period allows time for the intervened provider to make the appropriate changes in therapy.