Lexicomp

Healthcare professionals are faced with frequent drug interaction alerts on a daily basis. They are faced with the challenge of measuring the risk of these potential interactions to the patient prior to acting on the alert.  Today, many healthcare professionals are faced with the challenge of dealing with inappropriate alerts throughout their work days.

Medi-Span Clinical offers the ability to develop alert customization by site, department/group, or even by clinician. This "User Control" function enables you to allow for alerts to be turned off if they are not relevant to the user. Reduced noise and alert fatigue are further addressed through consolidation of common alerts, along with messages that are worded to be meaningful to a variety of clinician types.

Medi-Span, a part of Wolters Kluwer Health, is the leading provider of prescription drug information and drug interactions database solutions for thousands of health care professionals worldwide.

I just re-read a posting by my colleague Matt Bennardo about how Meaningful Use is now addressing patient portals.  A very informative posting.  Although I posted this before,  I am re-posting again and am pulling out an excerpt below:

"Recently, Physicians Practice reported on the challenges facing both providers and EHR vendors when it comes to new Stage 2 Meaningful Use rules. One item noted in the article is that patient portals are now mandatory functionality for EHRs, which was not true under Stage 1.

Though healthcare providers are challenged with setting up and maintaining patient portals for their patients, EHR vendors have the even bigger task of ensuring their software is compatible with a patient portal. For many vendors, this will mean developing their own patient portal as an extension of the EHR system.

Patients are different from clinicians
As this work begins, developers will need to remember that patients are very different from clinical users like doctors, pharmacists, and nurses. Information on medication and conditions that is appropriate for clinicians will often leave patients scratching their heads -- or in a panic.

It will be crucial for developers to leverage "consumer level" content -- that is, information on clinical topics that is written with non-technical consumers or patients in mind. One provider of such information is  Lexicomp.    Not only do they have patient education leaflets for drugs and diseases, but they have consumer-level interaction monographs that can be used in conjunction with some clinical decision support functions.

Contact Lexicomp today to learn more about this consumer-level data to help you build out your patient portal."

One of the main functions of an EMR or EHR is to enable clinicians to provide patient education materials on conditions and treatments to patients. This functionality is part of the set of requirements for Meaningful Use, but what do clinical users really expect?

Primarily, patient education should be relevant to the specific patient being treated. This means that the materials should:

• Be written at a level that the patient can understand -- it should not be written for a clinical audience
• Be written in a language that the patient reads -- ideally the language they prefer
• Reflect the special needs of the patient (e.g., pediatric vs adult)

As to how the patient education should be delivered to the patient, multiple avenues are best. Consider allowing clinicians to print patient education, as well as send it via email or other secure electronic transmission to the patient. Many EMRs are also building patient portals that contain libraries of such materials.

Two trusted providers of patient education are Lexicomp and Medi-Span. Together, these companies provide patient education to hundreds of thousands of clinicians in the United States and around the world.

With the U.S. elections over and President Obama retaining the White House (along with Democratic majority in the Senate), it appears that Meaningful Use is here to stay. Earlier in the year, the Supreme Court upheld the most controversial parts of the new healthcare laws as well.

But what does this mean? It's been clear from the beginning that the Department of Health and Human Services (HHS) does not view Meaningful Use as a one-time program. Instead, it views it as an ongoing initiative that will define healthcare information technology for the forseeable future. This was evident when the new guidelines this year were styled as a "2014 edition" rather than "Stage 2". In not numbering the requirements, HHS is making clear that we can expect many future iterations to be published.

What other clinical decision support functions can we expect CMS and ONC to add to the guidelines in the future? If we look to existing EMR and EHR functionality as a guideline, here are some possibilities:

• Drug-disease or drug-food interaction checking
• Dose-range checking
• Separate interactions checking for pediatric and adult patients
• Separate patient education for pediatric and adult patients
• Patient education in the language spoken by the patient
• Ability to e-prescribe controlled substances

These functions are already possible with the drug and reference data available from such vendors as Lexicomp and Medi-Span. Some EMRs and EHRs are already implementing this functionality, which is allowing them to get ahead in a competitive marketplace.

Don't fall into the trap of just keeping up with federal requirements! Only by looking to the future can you meet the needs of clinical users and create real value for your product.

Now that the election is now over,   the next six months will be interesting to watch.  There had a bit of slow down and a wait and see attitude.  Those EMRs that were on the fence,  will likely start moving rapidly quickly.   They likely will want to take a look at Lexi-Data or Medispan for to supply the drug information as part of the certfication process.  With these  two highly respected drug databases comes a knowledge that support teams will be there to facilitate a quick and simple development process.

My colleague  Marissa said it succintly earlier this week when she wrote:

"EMR vendors end up in a time crunch to select a drug database if they don't take the time of evaluating them early in the process.  This is an often overlooked, but very important component especially if you plan on going through the various certifcation processes.  Not only do you need to select a drug database that has high quality content, but you also need to determine the structure of the data files and how easy are they to work with. 

With Lexi-Data, Wolters Kluwer Health brings trusted, actionable drug information clinicians want directly in their EMR.  With new functionality that clinicians embrace, Lexi-Data delivers decision support functionality that helps reduce alert fatigue and meets the industry's regulatory requirements.  We have a great understanding of Meaningful Use criteria and CCHIT requirements that eases our clients development burden.  We have experts on staff that continuously monitor the latest industry requirements to ensure our funtionality enables users to meet Meaningful Use criteria and CCHIT's medication-related requirements.

If you are interested in learning more about Lexi-Data for your EMR, please give us a call."

EMR vendors end up in a time crunch to select a drug database if they don't take the time of evaluating them early in the process.  This is an often overlooked, but very important component especially if you plan on going through the various certifcation processes.  Not only do you need to select a drug database that has high quality content, but you also need to determine the structure of the data files and how easy are they to work with. 

With Lexi-Data, Wolters Kluwer Health brings trusted, actionable drug information clinicians want directly in their EMR.  With new functionality that clinicians embrace, Lexi-Data delivers decision support functionality that helps reduce alert fatigue and meets the industry's regulatory requirements.  We have a great understanding of Meaningful Use criteria and CCHIT requirements that eases our clients development burden.  We have experts on staff that continuously monitor the latest industry requirements to ensure our funtionality enables users to meet Meaningful Use criteria and CCHIT's medication-related requirements.

If you are interested in learning more about Lexi-Data for your EMR, please give Lexicomp a call.

I just read a posting by my colleague Matt Bennardo  about how Meaningful Use is now addressing patient portals.  A very informative posting.   In case you missed it,  I am pulling out an excerpt below:

"Recently, Physicians Practice reported on the challenges facing both providers and EHR vendors when it comes to new Stage 2 Meaningful Use rules. One item noted in the article is that patient portals are now mandatory functionality for EHRs, which was not true under Stage 1.

Though healthcare providers are challenged with setting up and maintaining patient portals for their patients, EHR vendors have the even bigger task of ensuring their software is compatible with a patient portal. For many vendors, this will mean developing their own patient portal as an extension of the EHR system.

Patients are different from clinicians
As this work begins, developers will need to remember that patients are very different from clinical users like doctors, pharmacists, and nurses. Information on medication and conditions that is appropriate for clinicians will often leave patients scratching their heads -- or in a panic.

It will be crucial for developers to leverage "consumer level" content -- that is, information on clinical topics that is written with non-technical consumers or patients in mind. One provider of such information is Lexicomp. Not only do they have patient education leaflets for drugs and diseases, but they have consumer-level interaction monographs that can be used in conjunction with some clinical decision support functions.

Contact Lexicomp today to learn more about this consumer-level data to help you build out your patient portal."

Recently, Physicians Practice reported on the challenges facing both providers and EHR vendors when it comes to new Stage 2 Meaningful Use rules. One item noted in the article is that patient portals are now mandatory functionality for EHRs, which was not true under Stage 1.

Though healthcare providers are challenged with setting up and maintaining patient portals for their patients, EHR vendors have the even bigger task of ensuring their software is compatible with a patient portal. For many vendors, this will mean developing their own patient portal as an extension of the EHR system.

Patients are different from clinicians
As this work begins, developers will need to remember that patients are very different from clinical users like doctors, pharmacists, and nurses. Information on medication and conditions that is appropriate for clinicians will often leave patients scratching their heads -- or in a panic.

It will be crucial for developers to leverage "consumer level" content -- that is, information on clinical topics that is written with non-technical consumers or patients in mind. One provider of such information is Lexicomp. Not only do they have patient education leaflets for drugs and diseases, but they have consumer-level interaction monographs that can be used in conjunction with some clinical decision support functions.

Contact Lexicomp today to learn more about this consumer-level data to help you build out your patient portal.

Now that the government has released the 2014 Edition of Meaningful Use (also called Stage 2), it will be important for EHR vendors to ensure that they can meet all the required criteria. Here's a quick guide to how Lexicomp can help you meet the requirements:

• Drug-drug and drug-allergy interaction checking [170.314(a)(2)]
• Patient education materials [170.314(a)(15)]
• eMAR (electronic medication administration record) [170.314(a)(16)]
• Clinical information reconciliation [170.314(b)(4)]
• Immunization information [170.314(f)(1)]
• Transmission to immunization information registries [170.314(f)(2)]
• Electronic prescribing [170.314(b)(3)]
• Problem lists [170.314(a)(5)]
• Medication lists [170.314(a)(6)]
• Medication allergy lists [170.314(a)(7)]
• Clincial decision support functionality [170.314(a)(8)]

For more information, contact Lexicomp today!

• Our Web API solution empowers integration of all Lexicomp content. Consistent API programming calls save time and allow clinicians to launch from their internal applications into our clinical databases, utilizing whatever delivery platform they choose.

• Our Web Services platform is written for compatibility with Microsoft® .NET™ and Java™ programs. XML data can be obtained via standardized calls and is then processed and returned in real-time. Your application will retrieve and parse the content into your display, making complete customization a reality.

XML Datasets

• If live Internet calls are not preferred, XML datasets are available for download from an FTP site and incorporated directly into the database.

If you have any questions about Lexi-Data, please contact us!

Thanks to Marissa for her recent post re:  the popular use of Lexi-Data by EMRs.  I would like to add that if Lexi-Data doesn't fulfill of all of your ERM needs, then the best alternative would be to take a look at Medi-Span,  Lexi-Data's sister company data provider.  If you want to know what Marissa said,  I am excerpting below:

"Over the last few years, Lexicomp has become one of the leaders in providing EMR development companies with drug data to include in their products.  We've worked with hundreds of companies to go through MU certification and we continue to stay abreast of changes in the industry. 

Not only does Lexi-Data provide all of the standard drug information that one would expect from other suppliers, but it also provides the best pediatric dose range dosing information, customization for alerts, trusted referential content for users and patient education handouts.  Lexi-Data helps EMRs satisfy several areas of MU crtieria such as: drug-drug interaction checking, drug-allergy interaction checking, patient specific education resources, and CVX/MVX mapping.

Lexi-Data offers an incredibly easy to use data structure and API's and most importantly,  Lexicomp is unparalleled in its customer service and providing assistance in the development process. If you are developing a new EMR and need a drug information supplier, make sure that Lexicomp is on your list."

Lexicomp is a recognized leader in providing patient education leaflets that are easy for patients to read and understand.   Later this month we will be offering improved patient education handouts and an increase in the overall number of handouts in the area of Conditions, Procedures, Discharge Instructions and Healthy Living.  These high quality, evidence-based leaflets will maintain compliance with Joint Commission standards on which clinicians rely every day. The leaflets will be available in both English and Spanish and the top 200 leaflets will be translated into 19 languages.

In order to help EMR vendors meet new Meaningful Use requirements, the leaflets will be coded to both ICD9/10 and SNOMED terms.  Additionally, we are enhancing the delivery capabilities of our patient education materials. A new and improved API along with HL7 Info Button compliance will allow for calls into any of the Lexicomp patient education materials

If you have an EHR, EMR, HIS system, ePrescribing system, patient portal, or consumer website and are looking to integrate patient education, please contact us today.  

Recently I have had several conversations with developers who are building software systems that require not only the standard drug interaction checking, but also a focus on pharmacogenomics.  Pharmacogenomics presents information concerning key genetic variations that may influence drug disposition and/or sensitivity.  Whether the timing of these conversations are coincidence or there is a more clinician focus on more personalized medicine, I'm not sure, but it is exciting. 

We know that pharmacists have always been advocates of individualized pharmacotherapy.  They employ efforts such as therapeutic drug monitoring programs to identify appropriate therapeutic dosage selection. Diagnostic genetic information will help predict not only an individual patient's response to some medications, but also the likelihood of drug interactions and adverse effects- truly enabling the individualization of drug and dosage selection.  

If you are in search of a Pharmacogenomics database, please contact us and we'd be happy to talk to you about our offering.  Our database provides rapidly-expanding genomic knowledge into the management of drug therapy as well as a concise reference on key polymorphisms known to influence drug response.

Over the last few years, Lexicomp has become one of the leaders in providing EMR development companies with drug data to include in their products.  We've worked with hundreds of companies to go through MU certification and we continue to stay abreast of changes in the industry. 

Not only does Lexi-Data provide all of the standard drug information that one would expect from other suppliers, but it also provides the best pediatric dose range dosing information, customization for alerts, trusted referential content for users and patient education handouts.  Lexi-Data helps EMRs satisfy several areas of MU crtieria such as: drug-drug interaction checking, drug-allergy interaction checking, patient specific education resources, and CVX/MVX mapping.

Lexi-Data offers an incredibly easy to use data structure and API's and most importantly,  Lexicomp is unparalleled in its customer service and providing assistance in the development process. If you are developing a new EMR and need a drug information supplier, make sure that Lexicomp is on your list.

Are you developing an EMR and trying to get to the market as quickly as possible?  Are you planning on going through Meaningful Use certification?  If you answered yes to either of these questions (or both!), here are a few tips to help you get started in selecting a drug database for your system.

1) Quality of Content - This is very important to consider as it is probably not the expertise of your developers.  Select a drug information vendor that has a strong reputation in the market and trusted clinical information. 

2) Flexibility - Select a vendor that offers flexibility and customization of the content.  For example, customization of drug interaction alerts in your system (your users will thank you!).  Also, consider the different delivery methods that the vendor offers of their content.

3) Simplicity of Data Structure - Select a vendor that offers simplistic data structure that you are comfortable with.  Also, consider the use of an API if it provided by the vendor.  The use of an already developed API will definitely decrease your development speed.

4) Customer Support - Ensure that you have a dedicated support team to assist you if your developers have questions.  A company that strives for excellence in customer service should not charge you for support time.

Lexicomp works with hundreds of EMR and home healthcare companies to help them embed our clinical content into their systems.  We cover all areas of the core clinical decision support functions: drug-drug, drug-allergy, drug-condition, dose range checking, and duplicate therapy screening.  We support several components of Meaningful Use as well.   Lexi-Data is mapped to RXNORM and other standard vocabularies, supports CVX/MVX coding for transmission of immunization records, and contains patient education for medications and diseases.

Please feel free to contact us and one of our representatives would be happy to talk to you about our content and support.

Written patient education can cover a variety of topics including medication information, discharge instructions and explanations of medical procedures. There are a number of reputable sources for these materials on the market for individual clinicians and electronic medical record vendors alike. But finding a source that accounts for both readability and native of these materials is important. According to Institute of Medicine, Health Literacy: A Prescription to End , patients in the United States demonstrate an alarming rate of illiteracy when it comes to understanding written health information.

 The Keystone Patient Education guidelines promote the concept of patient education being written between a  5^th to 7^th grade reading level as well as a succinct style.  Bulleted, short statements are often helpful, as well as providing the ability to print these in a large font for the vision impaired.

Also critical is the ability to present the information in languages native to the patient to increase the level of comprehension. Although not finalized yet, there have been discussions of incorporating language into the ARRA Meaningful Use Stage 2 language requiring that written patient education be made available for any prominently used language within a given geographical area as defined by the U.S. Census Bureau.

One drug information solution that offers materials in 19 languages and follows Keystone guidelines for written patient education readability is Lexicomp Online, from Lexicomp. This same patient educational offering can be found in Lexi-Data in the three languages of English, Spanish and French Canadian.

Learn more about Lexi-Comp Integrated Data Solutions and how they can make your clinical decision support valuable to your clinicians.

Clinical decision support (CDS) is a broad term that can encompass a wide variety of tools or systems whose primary purpose to provide clinical guidance to health care professionals responsible for order entry and documentation in an electronic medical record (EMR). Additionally, CDS is an important certification component of Meaningful Use for electronic medical records.

Typically one thinks of the pop-up alerts within an EMR during order entry or documentation activities. Before CDS, clinicians performed the task of reviewing patient drug profiles in a "manual" method. For example a clinician completing an allergy review had to compare each drug record against each allergy noted. The clinician's personal knowledge of drugs and allergies were the tools of clinical decision support.

In today's world the EMR uses coded vocabularies to automate that clinical checking process. This automation improves the reliability and accuracy of the patient profile review; however, it also brings it's own "baggage" of potentially overwhelming the clinician with trivial information. Thoughtful implementation of the EMR settings, as well as the drug content data sets, can avoid provider dissatisfaction before it starts. Some drug content sets, such as Lexi-Data from Lexi-Comp, allow for some customization of data to help reduce the noise factor and make the CDS alerts more meaningful.

Learn more about Lexi-Comp Integrated Data Solutions and how they can make your clinical decision support valuable to your clinicians.

I have been asked to respost one of my blogs from 2011 

Are you developing EMRs and practice management systems where speed to market is critical?   One of the modules of such systems is the inclusion of drug information.    Since this is neither the expertise of your developers nor your content people,  it is important to identify the preferred drug information provider early in the process.   Four criteria are critical in making this decision.   First, quality of information.  Second, flexibility of design and APIs.   Third, simplicity of data structure.   Fourth, and very important, customer support during the development period and after release.    More and more EMRs are now using Lexicomp drug information as part of their offering.  And there is a reason for that.

Lexi-Data is the foundation of Lexicomp's clinical decision support architecture is quickly becoming the standard for when companies need an up-to-date comprehensive drug database.  This database provides patient specific alerts and referential content to support sound treatment decisions in areas such as drug interaction checking (drug-drug and drug-food), drug allergy checking, therapeutic duplication checking, RxNorm Mappings, supports Surescripts Certification,  Drug Classifications, dose range checking (adult and pediatric), Patient Education, Pediatric and neonatal drug interactions and more. 

Last week a Company colleague of mine posted some thoughts on his blog about ePrescribing and Controlled Substances.   Pretty interesting.  If not for 2012 than likely for 2013.    Not many EMR and EHR developers are quite up yet with both this need as well as the solution already developed by Lexicomp.  I imagine as Meaningful Use continues to gain steam and ePrescribe becomes entrenched,  the need for ePrescribe re: controlled substances becomes more obvious.  

Electronic prescribing, or eprescribing, is now a basic feature of most EMR and EHR systems. But there is one area where many of these systems still fall short -- eprescribing of controlled substances. This issue is especially important for EHR vendors who are planning to build their own eprescribing module, as physicians and pharmacists are coming to expect that eprescribing will be available for every substance.

The difficulty in prescrbing controlled substances (such as narcotics) is that federal classifications may not apply in every case. States have the ability to issue stricter guidelines on prescribing controlled substances than the federal government does -- and many states do just this. Your eprescribing system must be compatible with the guidelines of every single U.S. territory and state that your users may be practicing in. That means bringing together over 50 different sets of guidelines and making sense of them.

Luckily, Lexicomp has done the work of this already. Their controlled substance (CSA) database takes into account the differing restrictions at federal and state levels, and allows you to confidently implement eprescribing for all substances.