EMRs and EHRs have already greatly impacted the way clinical decisions are made. Safer and better decisions are possible, if there is quality and relaible drug data at the heart of all clinical decision support systems. To make their quality drug data even better, Lexi-Data has introduced a new structure which allows for the customization of Black Boxed Warning. These warnings act to reduce alert fatigue, while at the same time delivering warnings to the people who needs them most.
Such new technologies will make all areas of clinical decision support better, contact Lexicomp today to see what they can offer you.
One of the most common comments I hear from users of Electronic Medical Records (EMR) systems is associated with “alert fatigue” from unwelcome drug interaction notifications. Many users tell me that they are flooded with unavoidable but unnecessary alerts that interrupt their workflow, decrease productivity, and make the important alerts harder to see. Clinicians find themselves clicking through the alerts as quickly as possible which defeats the purpose of clinical decision support.
In today's fast-paced healthcare industry, electronic health record (EHR) and other healthcare information system vendors need smart, current drug data that will enable their systems to drive patient safety and improve healthcare -- without generating a flood of annoying alerts that will only be ignored. Lexicomp has recently included new functionality that can alert users with the appropriate Black Box Warning where appropriate in the current workflow.
In the most simple terms, an FDA Black Box Warning is the strongest warning that the US Food and Drug Administration (FDA) puts on a drug. It means that you should pay close attention to the drug's usage because there are some potentially extremely harmful or dangerous threats to your health that the already FDA approved drugs could pose.
The other side of the coin, however, is that an FDA Black Box Warning means that despite the FDA's knowledge of these harmful, serious and sometimes deadly side effects that they are still leaving the FDA approved drug on the market for you to be able to take and potentially experience these harmful side effects. In theory, these FDA Black Box Warnings are designed for both the doctor who is prescribing the drug to be aware of the problems and for you as the consumer to be more aware.
The warning is placed in a prominent 'black box' on the package insert of an FDA approved drug so that people and their doctors can be more aware of it, but few doctors ever see the pill bottles and the vast majority of consumers realistically aren't going to go through the amazingly large amount of technical and medically detailed information on a package insert. This can lead to doctors note being aware of a serious alert which can have serious consequences. With Lexicomp’s inclusions of Black Box Warnings within their medication database, the warnings can be provided to the physician during the prescription process where they are most needed.
In the last several years that have been more and more EMR entrants into the ambulatory marketplace. As part of the development of these products they have been required to include drug information as part of their clinical decision support solution. Lately there have been more requests to provide this drug and medicine information by way of web services calls rather than embedding the data directly into the product. Often times there might be limitations on the EMR's development team and accessing this drug information through web services call could be the simpler solution.
Lexicomp recently released web services calls for drug information that would cover Meaningful Use Stage 1. So for EMRs in the development stage looking for:
- Drug - allergy checking
- Drug - drug interaction
- Duplicate therapy checking
- Drug lists
You might want to give Lexicomp a call.
In the last two years Lexicomp has quickly become a major provider of drug information to EMR companies for clinical decision support. Many of the new EMRs hitting the market are using Lexicomp medicine information for drug interactions, dose range checking, therapeutic dosages, adverse drug advents, electonic eprescring, and more. Lexi-Data has become the popular choice based on top quality information, unparalleled customer service, state-of-the-art data structure and top-notch APIs. Now something new!!
Lexi-Data has introduced a new structure which allows for the customization of Black Boxed Warning to reduce alert fatigue, yet at the same time delivers the warning to the person who needs it most. This information structure is new and as far as we know not available elsewhere.
API and Database Features:
- Incorporates not only the BBW as published within the package insert, but also pulls contextual or supporting information as written by Lexicomp clinical experts
- Each summary is broken down and tagged as separate messages / instructions
- Each message is paired to a recipient user category – this allow for differentiating where in the workflow of an EMR the message may be displayed
- Can be filtered for a more specific and targeted set of messages to clinician/recipient groups, as defined for their site
This is terrific stuff. So for anyone developing drug interaction software or eprescribing modules, this is something you will want to look into.
EMR vendors are not the only ones rapidly deploying clinical decision support systems to healthcare providers. Dental professionals are demanding that their practice management systems overcome massive development hurdles in order to comply with Meaningful Use standards.
There is a buzz in the dental technology community about Meaningful Use and incorporating more clinical decision support into the practice management system workflow. If you are searching for the best dental specific drug database to integrate into your dental EMR, turn to Lexicomp. There are very few suppliers of drug data within the dental market and even fewer still that are easy to work with. And if you are looking for an easy-to-use, out-of-the-box ePrescribing tool, trust our partner DoseSpot to deliver the solution. What do all of these companies have in common? They are easy to work with and provide you with the ability to get to the market fast!
Don't wait to the end of your development process to worry about: dose range checking, pediatric dosing, drug calculators, medicine interactions, dosage precautions, clinical guidelines, drug interaction software, duplicate therapy, drug classifications, generic drug names, drug nomenclature and more. These are critical paths for a dental EMR build. But it's not just about the information. It's about who you select as your partner and who has seamless API's which makes your development easier.
You owe it to your product and your customer to make the right choice.
One of the key reasons that clinicians are frustrated with decision support related to drug interaction software is the potential for alert fatigue. Clinicans do not want to be messaged regarding dosage precautions related to an interaction which has already been recognized and addressed. It is particularly important in the era of electronic prescribing to engineer systems which can present the appropriate information to the appropriate person. Systems need to recognize whether an individual has previously addressed the issue, rather than simply blindly alerting to the presence of two medications within the medicine list. A collaborative effort between drug database providers and application vendors is needed, and discussions to improve the quality of alerts, while decreasing the quantity, are moving forward. These will greatly improve satisfaction with these tools.
If you are in pediatrics you are most likely familiar with the
Pediatric Dosage Handbook or
Pediatric & Neonatal Lexi-Drugs by Lexicomp. If you are not familiar with these resources I would highly recommend looking into these as many consider this information as the "bible" in safe pediatric dosing. Now that Meaningful Use has been introduced and the larger overall concept of clinical decsion support and integration, Lexicomp has taken this key content and made it available as a database accessed through APIs.
Now that more and more clinical decision support resources are being integrated into the workflow, Lexicomp has invested the resources to be able to offer healthcare applications like EMR, CPOE, etc., a comprehensive database that can easily be implemented for
pediatric speicific dosing and drug information, all right within the workflow. The content from Lexicomp's pediatric information can be implemented to build pediatric dosing checks as well as a pediatric dosage calculator to ensure that pediatric and neonatal patients receive safe, accurate dosing and treatment.
So wether you are a clinician or you are an EMR developer this information is a must have and important. Clinicians can benefit from Lexicomp's products the best way they see fit. Subscribing to our print or subscription based references or by having your EMR implement this Lexi-Data, this information cna be implemented right within your workflow.
More information on Integrating Lexicomp content into your workflow.
There have been thousands of articles written discussing why EMR adoption rates have been so low and why physicians especially have been resistant to moving into the electronic age. Little return on the initial investment, lack of efficiency in the system and no improvements in patient outcomes have been listed as reasons for reduced adoption rates.
One key element to the lack of efficiency and little improvement in patient care is due to the number of alerts that are generated when trying to use these systems. As a pharmacist, I enter in hundreds of medication orders in a shift and it is rare that I do so without receiving an alert from my HIS telling me about a drug interaction or duplicate therapy. These alerts although technically accurate, often involve medicine interactions that are so minor or irrelevant to hospital medicine.
If an HIS truly wants to improve patient care and become an indispensable part of medicine, it must provide clinical decision support that can accurately and appropriately give clinicians therapeutic alerts that are relevant and can help improve patient care. That is the goal of Lexi-Data. For more information about Lexi-Data, check out www.lexi.com.
Matt Bennardo had a great blog post last week where he wrote about the positive benefits of Meaningful Use on the development of EHRs and their impact on patient safety. He cites a study by Practice Fusion, where it has been shown that EHR's are having a real impact on the decrease in infant mortality. This is great news!
As Matt wrote, "Of course, to get these kinds of results, the information in the EHR needs to be accurate, timely, complete, actionable, and specific to the patient. With respect to pediatric and neonatal patients, that last point is especially important. An EHR that is only set up to perform dose range checking and interaction checking on adults won't be nearly as helpful when it comes to children."
All pediatric dosage calculators are not created equally. As Matt goes on to say, "But luckily there are drug information vendors like Lexicomp that understand there is a vast world of difference between adults and children -- and often between older children and neonates. Lexicomp's drug information is trusted by dozens of EHR vendors to guide clinicians in prescribing, fulfilling, and administering drugs to patients of all types -- including children.
Lexicomp provides both "machine readable" transactional information (geared towards specific populations) for use in clinical decision support, as well as "human readable" reference materials for clinicians and patients. Even Lexicomp's patient education leaflets are written with either adult or pediatric patients in mind.
If you are developing an EMR or looking to improve an EHR or HIS system, I would suggest reaching out to Lexicomp for some suggestions.
Did you know that Lexicomp provides clinical decision support data needed for patient specific alerts (i.e. drug interactions, allergy, duplicate therapy and dose range checking) and to support sound treatment decisions in EMR products and e prescribing applications?
Lexicomp actively pursues relationships with companies that offer complementary products and services to allow for system integration. Through our HIS vendors such as Epic, Cerner, GE, Meditech, and others, clinicians can link directly to Lexicomp’s superior drug information, enabling them to make even faster, safer decisions while improving patient outcomes at the point-of-care.
With the expected increase in the anesthesia information systems market as noted by Ryan Smith in his
meaningful use blog, it seems that many EHR, HIS, or EMR developers might do themsevles a favor by planning ahead and creating these systems now. With this being a new area for most companies, the question of where to purchase a drug database comes into play...who has the most trusted, reliable, and valuable data?
If you are in the market for an Anesthesiology & Critical Care database that provides detailed information on over 2,000 medications, then look no further than Lexicomp. Workflow is not interrupted when accessing the information through our Web API Solution, Web Services, or XML datasets. The integration delivers detailed drug and clinical reference information, including:
- anesthesia and critical care concerns, use, dosage, and monitoring parameters
- anesthetic drug interactions
This information comes together to support improved decisions at the point-of-care.
What do all of these have in common? Well for one thing, they are being driven in part by the demands of Meaningful Use requirements.
Here is just one example of Meaningful Use effect. Some of the demands are actually in place, and many others roll out over the next few years. EPrescribing in Florida looks like it might be taking an interesting turn as free application provided by the State may be going away, or so I have heard. This recently
posted ePrecribing blog described it in greater detail. And
a second blog.
As Meaningful Use requirements have dictated more relevant application of medication and drug data within EMR and EHR systems, the awareness of the nuances of these databases has also gone up. Recognition of the following terms is becoming more commonplace: Drug Reference Database; Dosage Range, Dosing in Pediatrics, Drug Interaction List,
Pediatric Dosage Calculator, Medicine Interaction. Clinical Decision Support Systems, Drug Content, and more.
As we attempt to incorporate more technology into medicine through the use of HIS, it brings to light the need for more than just a simple medication list. Health information systems are now being asked to help improve patient outcomes by performing other clinical decision support functions that go beyond a pick list. If we truly want to improve patient outcomes, it is important that our HIS provide relevant clinical guidance especially in a critical population such as pediatrics. Calculating pediatric doses is not always an easy task and having data in your HIS that can perform pediatric dosing calculations can be an invaluable tool in improving patient outcomes.
Lexicomp has a long standing reputation of providing this valuable and often difficult dosing information in the Pediatric Dosage Handbook. For over 20 years, we have been providing neonatal and pediatric dosing based on available literature and current clinical practice. More recently this information has been transformed into Lexi-Data's Pediatric Dosage Range Checking application. This content can be used within an HIS to provide guidance to your clinicians on appropriate dosing for this difficult and vulnerable population.
Matt Bennardo had a great
post last week regarding a study which showed the connection between EHRs and their improvement on pediatric care.
With several pediatric calculators on the market, how can one tell which to trust? A reference book can be helpful, yet many other considerations should be taken into account. It is vital to screen drug interactions with the full medicine list of the child along with their maturation. Having all this information readily available with an EMR can vastly work to reduce errors. When dealing with pediatrics, especially neonatal patients, attention to detail and continually updated, unbiased information is best. Lexicomp has all the options to achieve improved safety for patients of any age.
These options include:
- Pediatric Dosage Calculations in both transactional information for the clinical decision support systems and reference materials designed for clinicians.
- Pediatric focused patient education materials
Health information exchanges (or HIEs) have long been the odd duck of the future of healthcare. Their proposed roles have varied from relatively simple (providing a mechanism for exchanging healthcare information among local providers) to complex (actually delivering some clinical decision support systems to their members). Even now there is no consensus on what HIEs should be doing, how they should be funded, and how many there should be.
The truth is that most HIEs are still funded by state and federal grants. These grants are temporary, since it's expected that some viable system of self-support will eventually assert itself. But until there's real evidence that this is happening, it's best to think of the entire HIE model as founded on the shifting sands of government whimsy. As we know all too well, many programs are "ear-marked today, gone tomorrow".
Some states also provide CDS functionality directly -- such as the eprescribing program in Florida. But again, such initiatives exist at the mercy of lawmakers, whose opinions may change without notice. For that reason, all HIS, EMR, and EHR vendors should treat such programs as temporary and not rely on them to provide functionality to their customers.
However, there are also established companies that can provide the same functionality (and have been for years). For drug information to drive clinical decision support, one such vendor is Lexicomp. They also have several partners in the electronic prescribing space that can fill that need with a less capricious solution than government programs. Contact Lexicomp today to learn more about both solutions -- use the phone number or form on this page.
All the buzz about Meaningful Use sometimes makes us forget what EHR implementation is really supposed to be about -- improving patient care. But
this article from Practice Fusion's blog reminds us that EHR use can reduce errors, save lives, and makes it easier to serve patients better. That's what the real objective is!
The study in the article highlights the benefits of EHR use when pediatric patients are concerned. The researchers were able to link the use of electronic health records and associated clinical decision support systems to a quantifiable decrease in infant mortality -- especially among neonatal patients.
Of course, to get these kinds of results, the information in the EHR needs to be accurate, timely, complete, actionable, and specific to the patient. With respect to pediatric and neonatal patients, that last point is especially important. An EHR that is only set up to perform dose range checking and interaction checking on adults won't be nearly as helpful when it comes to children.
But luckily there are drug information vendors like Lexicomp that understand there is a vast world of difference between adults and children -- and often between older children and neonates. Lexicomp's drug information is trusted by dozens of EHR vendors to guide clinicians in prescribing, fulfilling, and administering drugs to patients of all types -- including children.
Lexicomp provides both "machine readable" transactional information (geared towards specific populations) for use in clinical decision support, as well as "human readable" reference materials for clinicians and patients. Even Lexicomp's patient education leaflets are written with either adult or pediatric patients in mind.
The market for anesthesia information systems is predicted to increase 50% by 2012 and be valued at $4 billion by 2017. According to a new report by iData Research (www.idataresearch.net), the leading global authority in medical device market research, the U.S. anesthesia, respiratory and sleep-management device market will reach approximately $4 billion by 2017, with strong growth being driven by anesthesia information management system (AIMS) sales. This report is accompanied by two companion reports, "Electronic Medical Records" and "Picture Archiving and Communication Systems (PACS)", which forecast rapid adoption of medical information technology due to approaching deadlines set out by the U.S. government's Healthcare Information Technology for Economic and Clinical Health (HITECH) Act.
Lexicomp maintains an Anesthesiology & Critical Care database that presents information on over 2000 medications used in the care of surgical or critically ill patients. This is a must-have drug reference for anesthesiologists, nurse anesthetists, intensivists, and other critical care practitioners.
When utilizing our Web API Solution, Web Services, or XML datasets, this type of information can be accessed from within the workflow. This integration delivers detailed drug and clinical reference information , including anesthesia and critical care concerns, use, dosage, monitoring parameters, and anesthetic drug interactions, where applicable to physicians, pharmacists and nurses, supporting improved decisions at the point-of-care.
The goal of policy makers in requiring the use of e-prescribing is to improve medication safety. Many systems have the ability to screen a new prescription for safety using clinical decision support tools such as drug interaction, drug allergy, duplicate therapy and dosage range checking. A recently published study by the Center for Studying Health System Change (HSC) analyzed the use of e-prescribing in physician practices and the impact on patient care. The study included 24 practices and found that while most e-prescribing systems used had access to patient medication information and clinical decision support tools built-in, only slightly more than half of the physicians reported accessing this information. Several reasons were cited for this low usage including the fact that it is difficult to import medication histories into the patient records and that physicians found little value in reviewing this information when making prescribing decisions.
The results of this study raise some interesting questions. The challenge of incorporating patient specific medication histories from multiple sources certainly is a real barrier and one that is pivotal to making CDS useful. Maybe more alarming is the perception that the alerts and checks that the system can provide are not useful in influencing prescribing decisions. This point can be challenging when e-prescribing systems are not built with reliable and clinically relevant data to power the CDS processes.
Lexicomp provides clinical information that can be used to perform key CDS functions such as drug interaction, drug allergy, duplicate therapy and dosage range screening. This content is derived from our well-established drug reference information that is evidenced-based, peer-reviewed and up-to-date. If you are a clinician working in health care, you most likely have relied on this content to help you make patient care decisions for many years. If CDS is going to accomplish its goal of improving patient care, it is going to require a strong, evidenced based library of clinical information. Something Lexicomp has been doing for over 30 years.
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