Recently, my colleague Ryan Smith wrote a blog post about alert fatigue in EHR and EMR systems. One observation he made was this:
"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."
I honestly believe that many EHR and EMR companies will live and die by how they handle alerts -- literally. Alerts are (by design) the most visible part of the system's interface for most clinical users. For that reason, you can be sure that clinical users will have opinions on how they should work and whether yours are useful or not. And no matter how revolutionary your product is on the back-end, you'll be getting thumbs up or thumbs down from users based almost entirely on what they see and interact with.
Pick your partners wisely to help you delight your customers
That's why it's impossible to overstate the importance of partnering with data companies that can drive real intelligence in your clinical decision support systems. Lexicomp is a transactional data provider that also sells consumer-level products directly to thousands of doctors, nurses, pharmacists, and dentists. Over the past thirty years, they have built up expertise in delivering exactly what clinicians want -- especially related to drug reference information, drug interaction checking, patient education resources, and much more. Who better to partner with you as you build an EHR or EMR system that has the same needs?
Moreover, the data you use in checking medicine interactions, dose range checking, and other clinical decision support functions needs to be flexible enough to support a wide range of alert preferences and local clinical guidelines. A provider like Lexicomp is at the forefront of alert customization, and continues to constantly look for more ways to make alerts work for healthcare providers so your EHR system can thrive in a multitude of real world practices -- not just the hypothetical "paper practice" of meaningful use regulations and ONC-ATCB certification.
There is a lot going right about regarding Meaningful Use and EMR developers seeking certification. More and more certifying bodies are in the marketplace making it easier to get certified. There are very few suppliers of drug data and even fewer still that are easy to work with. Lexicomp and Cerner/Multum are just two. And if you are looking for an easy-to-use, out-of-the-box ePrescribing tool, I would take a look at DoseSpot. What do all of these companies have in common? They are easy to work with.
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 an EMR build. But it's not just about the information. It's about who you select as your partner and who have seamless API's which makes your drop easier.
You owe it to your product and your customer to make the right choice.
Recent reports on research from the December 2010 issue of the Archives of Pediatric & Adolescent Medicine (abstract here) have pointed out that less than 3% of pediatric hospitals have what the researchers considered a "comprehensive EHR". Those with "basic EHRs" amounted to just 18% more.
According to the researchers, this means that an overwhelming majority of pediatric hospitals lack standard EHR functionality like ePrescribing. Clinical decision support functions are also not widely available.
Is the reason money... or value?
The survey cites lack of financing as the main reason for the low adoption. But we all know that questions of money are really questions of value -- if pediatric hospitals found EHR systems highly valuable, they would be more likely to find financing for them.
When you think about the data that drives most of the common functions of EHRs (functions like drug interaction checking, duplicate therapy, dosage range checking, dosage administration, and even patient education), it's no wonder that pediatric hospitals aren't seeing the value. Most of that data -- and, by extension, EHR functionality -- is designed for adults!
Lexicomp -- the industry leader in pediatric drug information
At the very least, pediatric hospitals need an EHR that they can customize with their own clinical guidelines on pediatric dosing and interactions. But better than that would be a system that already takes into account their specific needs. Lexicomp has been the undisputed market leader for reference information for pediatric hospitals for decades -- and now Lexicomp is offering transactional data as well.
The meaningful use standards put in place by CMS and ONC in July have everyone talking about what they need to do to get certified -- and what additional criteria might be coming in Stage 2. But an equally important question is: What's been left out? Asking (and answering!) that question is how EHR vendors can build systems that stand out in the marketplace and deliver benefits that aren't being provided by a hundred other systems.
Dosage precautions: My vote for the most important missing piece
As far as clinical decisions support goes, meaningful use requirements are surprisingly paltry. Even an important topic like medicine interactions only gets briefly covered in two areas: drug-drug interactions and drug-allergy interactions. (The missing pieces of this complex topic could be fodder for a whole other blog post!)
But dosage precautions are just as important as medicine interactions. We've heard a lot this year about how Dennis Quaid's infant twins ended up in a fight for the lives after being given a dose of the blood thinner heparin that was 1,000 times what should have been administered. Other children have died from similar mistakes. And yet, nothing in Stage 1 of meaningful use addresses this. But it's clear: dose administration and dose calculation -- especially as regards dosing in pediatrics -- are just as important to patient safety as drug interactions.
Patients, doctors, and pharmacists don't decide what's important based on certification guidelines
Fortunately, the absence of dosage precautions in the meaningful use final rule doesn't mean that the healthcare industry is ignoring this. Clinical guidelines in hospitals and practices govern dose calculation and dose administration on some level -- but mistakes sometimes still happen. There is definitely an appetite among healthcare professionals (and an increasing number of patients!) for better tools to help with this.
Better dose calculators are one way to respond to this need. Another way is alerts based on dosage range checking, or even more sophisticated systems that control dose administration with barcodes. But to drive any of these functions -- especially in pediatric dosage calculations -- your underlying data needs to be much more detailed and rigorous than what is usually available. FDA guidelines and prescribing information especially are inadequate because there are many circumstances they don't address.
Lexicomp has led the market in dose range checking for decades
Luckily, Lexicomp has exactly the data needed to make sophisticated dosage calculators and alerts a reality. Their decades of experience makes them the overwhelming choice of pediatrics hospitals across the U.S. Their data goes far beyond prescribing information published by drug companies, and draws from the expert consensus of the best hospitals in the nation, as well as a rigorous review of published studies on the topic.
Dosage precautions: My vote for the most important missing piece
As far as clinical decisions support goes, meaningful use requirements are surprisingly paltry. Even an important topic like medicine interactions only gets briefly covered in two areas: drug-drug interactions and drug-allergy interactions. (The missing pieces of this complex topic could be fodder for a whole other blog post!)
But dosage precautions are just as important as medicine interactions. We've heard a lot this year about how Dennis Quaid's infant twins ended up in a fight for the lives after being given a dose of the blood thinner heparin that was 1,000 times what should have been administered. Other children have died from similar mistakes. And yet, nothing in Stage 1 of meaningful use addresses this. But it's clear: dose administration and dose calculation -- especially as regards dosing in pediatrics -- are just as important to patient safety as drug interactions.
Patients, doctors, and pharmacists don't decide what's important based on certification guidelines
Fortunately, the absence of dosage precautions in the meaningful use final rule doesn't mean that the healthcare industry is ignoring this. Clinical guidelines in hospitals and practices govern dose calculation and dose administration on some level -- but mistakes sometimes still happen. There is definitely an appetite among healthcare professionals (and an increasing number of patients!) for better tools to help with this.
Better dose calculators are one way to respond to this need. Another way is alerts based on dosage range checking, or even more sophisticated systems that control dose administration with barcodes. But to drive any of these functions -- especially in pediatric dosage calculations -- your underlying data needs to be much more detailed and rigorous than what is usually available. FDA guidelines and prescribing information especially are inadequate because there are many circumstances they don't address.
Lexicomp has led the market in dose range checking for decades
Luckily, Lexicomp has exactly the data needed to make sophisticated dosage calculators and alerts a reality. Their decades of experience makes them the overwhelming choice of pediatrics hospitals across the U.S. Their data goes far beyond prescribing information published by drug companies, and draws from the expert consensus of the best hospitals in the nation, as well as a rigorous review of published studies on the topic.
Recent research from Chilmark (mHealth in the Enterprise: Trends, Opportunities and Challenges.) is predicting that the mHealth market will see exponential growth over the next several years. The research is predicting that mobile applications that can connect physicians to other hospital HIS such as CPOE and EMR will be the fastest growing group. This leads us to consider how this trend will impact patient safety and workflows. As more mHealth technology is developed, there will be a focus on clinical decision support tools within these applications. Physicians will be looking for guidance on drug-drug interactions, allergy screening and therapeutic dosing recommendations within these mHealth apps. Making sure that the information behind these systems is founded on current clinical guidelines and expert dosing recommendations will be the key to realizing an actual improvement in patient care.
The designation of post-gestational age can differ among sources. In Lexi-Comp's pediatric database this is determined from the first day of the last menstrual period until the birth of the baby. Because this is not equivalent to the date of conception there is obviously some degree of variability. Pediatric dosing calculations are frequently based on this parameter. This represents one of the key dosing precautions in premature infants. In addition, clinical guidelines may be based on this age.
In struggling to meet meaningful use guidelines, more and more small to mid-sized hospitals (up to 300 beds) are looking to larger vendors to fulfill their clinical IT needs. In addition to the current lot of community hospital vendors like CPSI, Healthland, HMS, and Keane, these hospitals are leaning more towards the big names to assist with their clinical decision support system implementations. Is this due to a perception that larger vendors have a better handle on the industry? That they have more resources available and are better positioned to handle to rapidly changing dynamics of the market? Or the perceived higher clinician adoption rate of these systems? Tough to say, but the shift has certainly begun.
As most large hospitals have already chosen a CIS, this area, the small to medium bed-range hospitals, provides the largest pool of potential clients for CIS vendors. As one of the leading providers, Cerner/Multum is positioned to support both large and small-to-medium sized hospitals. Powered by Lexi-Comp's drug information and drug interaction database, and including drug dosage calculators, drug classifications, pediatric dosing charts, and clinical guidelines, Cerner/Multum is a partner that will not only provide the content you need, but will help you through the integration, deployment, and training process.
Try out the offerings from the Lexi-Comp-Cerner partnership and learn about the integrated clinical decision support systems delivered by two of the most reputable names in the industry.
There are only a few real source providers of drug information that is integrated into various hospital and medical systems. More and more you are also starting to see this information show up on websites. Two leading providers are Lexi-Comp and Multum/Cerner.
The are some key things to look for if you have a need for drug information provider. First, make sure your vendor is really a partner and works well with you and is responsive to your requests. It might not sound like much, but makes all the difference in the world. Second, make sure they have effective APIs for you to grab the drug data. You might think about developing some of this yourself in-house, but the reality is that some of the requirements become complicated, and without the APIs it could get quite messy. For example, developing the algorithms for drug-drug or drug-allergy interactions. Third, make sure they have a solid reputation, but are not enormous in size. Otherwise you will get lost in the shuffle.
So if you need drug information such as: pediatric dosing charts, clinical guidelines, drug nomenclature, dose administration, drug interactions, generic and brand drug names, medicine lists, drug databases etc, make sure you work with the right partner.
More and more EMRs are scrambling around to secure drug data to include their product. Some of the EMR vendors are looking to do this after they have received certification and some are doing this as part of their certification process. One area that they might be overlooking involves the APIs (and the concomitant support provided) that the drug data vendor provides. Many EMR developers decide they want to do this in-house. Some decide they want to do this to save money, while others decide to do this because their IT staff wants to own the entire process. But there is a problem with this. Even if they are IT experts, they are not experts in the management of this drug data.
Whether their EMR product includes drug-drug or drug-allergy interactions, pediatric dosing charts, medication or generic brand names, therapeutic dosages drug classifications, medicine lists, dosage administration, duplicate therapy, clinical guidelines, or more; the EMR vendor does usually have the internal experience and expertise to manage this information.
You are better off working with your vendor, whether it be Lexi-Comp, DoseSpot, or Cerner/Multum and relying on the APIs they offer. It will be faster, less error-prone, eat up fewer resources and keep more folks in the organization happy.
What will hospital information and practice management systems look like in 2014? Will it be a radical shift, "encouraged" by government requirements? Or will the government have to retrench a bit from their demands because of the difficulties - both financial and developmental - that smaller hospitals will encounter? Hard to say, but there is a great deal at stake - including money, disruption, lost time, turning off patients etc.
EMR and EHR developers, hospitals and group practices have a lot on their plates. One area that tends to be an afterthought is the integration of drug information into the various systems. Many of these systems need drug data to generate medicine interactions, dose administration, pediatric dose calculations, therapeutic dosages, drug classifications and drug lists. There are only few providers of this information. The key is to select the provider who will provide the greatest support in integrating this data into your system. One that will help from assisting in clinical guidelines to eprescribing to drug nomenclature.
To convert raw data into a system that will like a drug interaction database for clinical decision support, means you need to look beyond just the data. You need to discern who will be the easiest vendor to work with and will hand hold if necessary. Sometimes going with the biggest provider is the best, other times, when customer support is critical to a successful implementation, it is best look to look long term.
EMR and EHR developers, hospitals and group practices have a lot on their plates. One area that tends to be an afterthought is the integration of drug information into the various systems. Many of these systems need drug data to generate medicine interactions, dose administration, pediatric dose calculations, therapeutic dosages, drug classifications and drug lists. There are only few providers of this information. The key is to select the provider who will provide the greatest support in integrating this data into your system. One that will help from assisting in clinical guidelines to eprescribing to drug nomenclature.
To convert raw data into a system that will like a drug interaction database for clinical decision support, means you need to look beyond just the data. You need to discern who will be the easiest vendor to work with and will hand hold if necessary. Sometimes going with the biggest provider is the best, other times, when customer support is critical to a successful implementation, it is best look to look long term.
Now more than ever, it's vital your EMR contains the drug data necessary to help customers achieve Meaningful Use of EHR. In fact, in a recent study conducted by CSC, 90 percent of hospital executives said meeting Meaningful Use guidelines was one of their top priorities.
The numbers speak for themselves. Your customers are on the fast track to prove Meaningful Use of EHR. And if you don't clearly communicate to users how your system will help meet Meaningful Use guidelines, you may get left behind.
Lexi-Comp's transactional data and reference solutions can help your system comply with the final rule on Meaningful Use by helping you support the technical capabilities required for certification of your system. Specifically, Lexi-Comp can provide your EMR the core drug data and reference information you need to achieve the clinical decision support component of Meaningful Use. When integrated into your system, Lexi-Comp will:
The numbers speak for themselves. Your customers are on the fast track to prove Meaningful Use of EHR. And if you don't clearly communicate to users how your system will help meet Meaningful Use guidelines, you may get left behind.
Lexi-Comp's transactional data and reference solutions can help your system comply with the final rule on Meaningful Use by helping you support the technical capabilities required for certification of your system. Specifically, Lexi-Comp can provide your EMR the core drug data and reference information you need to achieve the clinical decision support component of Meaningful Use. When integrated into your system, Lexi-Comp will:
- Provide data for drug-drug, drug-disease and drug-allergy interaction screening
- Provide duplicate therapy and dose range checking for pediatric and adult patients
- Provide a drug list of dispensable products with mapping to NDC numbers, RXCUI, Lexi-Comp's Global ID, Multum DNUM and generic product codes
- Support the maintenance of active medication and allergy lists within an EMR
- Promote interoperability
- Allow users to generate patient-specific education leaflets
Summer means hot dogs, fireworks, swimming and for hospitals it means a new batch of residents. Although working with new residents can be challenging at times, new practitioners offer a wonderful opportunity to test our clinical decision support systems that are in place to help improve patient care. By definition, new practitioners have little practice experience and rely on decision support alerts to avoid drug interactions and medication dosing mistakes. Additionally, residents often embrace new technology and can be a driving force as we strive to achieve meaningful use of our health information systems.
Rather than the usual, "here we go again" attitude toward working with new residents, this is the time to ensure that the clinical information systems we have in place are based on clinical practice guidelines and can improve patient care. Ultimately, these new practitioners can be the strongest advocates for adopting this new technology provided the drug interaction, dosage range checking and duplicate therapy alerts that we bombard them with help improve patient care.
Rather than the usual, "here we go again" attitude toward working with new residents, this is the time to ensure that the clinical information systems we have in place are based on clinical practice guidelines and can improve patient care. Ultimately, these new practitioners can be the strongest advocates for adopting this new technology provided the drug interaction, dosage range checking and duplicate therapy alerts that we bombard them with help improve patient care.
One of the concepts we have been trying to shed some more light on is the importance of having drug data and clinical decision support data that can be easily customized to the needs of the end user location. In last year's Agency for Healthcare Research and Quality (AHRQ) Annual Meeting there were Guidelines Into Decision support that were presented. These are also know as the acronym GLIDES. These guidelines are actually a pretty interesting take on the advancement of Clinical Decision Support.
In order to account for users in various types of settings and locations, as well as different dosage precautions, this report specifically calls out the need for better customization. This may seem a lofty goal but is, nonetheless, worthwhile. The need to customize clinical decision support to the end user makes complete sense in the fact that being able to deliver appropriate alerts through an EMR geared toward a certain specialty is critical. For example, pediatric dosage calculations and alerts would really be most appropriate within a pediatric practice and, for this reason, these end users may want to see something different. In an EMR for an oncology practice it would make sense that an alert specific to a chemo regimen appear. Just something else to think about when building your drug data.
EHR vendors play a critical role in creating higher quality, safer, more effective health care systems. Whether it's through ePrescribing, drug interaction screening or dose range checking, EHR systems offer clinical decision support to enhance therapy decisions. Recently, the final rules were published by the Department of Health and Human Services defining meaningful use of EHR and the EHR incentive program. Health care providers now have additional funding to support the meaningful use of EHR as well as guidelines that can help implementation in a way that improves patient care. Benefits of meaningful use of EHR include:
- Know more about patients - Information in the EHR such as patient medication lists can be used to coordinate and improve the quality of patient care.
- Make better decisions - With more information and clinical guidelines available for clinical decision support, healthcare professionals will have the information they need regarding treatments and conditions. Information ranging from pediatric dose calculations to duplicate therapy alerts help clinicians make better decisions.
- Save money - EHR adoption requires an initial investment of time and money but clinicians who have implemented EHR systems have reported significant time savings, workflow efficiencies as well as receiving government incentives.
In a recent study of hospital executives conducted by CSC, 67 percent say meeting meaningful use guidelines is their highest priority. For 42 percent of the respondents, helping owned and/or affiliated physicians' practices achieve meaningful use of EHR ranked second on the business agenda.
With a typical 275-bed hospital eligible to receive up to $6 million in Medicare and Medicaid incentive payments, implementing clinical decision support tools to help prove meaningful use is certainly not to be taken lightly.
One of the biggest barriers that remains is the lack of qualified IT staff within the hospital, as cited by 40% of the study respondents. Why not make it easy and partner with an EHR vendor that uses a fully integrated approach by housing a reputable drug database, drug interactions checker, and drug allergy notification tool in one place?
Lexi-Comp provides Lexi-Data, an easy to implement, integrated drug information tool along with the IT experience and support to get you up and running quickly!
Lexi-Comp provides Lexi-Data, an easy to implement, integrated drug information tool along with the IT experience and support to get you up and running quickly!
On July 14 the final Meaningful Use rules were released and gave some specific requirements for clinical decision alerting. This ruling means that clinical decision support and the drug nomenclature that is incorporated into these systems will be evaluated with a more critical eye than ever. With these new meaningful use requirements, clinicians that write more than 100 e-prescriptions during the reporting period must have drug-drug interaction, drug-allergy, duplicate therapy and formulary screening alerts enabled within their systems and have a way to track user response to these alerts.
With this paradigm shift in the way healthcare is being delivered, it will be paramount that these systems provide accurate, meaningful clinical decision support and avoid the pitfalls of alert fatigue. Now is the time clinicians should demand that the clinical systems that are implemented have quality alerting and drug reference information based on current clinical guidelines.
With this paradigm shift in the way healthcare is being delivered, it will be paramount that these systems provide accurate, meaningful clinical decision support and avoid the pitfalls of alert fatigue. Now is the time clinicians should demand that the clinical systems that are implemented have quality alerting and drug reference information based on current clinical guidelines.
EHR vendors developing clinical decision support applications must include dosage range checking into their ePrescribing systems. These clinical guidelines are particularly important for dosing in pediatric populations.
Medication ePrescribing involves the appropriate selection of an agent, a route of administration, and definition of a dosing strategy. For most medications, dosing is adjusted to specific demographics such as age and weight. In some instances, dosing may differ from the general range for treatment of a specific condition. Additional parameters associated with dosing include major organ function (renal / hepatic) and / or the use of dialysis.
Dosages are typically ordered by an amount and a schedule for administration. In some cases, this is also limited to a defined duration (ex. 10 mg once daily for 10 days). In order to maximize the safety of drug dosing, it is useful to evaluate the ordered dose relative to typical ranges used in patients with similar characteristics. For this reason, dose range checking data are particularly important in many applications.
Medication ePrescribing involves the appropriate selection of an agent, a route of administration, and definition of a dosing strategy. For most medications, dosing is adjusted to specific demographics such as age and weight. In some instances, dosing may differ from the general range for treatment of a specific condition. Additional parameters associated with dosing include major organ function (renal / hepatic) and / or the use of dialysis.
Dosages are typically ordered by an amount and a schedule for administration. In some cases, this is also limited to a defined duration (ex. 10 mg once daily for 10 days). In order to maximize the safety of drug dosing, it is useful to evaluate the ordered dose relative to typical ranges used in patients with similar characteristics. For this reason, dose range checking data are particularly important in many applications.
In a recent study by PricewaterhouseCooper, over 90% of hospital CIOs polled are concerned that they cannot meet government requirements demonstrating meaningful use of electronic health records and clinical decision support systems.
If hospitals are not compliant with the meaningful use guidelines by 2015, they're at risk of facing Medicare and Medicaid reimbursement cuts. The problem is that, to this point, there has not been a set of clearly defined requirements. In fact, just today, the CMS submitted the final rule on meaningful use to the Office of Management & Budget today. Hopefully clarification will be coming soon.
One of the concerns voiced by one of the members of PwC is that, "...many health care providers are mired in the complexity of incentive-rule criteria and may not be working towards longer-term goals for meaningful EHR usage." Focusing solely on the incentive piece of the program does not necessarily predicate the consideration of better care and patient safety.
The most important takeaway is: when implementing any system and, specifically, when attempting to meet these guidelines, don't be afraid to talk! Ensure that your EHR vendor is fully aware of your concerns surrounding proving meaningful use and that they have a solid and trustworthy drug database behind them.
The most important takeaway is: when implementing any system and, specifically, when attempting to meet these guidelines, don't be afraid to talk! Ensure that your EHR vendor is fully aware of your concerns surrounding proving meaningful use and that they have a solid and trustworthy drug database behind them.
As we move forward in the era of ARRA, new requirements for clinical information systems will begin to force specialty vendors of ER systems and anesthesiology systems to go beyond the traditional medication lists and begin to incorporate clinical decision support alerts within their applications. Traditionally, these systems have been self-contained and have not provided alerts such as drug interaction warnings, duplicate therapy notifications and dosage range checking when orders are processed. As new meaningful use criteria is developed, these systems are now being required to incorporate this type of functionality and soon the ER physicians will experience the wonderful frustration of "alert fatigue".
In these settings where time is of the essence and patients typically receive single doses that may be life-saving or recommended by current clinical practice guidelines, it is paramount to provide alerts that are truly useful and can/should impact therapy. I only hope that these systems evaluate carefully the data they use to meet these needs and provide useful alerts for these physicians, as they make critical medication decisions in a very stressful and time-sensitive situation.
In these settings where time is of the essence and patients typically receive single doses that may be life-saving or recommended by current clinical practice guidelines, it is paramount to provide alerts that are truly useful and can/should impact therapy. I only hope that these systems evaluate carefully the data they use to meet these needs and provide useful alerts for these physicians, as they make critical medication decisions in a very stressful and time-sensitive situation.
There is a big scramble in the EHR, EMR, HIS, HIE world (as a sports fan, I'd almost like to add, NBA, MLB, and NFL) to develop electronic medical systems which satisfy the needs of the emerging marketplace. It's tough. There is a lot of chaos out there at the moment. There is a great need to drive down costs, improve efficiency and at the same, somehow still deliver quality information.
One of the necessary components of these systems is the delivery of general drug databases as well as accurate, easy to access drug interaction information. EHR vendors and EMR developers are scrambling around looking to integrate medication information into their systems.
What they are most worried about at the moment is developing systems that are compliant with Meaningful Use requirements over the next few years. Many are currently in the midst of getting certified through SureScripts. So the drug interaction software is, in many respects, secondary to the demands of Meaningful Use. Mostly, they care about finding a drug information vendor who is easy to work, is fairly priced, will work out a pricing model that is flexible, provides easy to use APIs, and has good mapping for the various drug nomenclature systems that are out there, such as RX Norm. As a result, more and more folks are turning to Cerner/Multum and Lexi-Comp for answers.
It's a complicated area. Some of the considerations include: pediatric dosing; therapeutic dosing, dosage calculators, clinical guidelines, medicine interaction, medication brand names vs drug generic names, etc. It is important to understand these considerations, sooner than later.
One of the necessary components of these systems is the delivery of general drug databases as well as accurate, easy to access drug interaction information. EHR vendors and EMR developers are scrambling around looking to integrate medication information into their systems.
What they are most worried about at the moment is developing systems that are compliant with Meaningful Use requirements over the next few years. Many are currently in the midst of getting certified through SureScripts. So the drug interaction software is, in many respects, secondary to the demands of Meaningful Use. Mostly, they care about finding a drug information vendor who is easy to work, is fairly priced, will work out a pricing model that is flexible, provides easy to use APIs, and has good mapping for the various drug nomenclature systems that are out there, such as RX Norm. As a result, more and more folks are turning to Cerner/Multum and Lexi-Comp for answers.
It's a complicated area. Some of the considerations include: pediatric dosing; therapeutic dosing, dosage calculators, clinical guidelines, medicine interaction, medication brand names vs drug generic names, etc. It is important to understand these considerations, sooner than later.
Powered by Compendium