Dosage Calculator

According to iHealthBeat,  "a coalition of 25  interested consumer groups  said that ONC should resist pressure from health care providers to scale back requirements (Health Data Management, 2/28).

The consumer groups and unions expressed support for several issues, including:

• Transitioning all "optional" criteria in Stage 1 to "required" criteria in Stage 2;
• Advancing key criteria that have an impact on quality and safety, such as electronic prescribing and medication reconciliation;
• Improving collection of advance directives (CMIO, 2/28); and
• Providing patients with online access to their health data, as well as secure messaging capabilities."

It is unclear how much will be required if government dollars dry up.  But regardless,  medical institutions and vendors need to keep pushing forward.   It will be too difficult to turn the spigot on and off.  This theme kept coming through at HIMSS.

Specifically in the areas of EHRs,  EMRs,  HIS',  ePrescribing and more,  they need to keep moving forward in their efforts to include drug-drug interaction,  drug-allergy interaction,  therapeutic dosages,  medicine interactions,  dosage administration,  dosage precautions,  medication brand names and generic names,  pediatric dosage calculations,  and eprescribing.    Regardless of what the specific requirements will look like 12 months from now,  there is no doubt that these changes will improve patient outcomes.    Whether you go to Lexicomp or to Multum,  find a vendor that will be your solution partner to help you through minefields.  APIs are rarely just plug and play.  Having the right partner will make a big difference.

 Haven't heard of Brantley Whittington, CEO of the EHR firm Extormity?  Then perhaps you've been living under an HIT rock for the past several months.  Not to worry, he's made a big splash at HIMSS11 this year and the legend will only continue to grow.
 

 With over 14,000 providers registering for Meaningful Use incentives, and the GOP considering repealing the law that has set aside funding for EHR adoption, there's never been a more critical time than now to focus on Meaningful Use.

As a result of a request made by someone who particularly liked one of my posts last month,  I am reposting. This year at HIMSS should be pretty interesting,  and maybe a bit chaotic and a little unsettling.   Meaningful Use was getting bandied about last year,  but this year it is real,  tangible and around the corner.

Whether you are an  EMR vendor,   EHR manager,   ePrescribing vendor,  or someone else in this dynamic and quickly changing business segment,  you will want to see what it is going on.  One of the areas that is a bit overlooked and undervalued until you have signed a long-term agreement (and it is too late to reconsider)  is in the area of drug database information for clinical decision support. 

The data is important,  but equally important is the relationship with your drug information provider.  Once you make your selection,  you will be "stuck"  with them for a very long time.  Make the right choice.   Obviously,  other areas for evaluation have to do with the level and sophistication of APIs that the vendor has or are under development. 

Pediatric dosage calculations,  drug interaction software,  drug generic name,  drug brand name,  drug classifications,  drug and medicine interactions,  medicine lists,  clinical guidelines,  clinical information systems,  and more,  are all critical areas for consideration.

At HIMSS 2011 there will also be live demonstrations showing how our drug databases can be implemented and customized to meet the various specific needs of EMR vendors. Stop by and see us if you are a current customer or are looking to implement drug information or clinical decision support into your application, booth #6653.

Lexicomp will be attending HIMSS 2011 in Orlando.  This will be a great opportunity for any EMR, Hospital, or Consumer Health Site to visit booth #6653 and learn about our solutions for implementing decision support for drug interactions, duplicate therapy, drug allergies, and dose range checking, as well as drug databases, and patient education information for consumers. 

 A report posted January 21, 2011 by iHealthBeat states, "Nearly 90% of U.S. hospitals will need to install or upgrade their electronic health record systems during the next three years to comply with the federal government's meaningful use requirements."  Hospitals have the option to purchase a "ready made" from a vendor or to make their own.  No matter what the case, be sure your drug information complies with meaningful use.  While you are at, you might as well go above the requirements. 
 

This year at HIMSS should be pretty interesting,  and maybe a bit chaotic and a little unsettling.   Meaningful Use was getting bandied about last year,  but this year it is real,  tangible and around the corner.

Whether you are an  EMR vendor,   EHR manager,   ePrescribing vendor,  or someone else in this dynamic and quickly changing business segment,  you will want to see what it is going on.  One of the areas that is a bit overlooked and undervalued until you have signed a long-term agreement (and it is too late to reconsider)  is in the area of drug database information for clinical decision support. 

The data is important,  but equally important is the relationship with your drug information provider.  Once you make your selection,  you will be "stuck"  with them for a very long time.  Make the right choice.   Obviously,  other areas for evaluation have to do with the level and sophistication of APIs that the vendor has or are under development. 

Pediatric dosage calculations,  drug interaction software,  drug generic name,  drug brand name,  drug classifications,  drug and medicine interactions,  medicine lists,  clinical guidelines,  clinical information systems,  and more,  are all critical areas for consideration.

At HIMSS 2011 there will also be live demonstrations showing how our drug databases can be implemented and customized to meet the various specific needs of EMR vendors. Stop by and see us if you are a current customer or are looking to implement drug information or clinical decision support into your application, booth #6653.

Lexicomp will be attending HIMSS 2011 in Orlando.  This will be a great opportunity for any EMR, Hospital, or Consumer Health Site to visit booth #6653 and learn about our solutions for implementing decision support for drug interactions, duplicate therapy, drug allergies, and dose range checking, as well as drug databases, and patient education information for consumers. 

There are a lot of moving parts you will encounter as part of your certification process.  One area that should not create additional complications is with drug databases for clinical decision-making support.    This includes making sure you have the best drug-drug and drug-allergy calculators available.   There are only a few vendors in the marketplace in a position to deliver the high quality drug information your customer needs.

But it's not just about the drug information.  It's about the interface,  service,  assistance and support. Anyone can just send over drug information files.   But it's another story to interact with the vendor...............and feel guilt.   If you are looking to work with a drug data company (including: medicine lists, dosage administration, drug classifications, dosing calculators,  pediatric calculators,  clinical guidelines,  medicine interactions,  and more),  Lexicomp likely will provide the best service,  price and long term confidence.   If you are looking to work with a good ePrescribing company,  I would suggest DoseSpot.  They have a terrific product and are great to work with.

Don't forget to check out these companies at HIMSS conference in Orlando in February.

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. 

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.

Looking through the meaningful use requirements, there's no mention of integrated drug reference information being needed in EHR systems.  So why should you care if your drug data provider can give your users access to reference information in addition to transactional data?

The answer is in who is using your EHR: humans.  Although computers need rigidly structured tables to perform clinical decision support tasks like dosage calculation and drug interaction checking, that's not the best format for doctors and other (non-computer) clinicians.

For decades, clinicians have thumbed through well-worn copies of drug reference books, looking for answers to questions.  The human urge to know more isn't going to change simply because a computer is helping clinicians with some tasks now!  Doctors, nurses, and pharmacists are still going to want reference resources, and will find value in an EHR system that links directly to a resource like Lexicomp's Lexi-Comp Online.  Lexicomp is the only transactional data provider that has been publishing industry-leading drug reference material for the past 30 years, and it is now a convenient single stop for both human-readable and computer-readable drug information that can be integrated into EHR systems.

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.  

 Are you an EHR vendor trying to build your own system?  

There are many pitfalls to consider when evaluating the "build it" or "buy it" development scenario.  One component of any clinical decision support system is the drug database and drug nomenclature contained within the system.  This allows users to screen for drug interactions, review safe dosage ranges, and flag any potential duplicate therapies.  These functions are essential for any ePrescribing module and are a requirement for the Meaningful Use of EHR standards.

If you want to get your EMR system the market quickly, then the "buy it" scenario is probably your best choice.  Lexi-Comp offers this drug product information within its Lexi-Data product for integration into your EMR system.  Specializing in pediatric dosage calculations, Lexi-Comp is establishing its medication databases as the new standard for medication safety.

Just remember, you may end up spending just as much money developing your own EMR system as you will spend by purchasing a "bolt on" solution from a content vendor like Lexi-Comp.

If you are a physician,  you should be checking into EMR alternatives the allow for eprescribing.  When the mad scramble to comply starts in a year or two,  you don't want to be in the fray.  Not only that,  there will be incentives for those early adopters.  

Check out Lexi-Comp  or Cerner/Multum as possible providers.

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.