Consumers are increasingly taking an active role in their own healthcare -- a trend which can only result in better care. A key source of information for these patients are consumer-facing websites that include clinical and medication information. But those sites must of course get their information from somewhere.
Lexicomp is one such provider of information to consumer-facing medical websites. They specialize in best-in-class pharmaceutical information -- including indications, interactions (with other drugs, natural products, and more), possible allergies,
dosing for adults and children, precautions and warnings, and more. Lexicomp also offers patient education leaflets in a variety of languages.
What's more, Lexicomp supplies its information in a variety of formats, including access through convenient web services. Web services allows you to pull specific Lexicomp information into your website without the hassle of maintaining an on-site database. This solution requires less development and maintenance, and means that your users always have up-to-date information. It's a perfect solution for consumer-facing websites looking to expand their content offerings. Contact Lexicomp to learn more today.
Since the beginning of the government's Meaningful Use incentive plan, specialists have been in a strange position. Although they were eventually granted the right to seek exceptions from certain measurement criteria that didn't apply to their fields, they are still required to implement fully functional EMR or EHR systems that can do everything the CMS and ONC stipulate.
An increasing number of dentists are in the same boat as well, as state mandates require them to implement systems that include functionality (like
ePrescribing) that they may only use occasionally. This means that EMR vendors who create systems for specialists and dentists are now looking for ways to implement the broader functionality required by law without raising prices on their customers who may not see much value in it.
What are web services and how can they help?
Web services are a different method of accessing some of the functionality required by Meaningful Use and state mandates. Instead of implementing and updating a database in-house to drive the functionality, web services allow a vendor to access information remotely only when needed. By using web services, you don't need to expend valuable development resources on non-essential functions. You can also arrange with a vendor like Lexicomp to pay only for the functionality that you'll be using.
When it comes to functions like ePrescribing, dose range checking, interaction checking, and allergy checking, web services aren't appropriate for everyone. Heavy users of those functions will still want to have a local database they can quickly query with reliable redundant back-ups. But for those who consider this functionality a low priority or infrequent need, web services offer a new, more easily implemented, and sometimes less expensive solution to help dentists and specialists meet government requirements.
Contact Lexicomp today for more information!
Nothing is final yet, but in all likelihood Meaningful Use Stage 2 won't kick in until 2014. In addition, some of the draft recommendations floating around look a lot like Stage 1 with stricter compliance levels. In other words: much of the work for Stage 2 is going to fall on EPs and hospitals, rather than on EMR vendors. There will likely be some new functionality -- especially around provider-patient communication -- but probably not the crush of requirements we saw in Stage 1.
So what will EMR, EHR, and HIS vendors do with their reprieve? If they're smart, they'll take this opportunity to improve their products in ways that aren't (yet!) required by Meaningful Use but which will give them an advantage in the market. Here's some functionality that EMRs may be using this reprieve to pursue:
- Implementing dose range checking: From a clinical point of view, this is one of the big gaps in what we've seen so far in the first two stages of Meaningful Use. Many of the news stories we read about adverse drug events aren't about interactions or allergies at all -- they're about mistakes in dosing. This is especially true with pediatric dosing, which can be extremely complicated. If dosage precautions were more widely implemented, patient safety would be positively affected.
- Addressing alert fatigue: Many EMR systems are likely to live or die based on this issue alone. Whoever can figure it out will have an undeniable benefit over the competition. As with many Meaningful Use issues, it starts with drug information vendors -- does yours provide the detail needed to make alerts intelligent?
- Improving patient education: The new recommendations for Stage 2 Meaningful Use are all about provider-patient communication. And transcripts of workgroups show that CMS and ONC are very interested in improving not just the method of communication, but the quality of information that flows through it. It seems likely that this will eventually include things like specific patient education materials for pediatric and adult patients, delivered in the language they primarily speak.
EMR vendors that can solve some or all of these issues now will find themselves ahead of the game when the next round of MU guidelines come out. Not only that, but they'll be delivering real value to clinicians that sets them apart from all the other cookie-cutter competitors who are simply "checking boxes" on the Meaningful Use checklist.
But where to start? Lexicomp is a drug and clinical information vendor who can help with all of the items listed above -- and with many more as well. Call or fill out a form today to start learning about how Lexicomp can help you build value for your users, save money and development resources, and meet government requirements for your EMR system.
Pediatric dosing continues to be a major concern among clinicians in almost all practice settings. In fact, those who do not regularly treat children often have the most questions about proper dosing and treatment. One area where EMR, EHR, and HIS systems can meaningfully differentiate themselves is in providing this information.
Physicians, pharmacists and nurses know that children are not simply "little adults". Besides different dosage precautions, children may require different administration or routes -- and for some cases may receive completely different medications. Different patient education leaflets are also needed when treating children.
For these reasons, it's important to partner with a drug information vendor that is well regarded in pediatrics. Lexicomp is the drug reference vendor of choice among U.S. pediatric hospitals, and has specialized in this area for decades. Most clinicians will see children as patients at some point in their work, and they know that this vulnerable population requires special care. Using Lexicomp as a drug vendor can help put their concerns to rest and add value to their EMR, EHR, or HIS system.
Reports are circulating that spending on healthcare IT is set to grow at an annual rate of 24% over the next several years. This is phenomenal growth, and it's tempting to think that rising tides are going to raise everybody's boat. But with the proliferation of EHR vendors we've seen in the past couple of years, that conventional wisdom isn't likely to hold true. How do you make sure that you're one of the rising boats, and not one of the swamped ones?
Development talent is the scarcest resource right nowAmong other things, this boom in healthcare IT means more competition for talented developers with healthcare-specific experience. And the influx of cash means that a few well-funded or well-positioned EHR vendors are going to reap early rewards -- and then will likely start poaching even more top talent from other vendors by offering bigger salaries and more benefits.
Your best move is to protect your IT resources by having them focus only on the most crucial parts of your system -- the parts that will differentiate you in the marketplace. Use a drug information provider with robust APIs, an intuitive data structure, and superior customer service to take the burden off your own development team so they can focus on more important tasks. One such vendor is Lexicomp, who has helped many customers get to market faster after less-than-positive experiences with other medication list vendors.
Another tactic is to forgo building your own eprescribing tool (which can take months to certify anyway), and instead use a standalone module like DoseSpot.
Meaningful Use still rules the day -- but look ahead to Stage 2 and beyondWith the government incentives now beginning to pay out, more and more practices and hospitals are pursuing Meaningful Use certification. To compete, your system will need to meet the Stage 1 requirements like drug-drug interaction checking, drug-allergy interaction checking, and distribution of patient education materials.
But it's not enough to simply check off the existing boxes. Every other EHR vendor is rushing to do the same. Instead, you need to provide value above and beyond the others. Again, a drug information vendor like Lexicomp can help you exceed Stage 1 requirements and put yourself where you need to be for Stage 2 and 3. They offer functionality like dosage range checking for both adults and pediatric patients, detailed patient education pamphlets in multiple languages, and links to some of the best drug and clinical reference services available.
Deploying extra features like these in your system can help make it more likely that you'll be a rising boat when the money starts pouring in.
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.
Due to state initiatives, Florida has long been one of the national leaders in eprescribing. Physicians and other prescribers in the state are used to the convenience and improved safety of affordable electronic prescribing. Many clinicians in Florida have likely given little thought to the eprescribing sections of national Meaningful Use legislation, assuming they would easily meet requirements.
But just as Meaningful Use funding seemed to be at risk several times over the past few months, so too are many state healthcare initiatives facing potential cuts. It seems that no program, no matter how popular, is completely safe from defunding these days. What should doctors, dentists, and others in Florida do to protect themselves?
The most obvious answer is to research private eprescribing solutions that can be quickly and affordably integrated into existing systems to make an almost seamless transition and keep prescribers on track to comply with Meaningful Use in 2011 and avoid penalties. Although Lexicomp -- a leading provider of drug information -- doesn't offer an eprescribing solution itself, it does have partnerships with several.
Those in Florida looking for advice on which electronic prescribers to consider are welcome to contact Lexicomp for referrals to some of the best in the industry. Use the phone number or forms on this page to ask for advice.
Because Meaningful Use penalties for eprescribing are tied to Medicare and Medicaid reimbursement, it's physicians who rely on these programs most for their revenues who will feel the pinch first. In states like Florida with large populations of older, retired Americans, the impact will be much greater if doctors fail to implement electronic prescribing in accordance with government regulations.
State programs and laws add another layer of confusion to this situation. Some states, like Minnesota, have enacted laws requiring healthcare professionals to switch to eprescribing sooner than the rest of the country -- even those, like dentists, who write relatively few prescriptions.
Meanwhile, other states are slashing programs that helped doctors use electronic prescribing more cost effectively. All of these changes are forcing some practices to scramble to fill a gap they hadn't expected. So how can doctors, dentists, and others easily find cost-effective and easy-to-use eprescribing solutions?
Lexicomp is an industry leading drug information provider. Although they don't offer their own eprescribing solution, they have several partners in this space that have been meeting the needs of clinicians quickly and affordably across the U.S. If you're confused about which eprescribing solution to use, contact Lexicomp using the phone number or form buttons on this page for advice in navigating this area.
So far, the government's attempts to move physicians, hospitals, and other healthcare providers to EHR systems have been positive monetary incentives. Not every provider feels that the incentives (and the reporting requirements surrounding them) are worth the headache of EHR implementation, but the government is getting ready to trade its incentive carrots for penalty sticks.
Penalties have long been a part of the legislation on this topic, but they were always eventual penalties to be levied in the future. These days, the future is fast approaching.
The penalties themselves won't be payable until 2012 and 2013, but they will be levied in part based on what happens this year -- in 2011. If docs don't use electronic prescribing at all this year, they're liable to be dinged for the next two years. And the longer they wait, the tougher the requirements get, and the harder it is to get out of the penalty box.
The upshot is that EHR vendors need to be offering their customers full-service eprescribing systems. Otherwise they're leaving money on the table and exposing their customers to possible penalties over the next several years. If you're having difficulty building your eprescribing system or getting it certified, this is the time to seriously consider a standalone module like DoseSpot that can help you get certified faster and give your customers the functionality they need and expect.
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.
A recent study found that
59% of all Americans now use the Internet to research health topics. With all the misinformation prevalent online, it's increasingly important to make sure that there are also good sources that can accurately and completely answer patient questions.
Lexicomp is one of the best sources for drug information that can be easily integrated into patient portals, reference sites, and other consumer health websites. Information is available covering adverse drug events, potential allergies, interactions, and more -- both for pediatrics and adults. Furthermore, Lexicomp has some of the best and most comprehensive patient education materials and pamphlets in the industry.
These patient education leaflets put complex clinical information into words that patients understand, and are used in hundreds of hospitals worldwide. Lexicomp patient education is available in up to 19 different languages, which makes it valuable for sites serving diverse populations. Make sure that patients searching for healthcare information find what they need at your site or portal -- and in the language they speak!
Hospitals are complex organizations with many different systems used by different departments, and often not well integrated. All kinds of errors can occur -- human errors, data-entry errors, labeling errors. And unfortunately, sometimes those errors have fatal consequences, such as this case of a premature infant that received a lethal dose of sodium due to a parenteral nutrition compounding error.
In this particular case, the death was reported to have led from incorrect data entry into the compounder, insufficient oversight by the pharmacist, incorrect labeling, and an unfulfilled physician request for investigation into abnormally high sodium levels in the infant. Though neither the EMR nor the CPOE were directly implicated in the error this time, it's always worth thinking about whether your system would have been capable of preventing this mistake -- and if not, what you may need to change.
Needed: Dose range checking -- and then some
In order for any system to have detected this error, some form of dose range checking would need to have been in place. This wasn't a result of an adverse drug event or an improperly prescribed medication, so Meaningful Use interaction and allergy checking are of no use. Only knowledge of the correct dosage for this specific patient would help.
In fact, not even all dose range checking would be helpful. This patient belonged to a special class -- a neonate. So the dose checking would need to be differentiated between adult and pediatric (or, in this case, neonatal). Otherwise, a dose that would be appropriate for an adult but fatal to an infant could easily be prescribed.
IV compatibility also an issue
This case also dealt with a solution administered intravenously. In this particular case, there was no adverse reaction between the ingredients being compounded, but with IV administration that's always a possible danger. Therefore, to be 100% safe, your EHR or HIS would also need to contain information about IV Y-site compatibility.
And of course, all of this would need to be checked and double-checked at every stage of the process by every clinician: the physician entering the order into the CPOE, the pharmacist compounding the solution, and the nurse administering it to the patient. The systems that each clinician uses should be able to check for each of these factors (and more!), and also should be able to provide the clinicians with more "human readable" information in case something doesn't seem right.
With the state of healthcare IT today, most of us are still a long way off from being able to implement a perfectly integrated system that can eliminate this kind of error entirely. But taking a few steps with the systems we have control over can reduce tragic outcomes like this one. One place to start is to contact a clinical and drug information vendor like Lexicomp to find out what information is available to be integrated into your systems -- both transactionally for automatic clinical decision support and as reference material for clinicians to make use of.
Stage 1 of Meaningful Use has been criticized by some as simply encouraging EMR vendors, hospitals, and physicians to "check off boxes" in order to be eligible for government incentives. These critics look at Stage 1 and ask how the hodge-podge of "requirements" (many of which are still very optional) will really lead to better patient outcomes. By all accounts, CMS and ONC intend to use Stage 2 and Stage 3 to correct that perception.
Patient education -- just one small example
One simple example of this is in patient education leaflets that are mentioned in Stage 1. These pamphlets are intended to give important information to patients to help them better manage their own health and be more informed when they visit healthcare providers. Some of the most commonly distributed patient education materials are those related to prescription drugs, and they include information on dosage precautions and administration, potential adverse drug events, allergy symptoms and so on.
It's not even required to supply patient education materials to qualify for Stage 1 -- instead, it's an optional item in a menu set. Even if providers do choose the patient education menu option, the bar is very low. Providers need only supply patient-specific materials to 10% of patients. It's easy to see how critics may find fault with this.
But beefed up requirements are on the way!
Workgroups have been hashing out details of what will be required in Stage 2, and their proposed requirements are expected later this summer. Patient education is one area they've been discussing. Published minutes and transcripts from the workgroup meetings reveal that patient education will now be required for everybody, and that the percentage of patients who receive it will be drastically increased -- up to 80%. The Stage 1 requirement was clearly just to develop the functionality. Stage 2 is where the rubber meets the road.
But that's not all yet! The workgroups are additionally talking about better and more relevant patient education. One point of discussion has been providing the materials in "common primary languages" for every metropolitan statistical area. This would require providers to have patient education available in any language that is spoken by 5% of the population they serve, or at least 1000 people in the same population -- whichever is lower. This is a big deal, and not every information vendor is in a position to deliver on this!
Lexicomp can help bridge the gap
Luckily, some vendors are. Lexicomp has long had patient education materials in many languages. At last count, they could provide up to 19 different languages commonly spoken in the United States and Canada. This is just one example of how a forward-thinking drug information vendor was able to anticipate and meet advanced requirements before they were even formulated. So when evaluating vendor partnerships for your EMR or HIS system, it's not enough to find one who can check off boxes. Instead, you need to find a vendor with the same commitment to improving patient care that ONC and CMS are seeking.
With hundreds of EMR vendors rushing to enter the market these days and with limited time left in the government Meaningful Use incentives, speed to market is top of everyone's mind. Electronic health records and electronic prescribing are part of the near future of healthcare, and the first arrivals with the best products will likely win the race.
At Lexicomp, we have helped many EMRs implement clinical decision support systems and prepare for (and then pass!) ONC-ATB certification. Several of our satisfied customers have come to us after working with other drug information vendors and finding their databases difficult to work with and their customer service unresponsive.
Sometimes "How" is as important as "What"
Many drug information vendors can promise drug-drug interaction checking, drug-allergy interaction checking, and other required clinical decisions support functions. But once the developers get into the guts of the medication lists and supporting tables, will they be pulling their hair out and wasting precious days trying to make sense of awkward data structures?
That's why the secret to a fast deployment and better product often requires listening to the IT department. If they don't like what they see, then it's time to look for a new solution. At Lexicomp, we also have many customers who included numerous drug information vendors in their up-front analysis. This allowed them to save time by not going down the wrong path to begin with -- their IT department was able to review sample files ahead of time and make a recommendation that resulted in greater speed to market.
When choosing a drug information provider, listen to the people on your staff who will need to work with the data every day! If you ignore their suggestions, then don't be surprised when development is slow and functionality lags behind.
When EMR vendors talk about Stage 2 of Meaningful Use, they too often suggest it's just "more of the same" of the Stage 1 requirements. Optional menu choices become requirements, measurements become tougher, but overall -- not much of a change. The truth is that anybody who really believes that is in for a rude surprise when the proposed rule comes out later this summer.
Meaningful Use workgroups are hard at work behind the scenes -- and they aren't just debating what percentage of prescriptions need to be electronically ordered. There are some shifts in the overall focus of the incentive program -- such as this article noting that
patient engagement is going to be a lot more present in Stage 2.
What are EMRs doing to ensure positive patient engagement?If I were an EMR vendor, this is where I'd really start hoping that my team had done their homework in creating strategic partnerships. If they didn't then I could easily be stuck with a drug information provider that was "good enough" for Stage 1, but which doesn't have what it takes to drive patient engagement in Stage 2.
And for physicians, this is where the rubber meets the road. "Patient engagement" is another name for "customer service" in healthcare. If docs can't provide good service, they'll lose business. And if the gap in service was a result of sub-par patient education materials provided by your system -- well, then you'll lose business too.
Lexicomp has some of the most well regarded patient facing materials available. Not only is dosing information divided into separate pediatric and adult documents, but they offer several languages as well. Patient education is worthless if the patient can't understand it. Now that we know what's top-of-mind at CMS regarding patient engagement, isn't it better to try to get in front of the upcoming requirements than scramble to catch up when Stage 2 and Stage 3 come around?
In the past few years, new developments on many fronts have created innovation and changes among EMR vendors. Regulations like Meaningful Use have caused particular features and functions to gain sudden prominence. New technologies have given us buzzwords like "software as a service" (SaaS) and "the cloud" -- along with new ways to deliver information. New business models have some EMR companies giving away their product to users. And new hardware like tablets and smartphones are suggesting new ways that clinicians can interact with their EMR systems.
As EMR vendors plan to release new products or new versions of software to take advantage of some of these new opportunities (or to comply with government mandates), it's also the perfect time to evaluate the drug information that forms the basis of any EMRs clinical decision support.
When many EMRs were first designed several years ago, there weren't many choices for drug information. Now there are new vendors in the market with competitive offerings, like Lexicomp. Many new EMRs are finding it to their advantage to sign up with Lexicomp for their drug reference and clinical decision support information. If you've been using the same drug information vendor for years because you thought you had no other choice, it's time to find out why!
Congress is often compared to a sausage factory, and its laws to sausages. Anyone who sits down to read federal regulations on almost any topic would be sure to agree. Rarely do you come across a regulation that looks like a piece of steak -- simple, unadorned, and exactly what it appears to be at first glance. No, federal regulations are much more like sausages -- a mish-mash of ingredients of unidentifiable origin, all encased in an opaque shell that makes it impossible to tell if their label is accurate until you take a bite.
Now consider the sausage called "Meaningful Use". Clinicians, patients, and EHR vendors are just now getting their first nibbles of that sausage, and ONC and CMS are watching their faces closely to see how they react. In fact, it's public knowledge that the Meaningful Use sausage recipe is subject to change -- that's what Stage 2 and Stage 3 are all about.
It's a safe bet that not everybody is going to like this sausage. And ONC and CMS are going to respond to complaints in one way: by trying to stuff more regulations into the sausage casing in an attempt to make everybody happy.
What will the next Meaningful Use sausage recipe look like?
Nobody knows, of course. But the safe bet is that there will be more of everything. There will be more (and more complex) clinical decision support. Drug-drug and drug-allergy checking may be joined by drug-food, drug-age, drug-disease, or drug-lab checking. Dose range checking can be expected at some point -- and then the logical step there is customized dose range checking for pediatrics and adults and others with special needs.
There are already conversations taking place about delivering patient education materials in common primary languages. According to the Office of Civil Rights, those are languages that are spoken by more than 5% of a population or more than 1000 people in a population, whichever is lower. Does your EHR system have any customers in New York or Los Angeles or Chicago? Imagine how many common primary languages you'll need to support.
How will your data vendor support you when the sausage recipe changes?
It's impossible to say which of these criteria will appear in Stage 2, which in Stage 3, and which in future regulations that aren't even planned yet. (What -- did you think that Stage 3 would be the end of it?) So it's crucial to have a drug information partner with high quality information who is able to support a wide range of clinical decision support needs and who is ahead of the curve in clinical information and patient education. Moreover, you need a partner who gives you superior customer service. It's a tall order and not easy to fill -- but Lexicomp is all of these things.
Let me walk through the Meaningful Use conundrum faced by specialists and the EHR vendors who serve them, and then see if this sounds familiar...
Item #1: In the earliest days of Meaningful Use, many specialists believed that they'd never be able to qualify for pay-outs even if they adopted certified EHR technology, simply because so many of the measures didn't apply to them.
Item #2: Likewise, many specialists prefer to buy EHR systems that are customized specifically for the special needs of their practices. Why would an oncologist want to use the same system as a general practitioner?
Item #3: Eventually, specialists learned that they could qualify for Meaningful Use incentives by opting out of measurements that didn't apply to them. However, the EHR system they used still had to be able to fulfill all the requirements -- even the ones that don't apply to their specialty.
Put these three items together, and you get an interesting conundrum for developers of EHR systems for specialists. How do you build a system that could serve the needs of a general practitioner, while ensuring that it is still customized for the specialist it's intended for? And this conundrum gets even knottier when you start to look at specialties that have limited need for clinical decision support, e-prescribing or related topics. Because there's a cost in providing these things -- to deliver effective clinical decision support, you must partner with a vendor who has the data to back it up. But why would you want to spend money on something your customers are never (or rarely) going to use?
It's almost a catch-22. (That's why I cleverly called it a catch-21 in my headline.) What saves this from being a full-blown catch-22 is the existence of drug information vendors who are willing to work with you in this unique situation. Lexicomp is one such vendor that is willing to partner with EHR vendors developing systems for specialists with unique needs for data that may get minimal use. They understand the issues and will work to find an equitable solution to best serve the clinicians and patients.
I know things move fast in the healthcare IT world, but try to think all the way back to February 2011 -- in the distant past of two months ago. Thanks to HIMSS, "Meaningful Use" was on the tip of everybody's tongue. At last, it seemed that the conversations which had started gaining urgency last summer were entering the serious mainstream.
But now when I look at my Twitter feed or check health IT blogs, the mentions of ONC, Meaningful Use, the HI-TECH Act, and all those other topics are much fewer and farther between. What happened? Did HIMSS attendees finally solve all the Meaningful Use questions in Orlando to everyone's satisfaction? Yeah right.
There are more questions now than ever before
If you look hard enough in the right places, you'll find it's true. There are work groups evaluating comments, taking testimony, and formulating recommendations in the background. Oh sure, ONC and CMS have released some summary charts that are full of boxes saying "No change from Stage 1". But read any of the work group transcripts and you'll soon realize that Stage 2 is going to be full of interesting surprises.
No one can tell for sure what the final recommendations for Stage 2 and Stage 3 will contain, but it's hard to imagine that clinical decision support won't be expanded significantly. Stage 1's drug-drug and drug-allergy checking were always obviously the bare minimum -- excellent HIS and EHR vendors have been offering much more for years. And it seems extremely likely that Meaningful Use will ultimately require complex clinical decision support like dose range checking.
Can your drug information vendor handle this?
The question then becomes whether your information partners are positioned to respond to these kinds of needs. EHR vendors who hope to get their information from publicly available sources are soon going to find themselves unable to keep up with Meaningful Use. Meanwhile, those who license from commercial vendors need to understand if changes in needs will result in changes in fees. To stay viable, it's important to make sure that your costs are manageable for the next several years. If you haven't talked to your vendor about future costs yet, don't delay the discussion!
Predictions about consolidation in the EMR, EHR, and HIS marketplace are nothing new. A colleague of mine wrote about
the likelihood of consolidation all the way back in October. Hard to believe that post was written almost five months ago -- and since then, the marketplace has only grown more glutted. (ONC has added three more certifying bodies since that post was written to deal with the onslaught of new systems that need to be evaluated for Meaningful Use, including SureScripts as an ePrescribing certifier.)
But a recent announcement that human resources giant ADP is
acquiring an EMR points to a surprising twist that few people expected.
Although the details of this specific acquisition may not have been easy to foresee, it does fit a long-standing trend that has only been gaining momentum lately. Walking the exhibit floor at HIMSS, there was no shortage of large corporations setting their sites on the healthcare technology market in one way or another: Google, Intel, Cisco, CDW, Microsoft, Rubbermaid, to name just a few. This is a growth industry, and everybody wants to be a player.
Much of my colleague's analysis and advice from in October still holds true today, with this new kind of consolidation thrown in the mix.
"I would imagine that the companies that are able to stay ahead of the curve will continue to grow, but can the 500+ EMR and EHR vendors all survive this regulation wave? If you are an EMR or EHR vendor, choosing the best drug information provider is critical because time to market is vital.
So how do you choose the right provider? You should expect that your drug information vendor offer a variety of delivery options such as database tables that are compatible with Oracle®, SQL Server®, and MySQL® . The vendor should also provide a Software Development Kit (SDK) powered by Java™ or .NET APIs. Drug Databases are generally extremely normalized and complicated to navigate so utilizing a light weight and easy to use API and save tremendous time. The vendor should provide a high level of customer service and demonstrate a sense of urgency to client requests. They should also earn your loyalty by listening attentively and understand your needs, and then deliver a solution that translates into a mutually beneficial arrangement for both organizations."
To date, Lexicomp has helped many EMR and EHR companies not only pass muster with ONC regulations, but stand out in the crowded field by getting to market faster with powerful and customizable functionality and the highest quality medication available. Contact Lexicomp today to learn more!
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