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.
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