Drug Interaction Database

Healthcare professionals are faced with frequent drug interaction alerts on a daily basis. They are faced with the challenge of measuring the risk of these potential interactions to the patient prior to acting on the alert.  Today, many healthcare professionals are faced with the challenge of dealing with inappropriate alerts throughout their work days.

Medi-Span Clinical offers the ability to develop alert customization by site, department/group, or even by clinician. This "User Control" function enables you to allow for alerts to be turned off if they are not relevant to the user. Reduced noise and alert fatigue are further addressed through consolidation of common alerts, along with messages that are worded to be meaningful to a variety of clinician types.

Medi-Span, a part of Wolters Kluwer Health, is the leading provider of prescription drug information and drug interactions database solutions for thousands of health care professionals worldwide.

• Our Web API solution empowers integration of all Lexicomp content. Consistent API programming calls save time and allow clinicians to launch from their internal applications into our clinical databases, utilizing whatever delivery platform they choose.

• Our Web Services platform is written for compatibility with Microsoft® .NET™ and Java™ programs. XML data can be obtained via standardized calls and is then processed and returned in real-time. Your application will retrieve and parse the content into your display, making complete customization a reality.

XML Datasets

• If live Internet calls are not preferred, XML datasets are available for download from an FTP site and incorporated directly into the database.

If you have any questions about Lexi-Data, please contact us!

Recently I have had several conversations with developers who are building software systems that require not only the standard drug interaction checking, but also a focus on pharmacogenomics.  Pharmacogenomics presents information concerning key genetic variations that may influence drug disposition and/or sensitivity.  Whether the timing of these conversations are coincidence or there is a more clinician focus on more personalized medicine, I'm not sure, but it is exciting. 

We know that pharmacists have always been advocates of individualized pharmacotherapy.  They employ efforts such as therapeutic drug monitoring programs to identify appropriate therapeutic dosage selection. Diagnostic genetic information will help predict not only an individual patient's response to some medications, but also the likelihood of drug interactions and adverse effects- truly enabling the individualization of drug and dosage selection.  

If you are in search of a Pharmacogenomics database, please contact us and we'd be happy to talk to you about our offering.  Our database provides rapidly-expanding genomic knowledge into the management of drug therapy as well as a concise reference on key polymorphisms known to influence drug response.

Are you developing an EMR and trying to get to the market as quickly as possible?  Are you planning on going through Meaningful Use certification?  If you answered yes to either of these questions (or both!), here are a few tips to help you get started in selecting a drug database for your system.

1) Quality of Content - This is very important to consider as it is probably not the expertise of your developers.  Select a drug information vendor that has a strong reputation in the market and trusted clinical information. 

2) Flexibility - Select a vendor that offers flexibility and customization of the content.  For example, customization of drug interaction alerts in your system (your users will thank you!).  Also, consider the different delivery methods that the vendor offers of their content.

3) Simplicity of Data Structure - Select a vendor that offers simplistic data structure that you are comfortable with.  Also, consider the use of an API if it provided by the vendor.  The use of an already developed API will definitely decrease your development speed.

4) Customer Support - Ensure that you have a dedicated support team to assist you if your developers have questions.  A company that strives for excellence in customer service should not charge you for support time.

Lexicomp works with hundreds of EMR and home healthcare companies to help them embed our clinical content into their systems.  We cover all areas of the core clinical decision support functions: drug-drug, drug-allergy, drug-condition, dose range checking, and duplicate therapy screening.  We support several components of Meaningful Use as well.   Lexi-Data is mapped to RXNORM and other standard vocabularies, supports CVX/MVX coding for transmission of immunization records, and contains patient education for medications and diseases.

Please feel free to contact us and one of our representatives would be happy to talk to you about our content and support.

I have been asked to respost one of my blogs from 2011 

Are you developing EMRs and practice management systems where speed to market is critical?   One of the modules of such systems is the inclusion of drug information.    Since this is neither the expertise of your developers nor your content people,  it is important to identify the preferred drug information provider early in the process.   Four criteria are critical in making this decision.   First, quality of information.  Second, flexibility of design and APIs.   Third, simplicity of data structure.   Fourth, and very important, customer support during the development period and after release.    More and more EMRs are now using Lexicomp drug information as part of their offering.  And there is a reason for that.

Lexi-Data is the foundation of Lexicomp's clinical decision support architecture is quickly becoming the standard for when companies need an up-to-date comprehensive drug database.  This database provides patient specific alerts and referential content to support sound treatment decisions in areas such as drug interaction checking (drug-drug and drug-food), drug allergy checking, therapeutic duplication checking, RxNorm Mappings, supports Surescripts Certification,  Drug Classifications, dose range checking (adult and pediatric), Patient Education, Pediatric and neonatal drug interactions and more. 

My colleague  posed the following question earlier this week:

Does your drug interaction software comply with Meaningful Use?

He posed the question of  what EMR and EHR developers  need to consider when they make  decisions of which drug data vendor they should select for their product.  With the final fule for State 2 Meaningful Use imminnent,  this question of selecting the right drug database and drug information takes on an even more important role.   I am quoting Matt B's comment.  It is worth reading:

"As we await word from CMS and OMC on what criteria will be included in the final rule for Stage 2 of Meaningful Use, it's hard not to reflect on how interdependent many parts of healthcare have become. Doctors and hospitals now rely on their EMR or EHR vendors to ensure that they have the needed functionality to avoid penalties. And those vendors themselves rely on data providers to keep ahead of new criteria.

I sometimes wonder if EMR and EHR vendors know how much is riding on their decision to choose one medical reference database over another. The drug interaction software powered by that database will become an important part of many users' medical practices for the next several years. The readiness of that database provider to deal with changing regulations could make the difference between a clinician receiving an incentive payment, or a penalty.

A forward-thinking database provider is crucial to keeping your users happy. At Lexicomp, we are already preparing for future Meaningful Use criteria that may affect your users. For instance, we offer patient education leaflets in up to 19 different languages -- anticipating the day when CMS and OMC require that patients be informed of conditions and medications in the language they speak.

Contact Lexicomp now to find out more."

As we await word from CMS and OMC on what criteria will be included in the final rule for Stage 2 of Meaningful Use, it's hard not to reflect on how interdependent many parts of healthcare have become. Doctors and hospitals now rely on their EMR or EHR vendors to ensure that they have the needed functionality to avoid penalties. And those vendors themselves rely on data providers to keep ahead of new criteria.

I sometimes wonder if EMR and EHR vendors know how much is riding on their decision to choose one medical reference database over another. The drug interaction software powered by that database will become an important part of many users' medical practices for the next several years. The readiness of that database provider to deal with changing regulations could make the difference between a clinician receiving an incentive payment, or a penalty.

A forward-thinking database provider is crucial to keeping your users happy. At Lexicomp, we are already preparing for future Meaningful Use criteria that may affect your users. For instance, we offer patient education leaflets in up to 19 different languages -- anticipating the day when CMS and OMC require that patients be informed of conditions and medications in the language they speak.

Contact Lexicomp now to find out more.

I was re-reading a  posting  my colleague Dave White wrote several years ago  (like "counting sheep" during the daytime  -- very  therapuetic and reduces side-effects of too much multi-tasking.  Which of course helps my medium term memory,  as oppposed to eating my daily walnuts,  which aids  my critial thinking ability.).   Anyway, back to my point.

Even though Dave wrote this several years ago,  I think it is as meaningful today as it was then  -- despite the dynamic fluidity of the healthcare marketplace.   He wrote:

"With the recent changes regarding meaningful use of EHR, system vendors are faced with many clinical decision support challenges when developing new software applications.  One such challenge is how to easily integrate a drug interaction database into an existing EHR framework.  

To quickly overcome this obstacle, many EHR vendors are turning to Lexi-Comp for a drug interaction software solution.  Lexi-Comp has a comprehensive drug interaction database concerning drug-drug and drug-food interactions available through our integrated solution, Lexi-Data.  Lexi-Data's drug-drug interaction API accepts as an input one or more drugs.  Drugs can be single ingredient agents or multi-ingredient agents and requests for drug interaction checking can be made for either generic drug names or brand names.

To get the drug interaction data that you need with an uncompromising level of customer service, trust Lexi-Comp to deliver.  Contact Lexi-Comp today to learn how you can quickly and easily integrate a drug interaction database into your EHR system."

A posting on the FDA website says, "Most drugs prescribed for children have not been tested for children." At times, only 20 percent of drugs prescribed for children had labeled indications for such uses. Instead, pediatricians often rely on independent studies that demonstrate the effectiveness of "off-label" uses to guide their prescribing.

Drug data that relies on packaged inserts is woefully inadequate!
What this means is that clinical decision support systems (like electronic health records) that include only FDA-approved labeled uses for medications are not helping clinicians prescribe to children and patients. Though more trials are being done with children, they remain expensive and difficult, and are rarely needed to bring a drug to market. There will always be a gap.

To fill that gap, EHR systems must go beyond FDA information and partner with a drug interactions database provider that knows and corrects these shortcomings. Lexicomp is one such drug information vendor.

Over 30 years ago, pediatric drug references were one of Lexicomp's first offerings. They continue to focus on that area today, carefully combing and evaluating medical literature for effective off-label uses that should be reported alongside FDA-approved labeled uses. Lexicomp also provides pediatric-specific patient education, and even has special dosing for neonatal populations.

No other drug information resource can match Lexicomp's breadth and depth of information on pediatric prescribing!

With more people living longer, there's more attention being given to prescribing to geriatric patients. Recently, the BBC reported on a recent report that looked at whether older patients were getting the full benefits of medications available to them.

There are certainly more concerns when prescribing to older patients. They are more likely to have other medications or health conditions that may result in interactions or adverse reactions. Some older patients may be on fixed incomes and unable to afford medications.

But that's all the more reason why an EMR or EHR that contains detailed information about drugs, interactions, and effects on special populations can be valuable to doctors and pharmacists. When designing these systems, vendors should keep in mind the aging of the patient population.

Does your drug reference and clinical decision support data vendor supply information for geriatric patients? If you offer only generic information from a bargain drug interaction database, clinicians will soon learn that your system cannot provide the answers they need. Instead, evaluate your partners carefully and select one will provide valuable information for all your users.

We work with hundreds of EMR vendors to integrate our drug database into their EMR/EHR systems for clinical decision support.   Lexi-Data's reference and clinical decision support databases have been winning customers among small- and mid-sized EHR and EMR vendors.  I thought it would be helpful to provide all of the developers out there who are reading this with some of our most frequently asked questions.  The ultimate goal always being that your EMR will meet government regulations regarding Meaningful Use.  Here are a list of questions and factors to consider while you are doing your homework on a drug interactions database:

1. What kind of support is provided if I run into development issues?
2. What is the annual subscription fee for access to the content?
3. Is the drug database an approved database by SureScripts (if you will be building ePrescribing in-house instead of licensing it through a 3^rd party vendor)
4. Do you have sample data that I can work with?
5. What type of documentation do you provide for your database?
6. Consider how you want to access the content – through an FTP account download or via web services?  What delivery options are available?
7. Do you provide an API for easier implementation?  Is it powered by Java or .NET APIs?
8. How often is the content updated?
9. Is there a way to customize alerts to prevent alert fatigue within my system?
10. Do you offer reference content for users to access if they have questions about a drug?
11. Are patient education leaflets available in multiple languages?
12. What environments are compatible with the data?  Oracle®, SQL Server®,  MySQL®?

If you are shopping for a interaction database or medication list, be sure to do your homework. Request a trial of Lexi-Data's database today and see the difference for yourself. Whatever database you implement into your product will be with you for years to come, so make sure the vendor provides you with the highest level of customer service and demonstrates a sense of urgency to your requests. It's worth it to find one that will be easy to update and maintain so you can focus on the other requirements of your product. 

Several weeks ago Matt Bennardo posted a blog titled: "For EHRs and EMRs,  database structure can make all the difference."  It was a terrific posting, but I think it would have garnered a larger audience if the title had been:

"Why EMR developers care about  the data structure for drug information"

In sum,  it suggests that good data is important,  as is the selected fields,  but what many EMR developers hang their hat on regarding a drug information database decision,  is "data structure."  This one of the reasons that Lexi-Data has expanded so rapidly in the last few years --- a very intuitive and easy to understand and access data structure.   

Matt wrote:

When evaluating a drug interactions and reference database, what factors do you consider? It's important to have a database that will allow your users to meet government regulations regarding Meaningful Use, but there's more to it than that. Implementing a drug interactions database into your EHR product is not a trivial undertaking -- the structure of the data matters!

Lexi-Data's reference and clinical decision support databases have been winning customers among small- and mid-sized EHR and EMR vendors. Data structure is one reason for that. When our customers evaluate Lexi-Data and other options, they tell us that Lexi-Data is much more intuitive and simpler to implement.

If you are shopping for a interaction database or medication list, be sure to do your homework. Request a trial of Lexi-Data's database today and see the difference for yourself. Whatever database you implement into your product will be with you for years to come. It's worth it to find one that will be easy to update and maintain so you can focus on the other requirements of your product.

When evaluating a drug interactions and reference database, what factors do you consider? It's important to have a database that will allow your users to meet government regulations regarding Meaningful Use, but there's more to it than that. Implementing a drug interactions database into your EHR product is not a trivial undertaking -- the structure of the data matters!

Lexi-Data's reference and clinical decision support databases have been winning customers among small- and mid-sized EHR and EMR vendors. Data structure is one reason for that. When our customers evaluate Lexi-Data and other options, they tell us that Lexi-Data is much more intuitive and simpler to implement.

If you are shopping for a interaction database or medication list, be sure to do your homework. Request a trial of Lexi-Data's database today and see the difference for yourself. Whatever database you implement into your product will be with you for years to come. It's worth it to find one that will be easy to update and maintain so you can focus on the other requirements of your product.

The government is expected to release the final rule for Meaningful Use Stage 2 this July. The new rule is expected to build on reference and clinical decision support requirements from Stage 1 while adding considerable interoperability and patient engagement requirements. For EHR, EMR, and HIS vendors, this means another round of product enhancements to keep up the ever-changing regulations.

Throughout the changing requirements of Meaningful Use, pharmaceutical data provider Lexicomp has been providing drug interactions databases and other information that help EHR vendors to deliver certified products. They continue to update and enhance their data as new requirements are released.

Instead of writing out prescriptions on a piece of paper, doctors will perform this function directly into their electronic medical record.  The prescription travels from their computer to the pharmacy’s computer. Electronic prescriptions are sent electronically through a private, secure, and closed network – the Surescripts network.

By now it is not a surprise, more and more EMR and EHR  business owners and general managers are turning to Lexicomp to solve their drug information needs.   In a few short years,  Lexicomp has been the fastest growing provider of drug information to the EMR market.   This didn't happen by accident.  It came as a result of  Lexicomp's three-legged trifecta approach to providing drug information to EMR and EHR developers -- of any size!  

What are three aspects?

1. Top quality data
2. Elegant data structure with easy to use API's
3. The best customer and development support you can find anywhere.  (It makes your work so much easier)

In addition to supplying the expected information such as drug-drug and drug-allergy interactions, adverse drug events, RxNorm mapping, generic drug lists, drug nomenclature, and more.  Lexi-Data also offers an incredibly easy to use data structure and APIs!  Although, perhaps more importantly,  Lexicomp is unparalleled in its customer service and providing assistance in the development process. If you are developing a new EMR and need a drug information supplier, make sure that Lexi is on your list.

And if you are thinking about building your own ePrescribing module,  I call your attention to a posting my colleague Matt Bennardo published last week:

As EHR vendors find their products growing and signing up more users, many start to think about moving from using a third-party eprescribing solution to building their own. The reasons for making this switch are many:

• As your user base grows, eprescribing fees grow too
• Bring features in-house makes it easier to respond to specific customer needs
• A third-party solution is a risk, as you never can be sure what will happen in the market

One of the first steps in building your own eprescriber is to find a data provider who can supply you with medication lists and other information that Surescripts requires to certify your tool. Lexicomp is one such provider. They've been focused on providing drug data direct to clinicians for over thirty years, but now they can also supply you with database-ready information to power an eprescriber.

Lexicomp's customers have used their data to certify EMRs and EHRs with ONC testing bodies like Drummond, CCHIT, and Infogard. Their customers have also certified eprescribers using Lexicomp data with Surescripts. And best of all, Lexicomp's flexible pricing and easy implementation allows firms of all sizes to get up and running smoothly and quickly.

Recently someone asked, "What would you say are the most common words that people associate with Lexi-Data and the value and service that the database delivers?".   I would say it is a long list,  but the following short list comes to mind:  "drug interaction database , drug nomenclature,  drug reference pediatric , drug classifications list, pediatric dosage database, adverse drug events, drug interaction database for EHRs."

How to reduce "alert fatigue' and at the same provide the system  framework to improve outcomes?  That is the question that most system developers have been struggling with for over a decade.  It is difficult enough for a large hospital wide EMR to achieve this goal.  How much more difficult for ambulatory EMRs?

In the last few years,  Lexicomp has become a major provider of drug information used by ambulatory and smaller hospital EMRs.  As part of Lexi's entry into this market,  they have now included a unique aspect of their drug-drug interaction rating system,  which defnitely could help in improving "alert fatigue."  My colleage,  Mark Dachille recently said the following about "alert fatigue:"

"Another aspect that can prove beneficial is what types of alerts you choose to show users.  Lexicomp has recently rolled out another aspect of drug-drug interaction within Lexi-Data called risk rating.  By utilizing risk rating along with the more commonly known drug interaction severity, more impactful and actionable alerts can be provided to clinicians which will ultimately improve patient care and reduce alert fatigue for clinicians. 

Whether you are building a complete EMR, ePrescribing application, or mobile medical app utilizing drug interaction software, proper integration of the data is the key.  Taking the time and utilizing the right database that is easy to integrate and provides meaningful alerts will ultimately lead to an offering you can be proud of."

In speaking with a number of EMR developers and in reviewing many products which integrate clinical decision support utilizing commercial drug database, a few things have become apparent.  One of the the biggest challenges is to integrating clinical decision support for functions like drug-drug, drug-allergy, drug condition interaction checking  in a meaningful way that is not disruptive to a clinicians workflow. Many times just throwing alerts at clinicians can lead to alert fatigue and eventually alerts will be ignored.  In my experience, having a clinical resource to help with development will pay big dividends in the end.

Another aspect that can prove beneficial is what types of alerts you choose to show users.  Lexicomp has recently rolled out another aspect of drug-drug interaction within Lexi-Data called risk rating.  By utilizing risk rating along with the more commonly known drug interaction severity, more impactful and actionable alerts can be provided to clinicians which will ultimately improve patient care and reduce alert fatigue for clinicians. 

Whether you are building a complete EMR, ePrescribing application, or mobile medical app utilizing drug interaction software, proper integration of the data is the key.  Taking the time and utilizing the right database that is easy to integrate and provides meaningful alerts will ultimately lead to a product you can be proud of.

As more and more healthcare professionals are adopting EMR technology to meet Meaningful Use requirements, we are receiving more and more interest from dentists about adding clincial decision support technology into their dental practice management system.  They are quickly realizing that Lexicomp is the preferred vendor of choice to work with, because we provide the very best dental specific drug database to integrate into their EMRs as well as personalized customer support during development.   Another important piece to consider in a dental EMR is an ePrescribing tool.  Lexicomp has a close partnership with DoseSpot to deliver this solution.  By selecting DoseSpot for ePrescribing, our clients are able to get to the market faster and reduce their headaches in developing the tool on their own.

Lexi-Data provides the drug information for  dose range checking,  pediatric dosing, drug calculators, medicine interactions, dosage precautions, clinical guidelines, drug interaction software, duplicate therapy, drug classifications, generic drug names, drug nomenclature and more.  These are critical paths for a dental EMR build. 

To learn more about Lexicomp's dental solutions, please visit our website at http://www.lexi.com/individuals/dentistry/

If you are interested in learning more about our integration capabilities, we'd love to talk with you.  Please contact us at 1-877-819-6883.