Drug Interaction Database

Patients are becoming more involved in their own healthcare, and are increasingly making use of patient portals and consumer-facing websites to do research, follow their progress, and even answer questions they might have previously posed to their physician. At the very least, they are using these sites to be more informed during visits to their care providers so they can get more value from those encounters.

All of this creates an opportunity for innovative developers to provide accurate, reliable, easy-to-understand information to patients via the web. One source for medication and clinical information that can be easily integrated into such sites is Lexicomp.

Lexicomp is a leading provider of drug reference, clinical reference, and patient education leaflets and materials to clinicians. Over a thousand hospitals use Lexicomp's information every day during patient encounters. The information available includes medication lists, drug monographs, drug interaction information (including interactions with common food and natural products), drug allergy information, patient education documents, dose adminstration, warnings, and more.

And Lexicomp's information can be easily integrated into your site in a variety of ways. You can choose to have an installed local database, or to use web services to pull information from Lexicomp's servers as needed. Contact Lexicomp today to find out how to populate your patient portal or consumer website with the information your users are looking for.

• New web services calls that allow for implementation of Meaningful Use Stage 1 requirements without an installed database
• New Black Box Warnings information that helps alleviate alert fatigue
• Expanded patient education leaflets in multiple languages

For many years, the primary provider of drug reference and drug interaction information to researchers was Multum's Lexicon product. Today, there is also another product that is built on the foundation of Lexicon. That new product is Lexicomp's Lexi-Data Basic database.

In an earlier post, my colleague Ryan Smith explained how Lexi-Data Basic is now serving the needs of researchers:

"Lexi-Data Basic provides drug information that includes drug names (brand name, generic name, and common abbreviations), therapeutic categories, drug classifications, indications, and standard coding such as NDC, J-Cods, and ICD-9.  The Lexi-Data Basic product is powered by the widely known and trusted Multum Lexicon product which has been utilized by hundreds of universities and institutions in the past.  Multum is a registered trademark of Cerner Corp."

For more information on Lexi-Data Basic, click the links to fill out the form on this page.

One of the most common comments I hear from users of Electronic Medical Records (EMR) systems is associated with “alert fatigue” from unwelcome drug interaction notifications. Many users tell me that they are flooded with unavoidable but unnecessary alerts that interrupt their workflow, decrease productivity, and make the important alerts harder to see. Clinicians find themselves clicking through the alerts as quickly as possible which defeats the purpose of clinical decision support. 

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. Lexicomp has recently included new functionality that can alert users with the appropriate Black Box Warning where appropriate in the current workflow. 

In the most simple terms, an FDA Black Box Warning is the strongest warning that the US Food and Drug Administration (FDA) puts on a drug. It means that you should pay close attention to the drug's usage because there are some potentially extremely harmful or dangerous threats to your health that the already FDA approved drugs could pose.

The other side of the coin, however, is that an FDA Black Box Warning means that despite the FDA's knowledge of these harmful, serious and sometimes deadly side effects that they are still leaving the FDA approved drug on the market for you to be able to take and potentially experience these harmful side effects. In theory, these FDA Black Box Warnings are designed for both the doctor who is prescribing the drug to be aware of the problems and for you as the consumer to be more aware.

The warning is placed in a prominent 'black box' on the package insert of an FDA approved drug so that people and their doctors can be more aware of it, but few doctors ever see the pill bottles and the vast majority of consumers realistically aren't going to go through the amazingly large amount of technical and medically detailed information on a package insert. This can lead to doctors note being aware of a serious alert which can have serious consequences. With Lexicomp’s inclusions of Black Box Warnings within their medication database, the warnings can be provided to the physician during the prescription process where they are most needed.

• Incorporates not only the BBW as published within the package insert, but also pulls contextual or supporting information as written by Lexicomp clinical experts 
• Each summary is broken down and tagged as separate messages / instructions 
• Each message is paired to a recipient user category – this allow for differentiating where in the workflow of an EMR the message may be displayed 
• Can be filtered for a more specific and targeted set of messages to clinician/recipient groups, as defined for their site

What do these words have in common?  "Pediatric dosing information; Medicine lists; Medicine brand names;  Drug-drug interaction;  Drug-allergy interactions; Drug interaction database; ePrescribing;  Patient education."  

There are many EMR products under development, many targeting smaller hospitals and ambulatory facilities.  There are also a number of other EMR and Practice Management products that are going through major product re-design.  Many of these development groups need to confront the decision about what drug information supplier to use.  As the title of this posting says "EMR developers are now searching for drug and disease information providers that are easy to work with" (Note: most are not).   This might not sound like a tall order, but as it turns out, it is much more difficult than they think.   It's about the data as much as it about the quality of the relationship as well as the flexibility and helpfulness of the vendor. 

How much will they help in setting up the API's?  Do they have a specific pediatric dose range checking product?  Do they have patient education leaflets? Are they available in foreign languages? 

                         One drug data provider stands out above else....Lexicomp.  If your serious, check them out.

As it is part of Meaningful Use Stage 1, drug interaction checking is a critical piece.  Not only is it required for reimbursement, but it is also important for improving patient safety.  The difference between content and the quality and depth of the interaction information that you choose to integrate is important to understand.  Many common drug references have an interaction checker where you can manually enter the medications a patient is taking and check for the significance of any interactions.  For clinicians and patient safety this is important; however, when it resides outside of the workflow it can become time consuming.  

A drug interaction list within your system can increase the likelihood that interactions will be checked as it puts these alerts directly into the workflow.  Some of the most important aspects are not the common drug interactions, but the uncommon interactions that are not widely known. Keep in mind that users of your system will most likely want to customize or localize alerts to cut down on the number of insignificant alerts to reduce alert fatigue.  Lexi-Data can help with this as the database is structured to allow for customization, turning off of certain alerts, and is an overall robust interaction checker covering common and less common drug interactions. Lexi-data also allows for drug interaction checking via a web service so there is less IT development time and maintenance.  Contact Lexicomp to request more information on drug interaction lists. 

• anesthesia and critical care concerns, use, dosage, and monitoring parameters
• anesthetic drug interactions