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.
There have been thousands of articles written discussing why EMR adoption rates have been so low and why physicians especially have been resistant to moving into the electronic age. Little return on the initial investment, lack of efficiency in the system and no improvements in patient outcomes have been listed as reasons for reduced adoption rates.
One key element to the lack of efficiency and little improvement in patient care is due to the number of alerts that are generated when trying to use these systems. As a pharmacist, I enter in hundreds of medication orders in a shift and it is rare that I do so without receiving an alert from my HIS telling me about a drug interaction or duplicate therapy. These alerts although technically accurate, often involve medicine interactions that are so minor or irrelevant to hospital medicine.
If an HIS truly wants to improve patient care and become an indispensable part of medicine, it must provide clinical decision support that can accurately and appropriately give clinicians therapeutic alerts that are relevant and can help improve patient care. That is the goal of Lexi-Data. For more information about Lexi-Data, check out www.lexi.com.
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 now
Among 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 beyond
With 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.
Development talent is the scarcest resource right now
Among 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 beyond
With 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.
What do all of these have in common? Well for one thing, they are being driven in part by the demands of Meaningful Use requirements. Here is just one example of Meaningful Use effect. Some of the demands are actually in place, and many others roll out over the next few years. EPrescribing in Florida looks like it might be taking an interesting turn as free application provided by the State may be going away, or so I have heard. This recently posted ePrecribing blog described it in greater detail. And a second blog.
As Meaningful Use requirements have dictated more relevant application of medication and drug data within EMR and EHR systems, the awareness of the nuances of these databases has also gone up. Recognition of the following terms is becoming more commonplace: Drug Reference Database; Dosage Range, Dosing in Pediatrics, Drug Interaction List, Pediatric Dosage Calculator, Medicine Interaction. Clinical Decision Support Systems, Drug Content, and more.
As Meaningful Use requirements have dictated more relevant application of medication and drug data within EMR and EHR systems, the awareness of the nuances of these databases has also gone up. Recognition of the following terms is becoming more commonplace: Drug Reference Database; Dosage Range, Dosing in Pediatrics, Drug Interaction List, Pediatric Dosage Calculator, Medicine Interaction. Clinical Decision Support Systems, Drug Content, and more.
Matt Bennardo had a great post last week regarding a study which showed the connection between EHRs and their improvement on pediatric care.
With several pediatric calculators on the market, how can one tell which to trust? A reference book can be helpful, yet many other considerations should be taken into account. It is vital to screen drug interactions with the full medicine list of the child along with their maturation. Having all this information readily available with an EMR can vastly work to reduce errors. When dealing with pediatrics, especially neonatal patients, attention to detail and continually updated, unbiased information is best. Lexicomp has all the options to achieve improved safety for patients of any age.
These options include:
These options include:
- Pediatric Dosage Calculations in both transactional information for the clinical decision support systems and reference materials designed for clinicians.
- Pediatric focused patient education materials
As more hospitals are taking up the mantle of electronic medical records, the issue of security continues to plague the industry. Every day, more hospitals are identified as having security gaps - sometimes glaring, sometimes minor - but always of concern to the administrators, IT professionals, clinicians, and patients of those hospitals.
RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
Drug Reference Data - integrate drug reference information, such as drug images and black box warnings, into your system
Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients
A recent study released by the Office of the Inspector General showed "a lack of general [information technology] security controls during prior audits at Medicare contractors, State Medicaid agencies, and hospitals." 124 out of 151 breeches were considered "high-impact" - resulting in costly losses, injury, or death.
Given all that a hospital EMR implementation team and IT staff has to worry about concerning the safety and security of these systems, the one thing they shouldn't have to concern themselves with is the depth and quality of the drug information of their system.
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?
Lexi-Data, Lexicomp's clinical decision support database contains:
Drug Interaction Data - we'll provide your system data that enables clinicians to screen for drug interactions, including drug-allergy, drug-drug and drug-food
RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
Drug Reference Data - integrate drug reference information, such as drug images and black box warnings, into your system
Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients
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.
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.
Several weeks ago I wrote a blog posting that included a list of drug information considerations for EMR vendors that were launching new products or looking to improve their current products. As I wrote:
More and more EMR vendors and hospital EHR/HIS systems are attempting to improve their drug information to further enhance clinical decision support. Below are just a few areas where having the right medicine data can make all the difference in the world.
- Drug Interaction Lists
- Adverse Drug Event Alerts
- Patient Education Pamphlets in 19 Languages
- RxNorm Mapping
- Pediatric Dosage Calculations
- Drug Allergy Interactions
- Clinical Guidelines
- Drug Interaction Software
- Drug - Drug Interactions
- Drug - Allergy interactions
There are very few drug information providers in the marketplace that have both quality data and a top notch, customer-oriented support staff. Cerner/Multum and Lexicomp top the list. Lexicomp offers a unique blend of top quality information coupled with the finest internal support anywhere. Your IT guys will love you for going with Lexicomp -- a long-term partner in your road to success.
The landscape of Healthcare Information Technology is rapidly changing leaving many EMR vendors searching for answers about how to develop their systems. It also has caused confusion among clinicians as to what actually defines meaningful use of those systems.
For those seeking clarity as to the direction of healthcare, a recent report by the Department of Health and Human Services defines the National Strategy for Quality Improvement in Healthcare. It is interesting to note that Lexicomp content can help achieve the number one goal outlined in this report - safer care by reducing the number of serious adverse drug events.
Lexicomp's transactional drug data and reference information supports various components of Stage 1 meaningful use and certification criteria from ONC's Final Rule, specifically the implementation of electronic clinical decision support rules (drug-to-drug and drug allergy contraindication checking) based on the data elements included in: problem list, medication list, demographics and laboratory test results.
Lexi-Data, Lexicomp's clinical decision support database, will help you meet several aspects of clinical decision support required for certification. Here's how:
Drug Interaction Data - we'll provide your system data that enables clinicians to screen for drug interactions, including drug-allergy, drug-drug and drug-food
RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
Drug Reference Data - integrate drug reference information, such as drug images and black box warnings, into your system
Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients
Lexi-Data is designed for easy implementation. Our intuitive database design will help you seamlessly integrate complex drug databases into your system.
For those seeking clarity as to the direction of healthcare, a recent report by the Department of Health and Human Services defines the National Strategy for Quality Improvement in Healthcare. It is interesting to note that Lexicomp content can help achieve the number one goal outlined in this report - safer care by reducing the number of serious adverse drug events.
Lexicomp's transactional drug data and reference information supports various components of Stage 1 meaningful use and certification criteria from ONC's Final Rule, specifically the implementation of electronic clinical decision support rules (drug-to-drug and drug allergy contraindication checking) based on the data elements included in: problem list, medication list, demographics and laboratory test results.
Lexi-Data, Lexicomp's clinical decision support database, will help you meet several aspects of clinical decision support required for certification. Here's how:
Drug Interaction Data - we'll provide your system data that enables clinicians to screen for drug interactions, including drug-allergy, drug-drug and drug-food
RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
Drug Reference Data - integrate drug reference information, such as drug images and black box warnings, into your system
Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients
Lexi-Data is designed for easy implementation. Our intuitive database design will help you seamlessly integrate complex drug databases into your system.
What is holding you back from easy implementation? Perhaps you have a laundry list of items or perhaps money is constraint. Either way, look to Lexicomp for an intuitive database design that will help you seamlessly integrate complex drug databases into your system.
Other items that Lexicomp can help check off your list:
- Allows for specific clinical decision support functions, including drug-drug and drug-allergy interaction checking
- Has consumer-facing patient education materials
- Is compliant with the RxNorm
- Include comprehensive reference information for the US including drug generic name, drug brand name, drug classifications, and eventually clinical dosage guidelines for calculating pediatric and adult doses
So look around the market, investigate, but remember that Lexicomp can serve all your needs!
More and more EMR vendors and hospital EHR/HIS systems are attempting to improve their drug information to further enhance clinical decision support. Below are just a few areas where having the right medicine data can make all the difference in the world.
- Drug Interaction Lists
- Adverse Drug Event Alerts
- Patient Education Pamphlets in 19 Languages
- RxNorm Mapping
- Pediatric Dosage Calculations
- Drug Allergy Interactions
- Clinical Guidelines
- Drug Interaction Software
- Drug - Drug Interactions
- Drug - Allergy interactions
I visited a tag sale this weekend and saw a lamp that intrigued me. Though it was an expensive brand, it was neither a beautiful lamp nor a particulalry useful lamp based on its shape. I couldn't stop thinking about this lamp but, in the end, I decided that it was more expensive than I was willing to pay and I'd come back on the next day to see if it was still there, knowing that tag sales typically mark down their items on the last day.I visited the sale again on Sunday and imagine my surprise when I saw that the lamp had been marked up and was more expensive than when I had initially seen it! The sales staff were honest with me and told me that there had been so much interest in the lamp and so many people who said they were going to come back on Sunday, that they decided they'd raise the price.
As I said, this was neither an aesthetically pleasing lamp, nor was it particulalry useful, based on its awkward size and shape. Yet here they were, charging a premium for something that, from a utlititarian standpoint, did not warrant it; simply because they could.
Is your drug information provider charging a premium for sub-par (or at best, adequate) information? Does what you're getting really warrant what you're paying? Just because you're paying a premium for drug information for your EHR doesn't mean you're getting all that you need.
Lexicomp is not only a reasonably priced drug information provider, but can help by providing a medication list that includes both generic, brand name, and over-the-counter drugs. By providing drug interaction screening including drug-drug/drug-food/drug-herbal, dose range checking, and duplicate therapy screening, Lexicomp can help you as an EHR vendor, ensure your clients meet a number of Meaningful Use requirements.
Additionally, the Lexi-Data product is mapped to RXNORM and contains patient education information in up to 19 languages, which is another check box on the Meaningful Use requirements list.
So if you're looking for a drug information provider that can supply premium level content for a reasonable price, check out Lexicomp. You won't be disappointed!
You know the old line, "Just because I'm paranoid, doesn't mean they aren't after me." Well, the same holds true for my assessment of integrating drug data and medicine data into EMRs, EHRs, HISs, etc. I guess, I would say it like this, "Ok, I admit I'm biased, but that doesn't mean I am wrong." Biased about what? That Lexicomp, a recent arrival in the drug data marketplace, is growing fast based on its quality of data, quality of support, quality of data structure, and affordable pricing.
We are in a fast changing marketplace, which makes the advantages of Lexicomp even more pronounced. As I said several months ago in one of my posts:
"America is a great country. I wouldn't be surprised if there were more EMRs (and related systems) in development in the United States than the rest of the world combined. Cultural and marketplace paroxysms create stress and discomfort, and at the same time result in major breakthroughs and great new products. That is what is going on this country, day by day. The great scramble is on. There is much pressure to do things quickly and get to the market rapidly before the doors begin closing."
Does the drug information you're using provide only the bare-bones basics, or will they provide access to enhanced functionality like:
We are in a fast changing marketplace, which makes the advantages of Lexicomp even more pronounced. As I said several months ago in one of my posts:
"America is a great country. I wouldn't be surprised if there were more EMRs (and related systems) in development in the United States than the rest of the world combined. Cultural and marketplace paroxysms create stress and discomfort, and at the same time result in major breakthroughs and great new products. That is what is going on this country, day by day. The great scramble is on. There is much pressure to do things quickly and get to the market rapidly before the doors begin closing."
Does the drug information you're using provide only the bare-bones basics, or will they provide access to enhanced functionality like:
- Drug Interaction Lists
- Adverse Drug Event Alerts
- Patient Education Pamphlets in 19 Languages
- RxNorm Mapping
- Pediatric Dosage Calculations
- Drug Allergy Interactions
- Clinical Guidelines
Lexicomp's transactional drug data and reference information supports various components of Stage 1 meaningful use and certification criteria from ONC's Final Rule, specifically the implementation of electronic clinical decision support rules (drug-to-drug and drug allergy contraindication checking) based on the data elements included in: problem list, medication list, demographics and laboratory test results.
Lexi-Data, Lexicomp's clinical decision support database, will help you meet several aspects of clinical decision support required for certification. Here's how:
Drug Interaction Data - we'll provide your system data that enables clinicians to screen for drug interactions, including drug-allergy, drug-drug and drug-food
RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients
Lexi-Data is designed for easy implementation. Our intuitive database design will help you seamlessly integrate complex drug databases into your system.
Lexi-Data, Lexicomp's clinical decision support database, will help you meet several aspects of clinical decision support required for certification. Here's how:
Drug Interaction Data - we'll provide your system data that enables clinicians to screen for drug interactions, including drug-allergy, drug-drug and drug-food
RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
Drug Reference Data - integrate drug reference information, such as drug images and black box warnings, into your system
Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients
Lexi-Data is designed for easy implementation. Our intuitive database design will help you seamlessly integrate complex drug databases into your system.
As I was musing over what to write in this week's clinical decision support blog post, I recalled a post I wanted to write months ago but somehow never found time to. So, I'm bringing it out now, a little bit late, but still very relevant.
I'm a big fan of Johnny Cash. From his earliest work to his last few "American" recordings, his voice and music have an ethereal, timeless, and somewhat haunted quality that manage to connect and appeal to millions.
For Christmas last year, I received the "Christmas with Johnny Cash" CD and, as can be imagined, I was thrilled. Take two things that are wonderful of their own accord (Cash and Christmas carols), put them together, and you HAVE to get something greater than the sum of the individual parts, right?
Oh, how wrong I was. I'm saddened to say that this CD might be one of the worst I've ever listened to. One dreary dirge after another, mostly spoken word over top a few strummed guitar chords, with occasionally a gospel chorus in the background. It was nothing that I expected and after one listen my new CD was put away, likely never to be listened to again.
I started thinking of this and wondered, will your EHR fall into this same trap?
Any EHR system worth its salt has to have a solid drug information component as part of the backbone of the application. But just because you take a good EHR and good drug information content and put them together doesn't mean you're going to get a workable result that people can use easily.
Does the drug information you're using provide only the bare-bones basics, or will they provide access to enhanced functionality like:
Will they work with you as partners, to help you through integration, data structure issues, and making sure your system integrity is never compromised, like Lexicomp? Or will they sell you their data and walk away?
As an EHR vendor, you can't afford anything less than perfect alignment between your system and the information that ties into it. We'll help you make certain that you're combining the best aspects of each and ensure that the output is far greater than the sum of the inputs. So why not spend a few minutes getting to know Lexicomp?
I'm a big fan of Johnny Cash. From his earliest work to his last few "American" recordings, his voice and music have an ethereal, timeless, and somewhat haunted quality that manage to connect and appeal to millions.
I love Christmas, too. It's my favorite holiday, hands down. The food, the family, the friends, the time off to just reflect and appreciate all that you have. Quite possibly, my favorite aspect of Christmas is listening to Christmas carols.
For Christmas last year, I received the "Christmas with Johnny Cash" CD and, as can be imagined, I was thrilled. Take two things that are wonderful of their own accord (Cash and Christmas carols), put them together, and you HAVE to get something greater than the sum of the individual parts, right?
Oh, how wrong I was. I'm saddened to say that this CD might be one of the worst I've ever listened to. One dreary dirge after another, mostly spoken word over top a few strummed guitar chords, with occasionally a gospel chorus in the background. It was nothing that I expected and after one listen my new CD was put away, likely never to be listened to again.
I started thinking of this and wondered, will your EHR fall into this same trap?
Any EHR system worth its salt has to have a solid drug information component as part of the backbone of the application. But just because you take a good EHR and good drug information content and put them together doesn't mean you're going to get a workable result that people can use easily.
Does the drug information you're using provide only the bare-bones basics, or will they provide access to enhanced functionality like:
- Drug Interaction Lists
- Adverse Drug Event Alerts
- Patient Education Pamphlets in 19 Languages
- RxNorm Mapping
- Pediatric Dosage Calculations
- Drug Allergy Interactions
- Clinical Guidelines
Will they work with you as partners, to help you through integration, data structure issues, and making sure your system integrity is never compromised, like Lexicomp? Or will they sell you their data and walk away?
As an EHR vendor, you can't afford anything less than perfect alignment between your system and the information that ties into it. We'll help you make certain that you're combining the best aspects of each and ensure that the output is far greater than the sum of the inputs. So why not spend a few minutes getting to know Lexicomp?
Over the past decade, the number of reports of adverse drug events has been on a dramatic rise. The FDA currently uses an Adverse Event Reporting System (AERS) which has seen a large increase on the number of reports coming in. In fact, researchers at the University of Maryland School of Pharmacy revealed in a new study of adverse events linked to medications─compiled by the FDA since 1969─that 55 percent have been reported to the agency in the past decade.
Drug makers are required by federal regulations to report possible health problems possibly linked to their products, but reporting by doctors, patients, and others is voluntary. New safety warnings and technology making reporting easier could play a part in this increase in reports, but there may be other contributing factors. With the current US populations aging, more and more people are taking multiple medications to treat multiple medical conditions. This has been most apparent when I have spoken with a few nursing home and assisted living facilities who have relayed that a number of their patients currently have a medicine list of over 10 medications and some are as high as 20. With all of these medication being taken together, it stands to reason that additional adverse drug events are reported.
There is drug information software available to help with checking medication lists for things like drug food interactions, drug-drug interactions, drug-allergy interactions, and drug-condition interactions that could potentially help reduce these adverse drug event reports. In fact, software like Lexi-Data from Lexicomp has been included in a number of applications including EMRs, EHRs, analytic tools, and ePrescribing solutions with the intent of screening in real time for adverse events while medication are being prescribed. Also, new patient education materials that are easily understood by the patient can help reduce things like drug-food interactions by informing the patient of the potential.
While software systems generally rely on case studies or published information to screen for adverse drugs events, the increase in the number of reports to the FDA will hopefully help to identify additional adverse drug events that have yet to be identified, leading to better outcomes for patients in the future.
Several weeks ago I pointed out that an EMR or EHR vendor (or inside hospital HIS development team) overlooks some critical factors in making choices about drug data suppliers. No doubt the quality of the drug data is important, but that is just the beginning. These developers should be equally, if not even more, concerned about what I would call "softer" factors. such as:
1) Structure of the data (how easy is it to map to and identify?)
2) Availability and simplicity of the APIs offered by the vendor
3) How responsive is the drug information provider during the development period (this
will provide a major clue into how the long term relationship will work).
These might sound like simple things, but in the end, they are the most important things. Do your due diligence. Several years ago there were only a couple of drug data suppliers available. Now with the addition of the very well established drug information provider, Lexicomp, these development companies have a choice. Lexicomp has provided clinical decision support for three decades. It provides drug reference solutions to nearly 1500 hospitals in the United States, along with all divisions of the U.S. Military. The Vancouver study released last year, rated Lexicomp Online as the most preferred drug database.
If you are looking for drug information or medicine data, Lexicomp can help by providing a medication list that includes both generic, brand name, and over-the-counter drugs. By providing drug interaction screening including drug-drug, dose range checking, and duplicate therapy screening, Lexicomp can help EHR vendors meet a number of Meaningful Use requirements. The Lexi-Data product delivered by Lexicomp is also mapped to RXNORM and contains patient education which is another check box on the Meaningful Use requirements list.
1) Structure of the data (how easy is it to map to and identify?)
2) Availability and simplicity of the APIs offered by the vendor
3) How responsive is the drug information provider during the development period (this
will provide a major clue into how the long term relationship will work).
These might sound like simple things, but in the end, they are the most important things. Do your due diligence. Several years ago there were only a couple of drug data suppliers available. Now with the addition of the very well established drug information provider, Lexicomp, these development companies have a choice. Lexicomp has provided clinical decision support for three decades. It provides drug reference solutions to nearly 1500 hospitals in the United States, along with all divisions of the U.S. Military. The Vancouver study released last year, rated Lexicomp Online as the most preferred drug database.
If you are looking for drug information or medicine data, Lexicomp can help by providing a medication list that includes both generic, brand name, and over-the-counter drugs. By providing drug interaction screening including drug-drug, dose range checking, and duplicate therapy screening, Lexicomp can help EHR vendors meet a number of Meaningful Use requirements. The Lexi-Data product delivered by Lexicomp is also mapped to RXNORM and contains patient education which is another check box on the Meaningful Use requirements list.
Here are some of the qualifications that drug reference and drug interaction data must meet to qualify:
-- Must allow for specific clinical decision support functions, including drug-drug and drug-allergy interaction checking
-- Must have consumer-facing patient education materials
-- Must be compliant with the RxNorm (a medication list maintained by the National Library of Medicine)
-- Must include comprehensive reference information for the US including drug generic name, drug brand name, drug classifications, and eventually clinical dosage guidelines for calculating pediatric and adult doses
When looking for drug information that meets all these requirement, pick one that will partner with you to meet your needs, whether they be speed to market, budgetary, or customer service.
This is what one of Lexicomp's satisfied customers has to say:
"We spent months researching and investigating the competition. Lexi-Comp business partnering and licensing division gave us the tools we needed to test it in our application to assure our clinicians that we had a reliable and trustworthy source. Their responsiveness to inquiries and requests sold us on a solid partnership we could count on."
- Coletta Dorado, CEO of IntuitivEMR
I was reading Ryan Smith's posting from several weeks ago and thought it was worth re-posting. Why? Because it is straightforward and to the point. And with all of the changing events going on, it is important to be aware of the alternative drug data vendors. Ryan wrote as follows:
Lexi-Data, Lexicomp's clinical decision support database, will help you meet several aspects of clinical decision support required for certification. Here's how:
RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients
Lexi-Data is designed for easy implementation. Our intuitive database design will help you seamlessly integrate complex drug databases into your system.
Lexi-Comp's transactional drug data and reference information supports various components of Stage 1 meaningful use and certification criteria from ONC's Final Rule, specifically the implementaiton of electronic clinical decision support rules (drug-to-drug and drug allergy contraindication checking) based on the data elements included in: problem list, medication list, demographics and laboratory test results.
Lexi-Data, Lexicomp's clinical decision support database, will help you meet several aspects of clinical decision support required for certification. Here's how:
Drug Interaction Data - we'll provide your system data that enables clinicians to screen for drug interactions, including drug-allergy, drug-drug and drug-food
RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
Drug Reference Data - integrate drug reference information, such as drug images and black box warnings, into your system
Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients
Lexi-Data is designed for easy implementation. Our intuitive database design will help you seamlessly integrate complex drug databases into your system.
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