This year at HIMSS should be pretty interesting, and maybe a bit chaotic and a little unsettling. Meaningful Use was getting bandied about last year, but this year it is real, tangible and around the corner.
Whether you are an EMR vendor, EHR manager, ePrescribing vendor, or someone else in this dynamic and quickly changing business segment, you will want to see what it is going on. One of the areas that is a bit overlooked and undervalued until you have signed a long-term agreement (and it is too late to reconsider) is in the area of drug database information for clinical decision support.
The data is important, but equally important is the relationship with your drug information provider. Once you make your selection, you will be "stuck" with them for a very long time. Make the right choice. Obviously, other areas for evaluation have to do with the level and sophistication of APIs that the vendor has or are under development.
Pediatric dosage calculations, drug interaction software, drug generic name, drug brand name, drug classifications, drug and medicine interactions, medicine lists, clinical guidelines, clinical information systems, and more, are all critical areas for consideration.
At HIMSS 2011 there will also be live demonstrations showing how our drug databases can be implemented and customized to meet the various specific needs of EMR vendors. Stop by and see us if you are a current customer or are looking to implement drug information or clinical decision support into your application, booth #6653.
Lexicomp will be attending HIMSS 2011 in Orlando. This will be a great opportunity for any EMR, Hospital, or Consumer Health Site to visit booth #6653 and learn about our solutions for implementing decision support for drug interactions, duplicate therapy, drug allergies, and dose range checking, as well as drug databases, and patient education information for consumers.
Last Monday I posted that there was opportunity for a piece of the growing EHR marketplace with 4,000 companies jumping to start the registration process. Another sign of growth has been reported today by HealthData Management. According to a recent posting, "U.S. market for inpatient and outpatient electronic health records software was nearly $1.98 billion in 2009 and will steadily increase to $3.8 billion in 2015" as found in a new report by the research firm IDC Health Insights, Framingham, Mass.
These numbers can be further broken down in Ambulatory and Inpatient EHR electronic records software spending. Ambulatory EHR Spending by all types of providers totaled $633.5 million in 2009, rising in 2015 to $1.41 billion. Inpatient EHR Spending was $1.34 billion in 2009, rising in 2015 to about $2.4 billion.
With all this money being spent and more to come, it's not too late to get your software on the certification track with trusted drug data. Don't wait until the end of your development process to worry about: 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 an EMR build. But it's not just about the information. It's about who you select as your partner and who have seamless APIs which makes your job easier.
You owe it to your product and your customer to make the right choice.
Recently, I posted the blog below and since then, it seems the scramble to gain Meaningful Use dollars through ePrescribing is on. The first reimbursements for this MU compliance occurred this week for medicaid reimbursement. EMR companies that are quickly trying to get certified by early 2011. ePrescribing and Meaningful Use are the mantras of the day, and one area that should not be overlooked is the inclusion of selecting the right drug data and working with the right drug information supplier.
"Quoting a colleague of mine: 'A recent article by HealthData Management summarizes that, 'The new law mandates use of electronic prescribing by Jan. 1, 2011. Prescribers and dispensers must use either the Health Level Seven messaging standards or the National Council for Prescription Drug Programs’ SCRIPT standard to transmit prescriptions and prescription-related information. The law does not mandate use of electronic health records. But to ensure EHR systems are interoperable, they must be CCHIT-certified. Further, the EHRs must meet the e-prescribing provisions of the law.'
Looks like ePrescribing will become a widespread reality within 2 years. There will likely be some business opportunities for some small companies to fill in the gap between ePrescribing as part of robust EMR systems and those that just need a tool to facilitate ePrescribing, without integration into their system.
As more companies look for opportunity in the business "seams," they will need to work with a drug database company to close the loop. And if they want to do it quickly and work with a vendor who serves as a partner, and not just a supplier, more and more are turning to Lexicomp.
Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp will also provide the service and support to allow the vendor to move quickly. With this quickly changing marketplace, working with a drug interaction software company to facilitate the product launch is imperative. If you are looking for a stand alone online ePrescribing application, I would strongly suggest taking a look at DoseSpot. They have a great product."
There is a lot going right about regarding Meaningful Use and EMR developers seeking certification. More and more certifying bodies are in the marketplace making it easier to get certified. There are very few suppliers of drug data and even fewer still that are easy to work with. Lexicomp and Cerner/Multum are just two. And if you are looking for an easy-to-use, out-of-the-box ePrescribing tool, I would take a look at DoseSpot. What do all of these companies have in common? They are easy to work with.
Don't wait to the end of your development process to worry about: 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 an EMR build. But it's not just about the information. It's about who you select as your partner and who have seamless API's which makes your drop easier.
You owe it to your product and your customer to make the right choice.
ePrescribing is gaining momentum. Partly this is due to more hospitals, doctors and dentists aiming to be compliant. In several states, this is happening because of state mandates.
There will likely be some business opportunities for some small companies to fill in the gap between ePrescribing as part of robust EMR systems and those that just need a tool to facilitate ePrescribing, without integration into their system.
There is a mad scramble by companies and start-ups to fill this compliant gap as soon as possible. Whether they know it or not, they will need to work with a drug database company to secure compliance. And if they want to do it quickly and work with a vendor who serves as a partner, and not just a supplier, more and more are turning to Lexicomp. Lexicomp is becoming a force in the delivery of drug data for those firms that are now (or will become) involved in the ePrescribing sector.
Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp also takes the time to work with their customers to resolve situations in a timely way.
EMRs should work with a drug interaction software company early in the process to avoid any late surprises in the certification process.
Also, if you are looking for a stand alone online ePrescribing application, I would strongly suggest taking a look at DoseSpot. They have a great product.
Last week I posted the blog below and I've sensed that it has resonated with the marketplace -- particularly EMR companies that are quickly trying to get certified by late 2010 or early 2011. ePrescribing and Meaningful Use are the mantras of the day, and one area that should not be overlooked is the inclusion of selecting the right drug data and working with the right drug information supplier.
"Quoting a colleague of mine: 'A recent article by HealthData Management summarizes that, 'The new law mandates use of electronic prescribing by Jan. 1, 2011. Prescribers and dispensers must use either the Health Level Seven messaging standards or the National Council for Prescription Drug Programs’ SCRIPT standard to transmit prescriptions and prescription-related information. The law does not mandate use of electronic health records. But to ensure EHR systems are interoperable, they must be CCHIT-certified. Further, the EHRs must meet the e-prescribing provisions of the law.'
Looks like ePrescribing will become a widespread reality within 2 years. There will likely be some business opportunities for some small companies to fill in the gap between ePrescribing as part of robust EMR systems and those that just need a tool to facilitate ePrescribing, without integration into their system.
As more companies look for opportunity in the business "seams," they will need to work with a drug database company to close the loop. And if they want to do it quickly and work with a vendor who serves as a partner, and not just a supplier, more and more are turning to Lexicomp.
Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp will also provide the service and support to allow the vendor to move quickly. With this quickly changing marketplace, working with a drug interaction software company to facilitate the product launch is imperative. If you are looking for a stand alone online ePrescribing application, I would strongly suggest taking a look at DoseSpot. They have a great product."
Quoting a colleague of mine: "A recent article by HealthData Management summarizes that, 'The new law mandates use of electronic prescribing by Jan. 1, 2011. Prescribers and dispensers must use either the Health Level Seven messaging standards or the National Council for Prescription Drug Programs’ SCRIPT standard to transmit prescriptions and prescription-related information. The law does not mandate use of electronic health records. But to ensure EHR systems are interoperable, they must be CCHIT-certified. Further, the EHRs must meet the e-prescribing provisions of the law.'"
Looks like ePrescribing will become a widespread reality within 2 years. There will likely be some business opportunities for some small companies to fill in the gap between ePrescribing as part of robust EMR systems and those that just need a tool to facilitate ePrescribing, without integration into their system.
As more companies look for opportunity in the business "seams," they will need to work with a drug database company to close the loop. And if they want to do it quickly and work with a vendor who serves as a partner, and not just a supplier, more and more are turning to Lexicomp.
Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp will also provide the service and support to allow the vendor to move quickly. With this quickly changing marketplace, working with a drug interaction software company to facilitate the product launch is imperative. If you are looking for a stand alone online ePrescribing application, I would strongly suggest taking a look at DoseSpot. They have a great product.
Try telling a doctor that she's just like a pharmacist, or a nurse practitioner that he's just like a physician's assistant, and you'll soon find out that the differences between healthcare professionals run wide and deep. Companies that sell drug reference books and drug reference software directly to doctors, pharmacists, nurses, and dentists have long known this -- but do EHR vendors and the suppliers of transactional drug data know it?
In the reference market, you'll find there are different products with similar drug interaction and drug reference information marketed to each type of healthcare professional. The underlying information is often the same, but a doctor's first choice would never be a resource designed for a pharmacist, and vice versa.
When spending their own money, healthcare professionals seek out specific resources The reason for this is simple: Healthcare professionals adamantly will not accept "one-size-fits-all" reference resources! They actively seek out those that have the right level of detail, the right formatting, and the right focus on relevant topics to help them do their jobs quickly, efficiently, and safely.
For example, doctors like to have diagnostic information alongside drug information, but have less need for the in-depth pharmacokinetics and pharmacodynamics that pharmacists often require. Nurses, meanwhile, are most interested in information about proper administration of a drug and patient education. These different needs have driven the evolution of the drug reference market over the past several decades -- don't fool yourself into thinking they won't be important to EHRs as well!
Clinicians are also going to have a huge amount of input into which EHR vendor their hospital or practice partners with. And if they won't accept a generic approach in a drug reference book (retail: $150), you can be sure they won't accept it in a clinical decision support system (retail: $15,000)!
Does your drug information data provider understand this? Lexi-Comp is the only drug data provider that operates across the entire spectrum of healthcare professionals. Lexi-Comp sells reference resources directly to pharmacists, physicians, nurses, dentists, and specialists -- and they choose Lexi-Comp because of the value they find in resources that are specially tailored to their needs.
Moreover, Lexi-Comp is the only transactional data provider that has such a wide reference user base of pharmacists and clinicians. Imagine the power of partnering with a clinical decision support data provider who already understands what each of your different end users may want! After thirty two years of delighting clinicians with superior reference products, Lexi-Comp knows how to keep delighting them with data. That's something that the "one-size-fits-all" providers can't say.
The message is out there and will only get stronger over time: meaningful use of EHR systems, as defined by the federal government, is not the be-all and end-all of healthcare IT. EHR vendors who are preparing their products for market need to think harder than ever about meeting the needs of their customers -- not just checking off boxes on a government-mandated list.
How Big a Role Will Incentive Dollars Play?
"Meaningful use" and government incentive dollars are the hot topic of the moment. But there is increasing evidence that healthcare providers don't unanimously believe the money is compelling. They understand that government incentives are temporary -- whereas their EHR systems are going to provide clinical decision support for years to come. Research has even shown that the promised penalties aren't changing many minds.
More and more, opinions like this one are being voiced. The message to doctors and other eligible practitioners is to find an EHR system that fits their specific needs and saves them time and money by boosting productivity -- even if that system isn't certified by an approved body.
Are You Banking on Benefits You Can't Control to Sell Your Software?
If you're counting on government incentives to sell your EHR software, then your business model is standing on shaky ground. Not only are those incentives temporary, but they're not even guaranteed. Experts agree that the most recent elections won't put pay-outs at risk -- for now. But this election is a reminder that everything in government is changeable.
The news isn't all bad, however. Meaningful use and incentive money have raised the awareness of the EHR industry among many potential customers. But it's going to be customer benefits -- not government mandates -- that decide the ultimate winners. Make sure your product is built to go beyond meaningful use and meet real customer needs.
Delight Your Customers and Win in the Long Term
Some of the most high profile parts of your product are your ePrescribing and drug interaction checking. Clinicians will be making the decisions on which EHR systems are implemented, and these are examples of functionality they will interact with every day. To win business, you will need to exceed their expectations and deliver more than what the government requires -- for example, industry leading information on dosing (especially pediatric and geriatric dosing), evidence-based off-label uses, and patient education leaflets. For information like this, you will need to partner with an information company that understands the needs of clinicians, such as Lexicomp or Multum.
Pediatric dose calculations represent a particular challenge to some healthcare professionals. A drug reference book can help, but there are additional considerations which are not part of the text. Considerations such as the maturation of the child and nutritional status are not easily factored. In addition, drug interactions may play a role in the adjustment of dose. When using a pediatric dosage calculator, it is important that the medicine list be reviewed, as a calculator typically focuses on only a single medication. Augmenting the decision-making process with drug interaction software can help assess these influences on dosing. Both processes are essential in arriving at an appropriate therapeutic dosage.
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 product, 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.
With millions of federal funds on the line, achieving meaningful use is a top priority in many workplaces right now. With the vast majority of decisions needed to be made, make one that will ensure success - choosing the right drug data provider. After all, if you do not have the right drug information, patient safety is at risk. Choosing a drug data vendor that is easy to work with, has easy-to-use APIs, is cooperative in developing interoperability structures, and who provides great value will make certification easier and faster. Lexi-Comp is an industry leader in drug interaction software checking, drug-allergy checking and dose range checking. Make sure your drug information provider is the right partner for you.
I recently came across an interesting article on ABC News that argues that accidentally giving children wrong doses of over the counter medicines could be a form of child abuse.
Although this debate will likely not be solved without the involvement of lawyers and much more research on the topic, I couldn't help but wonder if something COULD be done to help prevent the accidental misuse of commonly used medications for children. For one, children have unique needs when it comes to drug dosing. Secondly, in order to properly prescribe appropriate doses of medications to children, pediatric practices must seek to implement EMRs into their practice settings that are pediatric-specific and specialize in providing drug information that meets the unique needs of pediatricians.
Luckily there’s Lexi-Comp. When integrated into an EMR or various other healthcare applications, Lexi-Data – Lexi-Comp’s comprehensive drug database – provides pediatricians the clinical decision support they need to enhance pediatric care. In addition to providing drug interaction software checking, drug-allergy checking and dose range checking, Lexi-Comp can provide pediatric-specific drug data and pediatric dosage calculators that enable EMRs to meet the special needs of pediatric practices. In the end, pediatricians will be better equipped to improve patient care and help decrease the occurrence of accidental “child abuse.”
If you are currently looking for drug database supplier to provide data for your EHR, EMR, HIS or other practice management system, it's an important decision. And now that ePrescribing is a critical component in all of the new systems under development, the importance of working with top quality drug interaction software and data companies takes on an even more important role.
So what's important in making your selection? Certainly price is. There is no reason to overpay and leave money on someone else's table. Negotiating an agreement where your price is locked in, should also be an important part of your data acquisition strategy. There are very few drug database companies, and only one or two would likely give you the option of locking into long term pricing without escalation clauses. Think about it before you sign.
But even more important is to find a vendor who you can work closely with, whose IT staff is flexible and cooperative, and who has the easiest to use and most developed APIs. Think about whether the vendor has the preferred and pre-eminent pediatric dose calculations and pediatric dosing charts. EHR vendors are now starting to see that those organizations who used to dominate the industry may no longer be their best choices. The health information industry is changing rapidly. Find someone flexible and cooperative, who has the best information available.
Paper prescriptions will soon be a thing of the past.
Thanks to federal IT incentives as well as an increasing demand by physicians, pharmacies and payers for increased efficiency and safety, the healthcare industry will likely soon see electronic prescribing options completely replace the sloppy, handwritten prescriptions that have dominated the industry for so long. With more and more healthcare providers implementing EMR systems into their practice settings, the popularity and demand of drug data solutions for e-prescribing applications is on the rise. Some of the benefits of e-prescribing include: fewer medication errors and improved patient outcomes; streamlined prescription writing through automated data entry process; increased patient safety; more efficient refill request processes; and clinical decision support to help provide drug-allergy notifications and detect harmful drug-drug interactions.
In order for a physician, pharmacy or payer to utilize the e-prescribing component of their EMR, their system must be Surescripts certified, ensuring the software sends and receives electronic information in accordance with industry standards. Due to Lexi-Comp’s strategic partnerships with e-prescribing vendors that use Lexi-Comp’s clinical decision support information (drug interacting software checking, drug-allergy checking, dose range checking, etc.), Lexi-Comp can help end users obtain the functionality needed to achieve certification of their e-prescribing system.
Learn more about how Lexi-Comp can help EMRs develop software for e-prescribing.
As my Lexi-Comp colleague Chris Madjerich stated in a previous blog post, the final rule for meaningful use was issued on July 14. This final rule gave EMR vendors the criteria needed to become certified for meaningful use. It also added emergency departments (ED) as a "Place of Service," meaning they are now eligible to use Computerized Physician Order Entry (CPOE) to receive federal incentives. In previous Meaningful Use rulings, EDs had been harshly overlooked even though they could arguably be the top place for error in such a fast paced and varied patient setting. This could not come at a better time for EDs as a National Health Statistic Report report states, "From 1996 through 2006, the annual number of ED visits increased from 90.3 million to 119.2 million visits, an increase of 32%. On average there were about 227 visits to U.S. EDs every minute during 2006."
Now it is more important than ever for hospitals to consider their ED in terms of certification and compliance. Learn more about how Lexi-Comp can help EMRs develop software for e-prescribing for emergency departments by providing drug interaction information, dosing calculators, and dosing precautions.
From the The National Progress Report on E-Prescribing, as seen on the Surescripts site: electronic requests for prescription benefit information grew from 79 million in 2008 to 303 million in 2009---an 284% increase! Prescribers access prescription benefit information using software provided by a vendor that is certified by Surescripts for this service.
To ensure the highest possible patient safety, Lexi-Comp's drug data integration can provide your EMR the core drug data content you need for drug names (brand and generic), updated NDCs, drug interaction checking, drug allergy checking, therapeutic duplication, dose range checking, Schedule II medications and more!
Drug alerts triggered to help remind clinicians of potential safety issues through the use of various programs (eg, drug interaction software, dosage range checkers, dosage calculators) are important and powerful decision support tools. However, healthcare providers may ignore a large number of these alerts because of poor specificity to the patient currently being cared for. Alerts may come at inefficient times in the workflow or they may interrupt workflow making them annoying rather than helpful. Our ability to better understand how to use alerts in the most effective manner is important to patient safety as evidenced by two recently published articles on the topic.
Wipfli R, Lovis C, "Alerts in Clinical Information Systems: Building Frameworks and Prototypes," Studies in Health Technology and Informatics, 2010:155: 163-9.
van der Sijs H, van Gelder T, Vulto A, et al, "Understanding Handling of Drug Safety Alerts: A Simulation Study," International Journal of Medical Informatics, 2010, 79 (5):361-9.
Avoiding medication errors relies on a proactive approach and strategic plan that includes use of drug alerts in CPOE, computer-assisted drug therapy, reliable drug reference databases, education in pharmacotherapy and therapeutics, dosage calculators, and drug interaction software as well as experienced pharmacotherapy specialists.
As e-prescribing standards go into effect, the interest in this technology appears to be on the radar of all electronic medical record providers due to the push of government incentives, health IT provisions of the American Recovery and Reinvestment Act (ARRA), the impact of Meaningful Use, and much more. The DEA has recently issued an interim ruling that would allow electronic transmission of prescriptions of controlled substances. Up until now, the DEA has been concerned that the lack of security controls for e-prescribing of controlled substances would lead to higher levels of illegal use. The good news with this ruling is that this opens up opportunities for healthcare professionals in the dental space because the majority of the medications that they prescribe are schedule II drugs. Ultimately, this interim ruling should help reduce the number of prescription errors caused by illegible handwriting, as well as the number of misunderstood verbally ordered prescriptions.
In addition to our strategic partnerships with e-prescribing vendors that utilize Lexi-Comp’s decision support information such as drug interaction software checking (drug-drug and drug-food), drug allergy checking, therapeutic duplication checking, dose range checking (adult and pediatric) and more, Lexi-Comp also offers drug reference book information that is written by dentists for dental professionals.
A colleague of mine, Mark Dachille, recently wrote a blog about the recent explosion of ePrescribing. In 2008 only 6.6% of the eligible prescriptions were ePrescibed. That number jumped to 18% by the end of 2009, a fantastic growth rate of 181%! The number of electronic requests for prescription benefit information grew at even a faster clip of 284% from 2008 to 2009. I think we have just seen the beginning. Within 5 years it will be a total transformation, driven by: government, costs, technology and momentum.
As most of you know, ePrescribing is a key component to "meaningful use" under the HITECH Act. Most institutions are scrambling to get on board as soon as possible and they are reaching out to a variety of new vendors to solve their problems.
Will ePrescribing help patient outcomes? Probably, given that it should reduce errors. Many of the ePrescribing systems will offer drug interaction and dosage calculator software that run in the background offering clinical decision support. It is supposed to make things more efficient. Will it? Who knows. But one thing is for sure, the days of paper are history.
If you are involved in developing software for ePrescribing, make sure you speak to the limited number of drug interaction databases and medicine lists as early as possible. There are only few providers -- Multum/Cerner and Lexi-Comp just to name a few.
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