AMIA 2013: Updates on Medication Safety Screening and CDS Standards

The AMIA 2013 conference was last month in Washington, DC. I had the honor of giving two talks on topics I often discuss on the Wolters Kluwer Health blog – medication safety screening and clinical decision support (CDS) standards.

My first talk was on the inter-rater agreement among physicians on the clinical significance of drug-drug interactions. Medication safety alerts can be conceptually divided into those that are clinically significant (signal) and those that are not clinically significant (noise). Alert fatigue occurs when the signal:noise ratio is too low and providers start to ignore the alerts. This problem is especially challenging to solve if physicians don’t even agree with each other on which drug-drug interaction alerts are clinically significant. I reported the results of a study we did looking at the this issue. We showed 16 physicians a set of 100 randomly selected interactions from our Medi-Span database. We asked each physician to indicate whether or not they considered each interaction to be clinically significant. The Fleiss Kappa, a chance-corrected measure of inter-rater agreement, was 0.21, which can be interpreted as poor agreement. Looking at it another way, there were only 3 interactions out of 100 where there was complete agreement among the 16 physicians on whether or not the interaction was clinically significant. These results underscore the need to provide user-level customization, including features such as, “Don’t show me this alert again” or “Don’t show me this alert again for this patient”.

My second talk was in the area of CDS standards, and in particular, I covered an example of a Health eDecisions Use Case 1 event-condition-action rule. This use case was balloted in January 2013 as an HL7 Draft Standard for Trial Use, but its publication is still pending because of the need to align it with evolving changes in the Virtual Medical Record model that it incorporates. The basic framework for a Use Case 1 artifact remains similar to what I described in a blog post about a year ago. The example I covered in the talk described how to represent a rule for a Practice-Changing UpDate from UpToDate that applies to adult women with breast cancer who are taking tamoxifen. The rule included the following components (each component being a section of XML):

  • Metadata – e.g. title, identifiers, publisher, general applicability
  • External data – e.g. definitions for breast cancer and tamoxifen using various standardized codes and where to look for the information in the Virtual Medical Record (VMR)
  • Expressions – e.g. BreastCancerActive, TamoxifenActive, PatientAgeInYears
  • Conditions – the conditions that must be true for the rule to evaluate to TRUE; in this case, BreastCancerActive AND TamoxifenActive and a few other criteria
  • Actions – in this case, a message with the text of the Practice Changing UpDate

Also at AMIA, Dr. Jacob Reider, the US Acting National Coordinator for Health Information Technology, indicated that the US federal government has funded the creation of Use Case 1 artifacts in certain content areas, including immunizations, Hepatitis C, and management of HIV. He noted the importance of having some content artifacts available in this format in order to encourage electronic medical record (EMR) vendors to build support for this knowledge format.

As always, the AMIA Annual Symposium was an informative and intellectually stimulating meeting, as well as a great opportunity to catch up with my informatics colleagues from all around the country and all around the world.

 

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Helping EMR Vendors Meeting Meaningful Use with Medi-Span Clinical

Now that the government has released the 2014 Edition of Meaningful Use (also called Stage 2), it will be important for EHR vendors to ensure that they can meet all the required criteria. Here's a quick guide to how Lexicomp can help you meet the requirements:

  • Drug-drug and drug-allergy interaction checking [170.314(a)(2)]
  • Patient education materials [170.314(a)(15)]
  • eMAR (electronic medication administration record) [170.314(a)(16)]
  • Clinical information reconciliation [170.314(b)(4)]
  • Immunization information [170.314(f)(1)]
  • Transmission to immunization information registries [170.314(f)(2)]
  • Electronic prescribing [170.314(b)(3)]
  • Problem lists [170.314(a)(5)]
  • Medication lists [170.314(a)(6)]
  • Medication allergy lists [170.314(a)(7)]
  • Clincial decision support functionality [170.314(a)(8)]

For more information, contact Lexicomp today!

- See more at: http://blog.lexi.com/#sthash.vvQQ7ESy.dpuf

Now that the government has released the 2014 Edition of Meaningful Use (also called Stage 2), it will be important for EHR vendors to ensure that they can meet all the required criteria. Here's a quick guide to how Lexicomp can help you meet the requirements:

  • Drug-drug and drug-allergy interaction checking [170.314(a)(2)]
  • Patient education materials [170.314(a)(15)]
  • eMAR (electronic medication administration record) [170.314(a)(16)]
  • Clinical information reconciliation [170.314(b)(4)]
  • Immunization information [170.314(f)(1)]
  • Transmission to immunization information registries [170.314(f)(2)]
  • Electronic prescribing [170.314(b)(3)]
  • Problem lists [170.314(a)(5)]
  • Medication lists [170.314(a)(6)]
  • Medication allergy lists [170.314(a)(7)]
  • Clincial decision support functionality [170.314(a)(8)]

For more information, contact Lexicomp today!

- See more at: http://blog.lexi.com/#sthash.vvQQ7ESy.dpuf

Are you an EMR vendor that is going through the maze of Meaningful Use certification and trying to find a drug database or HL7 InfoButton patient education handouts?  As if Stage 1 alone wasn't enough to grasp, now you have Stage 2 requirements to add to it.  It is very important for EMR vendors to do their homework and ensure that they can meet all of the required critiera.  Here's a quick list of requirements that Medi-Span Clinical can help you meet. 

  • Drug-drug and drug-allergy interaction checking [170.314(a)(2)]
  • Patient education materials [170.314(a)(15)]
  • eMAR (electronic medication administration record) [170.314(a)(16)]
  • Clinical information reconciliation [170.314(b)(4)]
  • Immunization information [170.314(f)(1)]
  • Transmission to immunization information registries [170.314(f)(2)]
  • Electronic prescribing [170.314(b)(3)]
  • Problem lists [170.314(a)(5)]
  • Medication lists [170.314(a)(6)]
  • Medication allergy lists [170.314(a)(7)]
  • Clincial decision support functionality [170.314(a)(8)]
  • - See more at: http://blog.lexi.com/#sthash.vvQQ7ESy.dpuf
  • Drug-drug and drug-allergy interaction checking [170.314(a)(2)]
  • Patient education materials [170.314(a)(15)]
  • eMAR (electronic medication administration record) [170.314(a)(16)]
  • Clinical information reconciliation [170.314(b)(4)]
  • Immunization information [170.314(f)(1)]
  • Transmission to immunization information registries [170.314(f)(2)]
  • Electronic prescribing [170.314(b)(3)]
  • Problem lists [170.314(a)(5)]
  • Medication lists [170.314(a)(6)]
  • Medication allergy lists [170.314(a)(7)]
  • Clincial decision support functionality [170.314(a)(8)]

We also specialize in easy-to-ready patient education handouts.  They are perfect for educating patients on their medications, diseases, conditions, procedures, or other healthy living topics.  We offer up to 19 languages!  We have a complete documentation guide on how to retrieve them through HL7 InfoButton calls as well.  Please contact us if you'd like more information!

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Design of Decision Support Interventions

Medication safety screening, as I have written about at length previously, has the potential to reduce prescribing errors and therefore to improve patient safety. I have also previously described alert fatigue, which occurs when the signal:noise ratio is so low that providers start to ignore the alerts. Design of clinical decision support (CDS) systems is therefore a critical factor in order to optimize the impact of these systems on patient care.

In a recent article in the International Journal of Medical Informatics, Horsky et al reviewed the literature in this area and formulated some recommmendations. Below are some highlights of their recommendations, from my point of view.

Use severity levels
In the category of reducing excessive alerting, the authors state the importance of tiering alerts by severity level, which is an important attribute of drug interaction databases, such as Wolters Kluwer’s Medi-Span® database. How the severity level is used varies by implementation, but in general, more severe alerts are generally configured as interruptive, whereas less severe alerts may be configured as informative. Interruptive alerts require acknowledgment by the user, whereas informative alerts provide information on the screen but do not require explicit acknowledgment. When a user acknowledgment is required, some systems require the user to provide a reason for overriding the alert. The authors suggest presenting a short list of reasons in a dropdown list.

Ensure correct underlying patient data
Still in the category of reducing excessive alerting, the authors emphasize the importance of having correct patient data in the electronic medical record (EMR). For example, if a patient is listed as having an allergy to penicillin, then allergy alerts will be triggered whenever penicillin or a similar drug is prescribed. If the patient is in fact not allergic to penicillin, the authors state that this allergy should be removed from the patient’s profile.

Use patient context
The authors also talk about using additional patient context as the basis to filter alerts. I previously summarized another paper looking at ways to develop these contextual models. In addition, the authors suggest distinguishing between new orders and renewals of existing orders, since in the latter case, the patient may already be tolerating the drug combination without any problems, so displaying the same alerts every time the medication is renewed contributes to alert fatigue.

Design of alert boxes
The authors provide a detailed table of optimal design attributes for alerts, making recommendations in areas such as color (e.g. reserve red for severe situations), size (e.g. variable), layout (e.g. simple geometry), font (e.g. draw attention to the drug names) and language (e.g. clear and concise). For the content, they recommend providing a link to a detailed explanation. For example, Medi-Span® contains a detailed monograph for each drug-drug interaction.

User control
The authors indicate that physicians may be allowed to turn off individual alerts with certain caveats related to their knowledge and comfort level. For example, Wolters Kluwer’s Medi-Span® Clinical software provides this capability.

Summary
In summary, the authors provide a practical set of design recommendations to reduce alert fatigue. The health information technology (HIT) community would be wise to adopt their excellent advice.

 

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5 Benefits to using Medi-Span for Developers

Medi-Span continues to be ranked as one of the top drug databases for EMR/EHR software vendors. So what benefits does it offer to developers?

  1. Meaningful Use support: Including drug-drug and drug-allergy interaction checking
  2. Superior customer service:  Every customer has a dedicated implementation specialist assigned to assist them
  3. Advanced filtering options: A unique system of filters helps to decrease alert fatigue for users
  4. Trusted content and name: Thousands of healthcare professionals rely on Medi-Span drug information every day
  5. Modular design - With our modular approach to APIs, you can select the APIs you need now for clinical screening and add on others at a later date
These are just five of the many benefits that Medi-Span customers enjoy. To find out more, request a demonstration today!

 

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Answering Key Drug-Drug Interactions Questions

Last month, I attended a drug-drug interaction (DDI) clinical decision support (CDS) conference funded by the Agency for Healthcare Research & Quality (AHRQ) and organized by the University of Arizona College of Pharmacy. The conference brought together various stakeholders and experts in the field to try to answer some key DDI questions. The work began by conference calls before the gathering and will continue through additional conference calls going forward. The work is divided into three workgroups:

Evidence Workgroup
This group seeks to develop guidelines for the systematic appraisal of drug-drug interaction evidence. Key questions include how to evaluate the DDI literature, how to account for theoretical or predicted DDIs, how to determine when a DDI can be extrapolated to other drugs of the same class, and how DDI evaluations should be communicated. The group spent some time trying to define what constitutes sufficient evidence for a DDI versus what might be considered insufficient evidence.

Content Workgroup
This group seeks to develop principles for including DDIs in CDS systems. Key questions include whether to create a common set of DDIs for Meaningful Use, whether to create a list of contraindicated DDIs, how alerts could be filtered more intelligently, and how DDIs should be categorized in terms of severity. My own view is that it’s difficult to create a consensus list of DDIs because there really isn’t any consensus. In the context of severity, the group talked about distinguishing between interruptive and informative alerts, and even within the category of interruptive, whether a distinction should be made between alerts whose information is important to consider versus alerts where some action is required.

Usability Workgroup
This group, of which I am a member, seeks to define preferred strategies for presenting DDIs in CDS systems. Key questions include what information to display with each alert, how the information should be displayed, whether the presentation should vary by user, how clinicians should interact with the system to override an alert, and how alert effectiveness should be measured. For example, we talked about whether certain aspects of alert displays could be standardized across EMR vendors, making use of certain colors and certain icons to convey certain information. We also talked about measuring alert effectiveness. One measure is the override rate, which is imperfect but still somewhat useful. An overridden alert does not necessarily mean it was inappropriate; for example, an alert might remind a clinician to order some monitoring tests, in which case the alert was useful but still overridden. Nevertheless, the override rate still gives us some information about whether an alert is useful.

Next Steps
The groups will continue to meet over the next few months to refine their recommendations. At the end of the project, the recommendations will be submitted for publication. Stay tuned!

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Drug Interactions

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.

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Meaningful Use, Patient Portals and other thoughts

I just re-read a posting by my colleague Matt Bennardo about how Meaningful Use is now addressing patient portals.  A very informative posting.  Although I posted this before,  I am re-posting again and am pulling out an excerpt below:

"Recently, Physicians Practice reported on the challenges facing both providers and EHR vendors when it comes to new Stage 2 Meaningful Use rules. One item noted in the article is that patient portals are now mandatory functionality for EHRs, which was not true under Stage 1.

Though healthcare providers are challenged with setting up and maintaining patient portals for their patients, EHR vendors have the even bigger task of ensuring their software is compatible with a patient portal. For many vendors, this will mean developing their own patient portal as an extension of the EHR system.

Patients are different from clinicians
As this work begins, developers will need to remember that patients are very different from clinical users like doctors, pharmacists, and nurses. Information on medication and conditions that is appropriate for clinicians will often leave patients scratching their heads -- or in a panic.

It will be crucial for developers to leverage "consumer level" content -- that is, information on clinical topics that is written with non-technical consumers or patients in mind. One provider of such information is  Lexicomp.    Not only do they have patient education leaflets for drugs and diseases, but they have consumer-level interaction monographs that can be used in conjunction with some clinical decision support functions.

Contact Lexicomp today to learn more about this consumer-level data to help you build out your patient portal."

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Post-election: What is the future for Meaningful Use?

With the U.S. elections over and President Obama retaining the White House (along with Democratic majority in the Senate), it appears that Meaningful Use is here to stay. Earlier in the year, the Supreme Court upheld the most controversial parts of the new healthcare laws as well.

But what does this mean? It's been clear from the beginning that the Department of Health and Human Services (HHS) does not view Meaningful Use as a one-time program. Instead, it views it as an ongoing initiative that will define healthcare information technology for the forseeable future. This was evident when the new guidelines this year were styled as a "2014 edition" rather than "Stage 2". In not numbering the requirements, HHS is making clear that we can expect many future iterations to be published.

What other clinical decision support functions can we expect CMS and ONC to add to the guidelines in the future? If we look to existing EMR and EHR functionality as a guideline, here are some possibilities:

  • Drug-disease or drug-food interaction checking
  • Dose-range checking
  • Separate interactions checking for pediatric and adult patients
  • Separate patient education for pediatric and adult patients
  • Patient education in the language spoken by the patient
  • Ability to e-prescribe controlled substances

These functions are already possible with the drug and reference data available from such vendors as Lexicomp (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) and Medi-Span. Some EMRs and EHRs are already implementing this functionality, which is allowing them to get ahead in a competitive marketplace.

Don't fall into the trap of just keeping up with federal requirements! Only by looking to the future can you meet the needs of clinical users and create real value for your product.

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Meaningful Use Now Addressing Patient Portals

I just read a posting by my colleague Matt Bennardo  about how Meaningful Use is now addressing patient portals.  A very informative posting.   In case you missed it,  I am pulling out an excerpt below:

 

"Recently, Physicians Practice reported on the challenges facing both providers and EHR vendors when it comes to new Stage 2 Meaningful Use rules. One item noted in the article is that patient portals are now mandatory functionality for EHRs, which was not true under Stage 1.

Though healthcare providers are challenged with setting up and maintaining patient portals for their patients, EHR vendors have the even bigger task of ensuring their software is compatible with a patient portal. For many vendors, this will mean developing their own patient portal as an extension of the EHR system.

Patients are different from clinicians
As this work begins, developers will need to remember that patients are very different from clinical users like doctors, pharmacists, and nurses. Information on medication and conditions that is appropriate for clinicians will often leave patients scratching their heads -- or in a panic.

It will be crucial for developers to leverage "consumer level" content -- that is, information on clinical topics that is written with non-technical consumers or patients in mind. One provider of such information is Lexicomp (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.). Not only do they have patient education leaflets for drugs and diseases, but they have consumer-level interaction monographs that can be used in conjunction with some clinical decision support functions.

Contact Lexicomp today to learn more about this consumer-level data to help you build out your patient portal."

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Patient portals now required by Meaningful Use

Patient Education

Recently, Physicians Practice reported on the challenges facing both providers and EHR vendors when it comes to new Stage 2 Meaningful Use rules. One item noted in the article is that patient portals are now mandatory functionality for EHRs, which was not true under Stage 1.

Though healthcare providers are challenged with setting up and maintaining patient portals for their patients, EHR vendors have the even bigger task of ensuring their software is compatible with a patient portal. For many vendors, this will mean developing their own patient portal as an extension of the EHR system.

Patients are different from clinicians
As this work begins, developers will need to remember that patients are very different from clinical users like doctors, pharmacists, and nurses. Information on medication and conditions that is appropriate for clinicians will often leave patients scratching their heads -- or in a panic.

It will be crucial for developers to leverage "consumer level" content -- that is, information on clinical topics that is written with non-technical consumers or patients in mind. One provider of such information is Lexicomp. Not only do they have patient education leaflets for drugs and diseases, but they have consumer-level interaction monographs that can be used in conjunction with some clinical decision support functions.

Contact Lexicomp (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) today to learn more about this consumer-level data to help you build out your patient portal.

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Stage 2 Meaningful Use Criteria: Your Support Guide

Now that the government has released the 2014 Edition of Meaningful Use (also called Stage 2), it will be important for EHR vendors to ensure that they can meet all the required criteria. Here's a quick guide to how Lexicomp (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) can help you meet the requirements:

  • Drug-drug and drug-allergy interaction checking [170.314(a)(2)]
  • Patient education materials [170.314(a)(15)]
  • eMAR (electronic medication administration record) [170.314(a)(16)]
  • Clinical information reconciliation [170.314(b)(4)]
  • Immunization information [170.314(f)(1)]
  • Transmission to immunization information registries [170.314(f)(2)]
  • Electronic prescribing [170.314(b)(3)]
  • Problem lists [170.314(a)(5)]
  • Medication lists [170.314(a)(6)]
  • Medication allergy lists [170.314(a)(7)]
  • Clincial decision support functionality [170.314(a)(8)]

For more information, contact Lexicomp today!

1 Comments »

Achieving Meaningful Use with Lexicomp Data

When integrated into an EMR, Lexicomp's (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) drug reference content and drug interaction data will help you achieve the clinical decision support component of Meaningful Use.  We have worked with hundreds of EMR vendors to help them go through the process of certification.  Lexi-Data, as an integrated component of an EHR, supports the CMS definition of Meaningful Use:

Lexi-Data supports the use of computerized physician order entry in both inpatient and ambulatory arenas:

  • Provides a drug list of dispensible products
  • Data for drug-drug, drug-allergy and drug-disease interaction screening
  • Data to support duplicate therapy and dose range checking for pediatric and adult patients
  • Data that allows users to generate patient-specific education handouts
    • Medication leaflets in 19 languages for both adults and pediatrics
    • Soon we will have available disease/condition/discharge instruction leaflets
  • Maintenance of active medication and allergy lists
  • Promotes interoperability with its ability to map to standardized vocabularies.

We offer a variety of delivery methods of the data which include: 

 
Web API Solution
  • 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.
Web Services
  • 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!

1 Comments »

Lexi-Data: The Drug Data of Choice for EMRs- Redux

Drug Data

Thanks to Marissa for her recent post re:  the popular use of Lexi-Data (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) by EMRs.  I would like to add that if Lexi-Data doesn't fulfill of all of your ERM needs, then the best alternative would be to take a look at Medi-Span,  Lexi-Data's sister company data provider.  If you want to know what Marissa said,  I am excerpting below:

"Over the last few years, Lexicomp has become one of the leaders in providing EMR development companies with drug data to include in their products.  We've worked with hundreds of companies to go through MU certification and we continue to stay abreast of changes in the industry. 

Not only does Lexi-Data provide all of the standard drug information that one would expect from other suppliers, but it also provides the best pediatric dose range dosing information, customization for alerts, trusted referential content for users and patient education handouts.  Lexi-Data helps EMRs satisfy several areas of MU crtieria such as: drug-drug interaction checking, drug-allergy interaction checking, patient specific education resources, and CVX/MVX mapping.

Lexi-Data offers an incredibly easy to use data structure and API's and most 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 Lexicomp is on your list."

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A Growing Trend In Medicine: A Focus on Pharmacogenomics

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.

 

 

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Lexi-Data: The Drug Data of Choice for EMRs

Over the last few years, Lexicomp (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) has become one of the leaders in providing EMR development companies with drug data to include in their products.  We've worked with hundreds of companies to go through MU certification and we continue to stay abreast of changes in the industry. 

Not only does Lexi-Data provide all of the standard drug information that one would expect from other suppliers, but it also provides the best pediatric dose range dosing information, customization for alerts, trusted referential content for users and patient education handouts.  Lexi-Data helps EMRs satisfy several areas of MU crtieria such as: drug-drug interaction checking, drug-allergy interaction checking, patient specific education resources, and CVX/MVX mapping.

Lexi-Data offers an incredibly easy to use data structure and API's and most 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 Lexicomp is on your list.

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Lexi-Data, The Most Preferred Drug Database for EMR Vendors

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 (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) 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.

2 Comments »

New EMRs need to get to market fast and still consider integrated drug databases

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 (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.).  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. 

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Drug Interaction Software, Meaningful Use and other relevant issues

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 (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.), 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."

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Does your drug interaction software comply with Meaningful Use?

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, (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) 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.

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How to Integrate a Drug Interaction Database -- For EMR and EHR vendors

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 (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) 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."

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