ePrescribing

e-Prescribing Controlled Substances

Tuesday, February 14, 2012 by Marissa Van Rooy

Electronic prescribing (e-Prescribing) is a key component to improving patient safety and reducing medication errors, because it provides real-time clinical decision support to physicians at the time of order entry. It is estimated that approximately 7,000 deaths occur each year in the United States from preventable medication errors. That is why physician adoption of e-Prescribing has been incentivized by the federal government. However, one of the biggest challenges surrounding physician’s adoption of e-Prescribing is the ability for them to electronically transmit prescriptions for controlled substances.

Prior to June 2010, all controlled substance prescriptions were required to be on paper, so instead of maintaining one process for paper-based controlled substances and another that is electronically based for noncontrolled substances; physicians were choosing to stick with a paper-based prescription process. In an effort to remove this headache and extra work that was required by physcians there was a new ruling made by the US Drug Enforcement Administration (DEA) to encourage physicians adoption. In June 2010, the DEA revised the Code of Federal Regulations to allow the electronic transmission of schedule II-V controlled substances to pharmacies. Now physicians can migrate to an electronic system and not worry about maintaining a separate paper-based system.

Lexi-Data is the foundation of Lexicomp's comprehensive clinical decision support database and it contains federal CSA codes as well as a list of state level overrides that e-Prescribing systems need to make this happen.

Lexicomp will be exhibiting at HIMSS 2012 in Las Vegas from February 20 - 24. Stop by for a visit at Booth #5134 and learn more about the preferred choice of drug information databases!

Electronic Prescribing

Tuesday, January 17, 2012 by Ryan Smith

It is estimated that approximately 7,000 deaths occur each year in the United States due to medication errors. Studies conclude that e-prescribing is the solution to improved patient safety and reducing sky-rocketing medication costs.

Lexicomp understands that for most practices, moving from paper to an electronic medical record or electronic health records can a challenge. Lexicomp has the drug information foundation which was built for healthcare IT professionals. Lexicomp provides the drug reference and data content you need to get your system certified sooner. When you choose our Lexi-Data product, you'll get superior customer service, easy implementation, and timely updates.

Electronic Prescribing

Monday, December 12, 2011 by Ryan Smith

ePrescribing is offered as a way to prevent medication errors that arise due to difficulties in reading or understanding handwritten prescriptions. ePrescribing could also reduce adverse drug events (ADEs) by making information such as drug interactions and contraindications available to prescribers at the time they are preparing a prescription.

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 product 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, and more.

EMR's now have a web services option to access drug data

Thursday, December 1, 2011 by David Wilkof

Lexicomp has now released the second phase of a comprehensive web services solution to EMR developers to access drug information. For those EMR and Practice Management systems that do not want to store drug information in their product, they now have an option. In the second phase, Lexicomp has released web services to include a proprietary Black Box warning decision tool to reduce alert overload. Phase II also include dose range checking (DRC) and 12 new searching tools.

For EMR developers that have need for any of the following drug nformation or tools in their product, Pediatric Dose Range Checking (Lexicomp is the leader in this area); Patient Education Materials; Drug Interaction Software; RxNorm Mapping; Medicine Lists, Generic Drugs; Dose Information; ePrescribing, and more--- they should call Lexicomp.

Development slowed by your drug information database provider? 3 tips!

Sunday, November 27, 2011 by Matt Bennardo

EMR and EHR vendors are discovering that the responsiveness of their data providers can have a big impact on their ability to get certification or get to market. This is especially true in drug interaction databases, where the quality of the data can affect crucial product goals like Meaningful Use certification or SureScripts eprescribing certification.

Even beyond certification, a data provider can affect how quickly you can develop new features, respond to customer requests, or even whether you can develop new and necessary functionality at all. In many ways, a drug information vendor is one of a health IT developer's most important partners.

What if the partnership doesn't work out?
Real problems can arise if this partner is unresponsive or doesn't provide the expected level of customer service and new feature development. An EHR or EMR can literally be left treading water in situations such as these. What to do? Here are three tips.

1. "Bolt on" additional functionality: For some functionality, it's possible to lease an already-certified third-party solution that will help you meet short-term needs if your own development is stalled. The classic case for this electronic prescribing -- many EMR developers use pre-existing third-party eprescribing modules to get them to market faster while developing their own. One provider of such modules is DoseSpot.

2. Use web services to easily integrate multiple sources: Sometimes a single source just doesn't have everything you need, but maintaining multiple in-house databases can be costly and time-consuming. For specific bits of information you want to add -- for instance, patient education documents in foreign languages -- it may be easiest to access a second vendor using web services. This puts the responsibility for maintaining the data on the vendor, and leaves you with a much smaller development and maintenance task. One drug data provider, Lexicomp, now supplies much core functionality through web services, including all major Meaningful Use Stage 1 items.

3. Cut the anchor as soon as you can: Sometimes all you can do is look for another provider. The two items above can help you in some circumstances, but for core functionality you may need to cut your losses. The earlier you can identify a bad relationship, the better. One customer of Lexicomp came to us after unsuccessfully trying to work with another vendor's dataset. After a short while with the other database, they knew it wasn't right, and so they were able to painlessly replace the data with Lexicomp's. In less than a month after that, their product was live.

The moral of the story is that your drug vendor relationships are crucial to your success. If they don't feel right, then stop and look for alternatives. A slight delay upfront is better than being trapped with a vendor who makes it more difficult for you to meet your customers' needs and innovate new features.

5 Benefits of Lexicomp's Drug Interaction Database

Friday, November 25, 2011 by Matt Bennardo

Lexicomp is increasingly the preferred choice of EHR and EMR vendors for pharmaceutical and clinical information. What benefits do they deliver for developers?

Meaningful Use support: Including drug-drug and drug-allergy interaction checking
Superior customer service: Every customer receives personal service, no matter the size
Advanced filtering options: A unique system of complex filters allows users to target Black Boxed Warnings to particular users and circumstances
Trusted content and name: Thousands of physicians, pharmacists, nurses, dentists, and other clinicians buy information direct from Lexicomp because they trust it
Full support for eprescribing: Customers have used Leicomp's clinical decision support to create their own e-prescribing modules for EMRs and EHRs

These are just five of the many benefits that Lexicomp customers enjoy. To find out more, request a demonstration today!

Selecting the right drug interaction database in developing an new EHR

Monday, November 21, 2011 by David Wilkof

As Matt Bennardo pointed out, when EMR and EHR companies are under development and they are looking to include drug and medicine information, they must given proper consideration to the quality of the drug information, the ease of installation, and the level of customer service provided by the drug data provider. In order to meet the Meaningful Use standards, the EMR and EHR developers now care more about drug and medicine information than ever before. They now care about drug interactions, drug-drug and drug-allergy interactions, adverse drug events, patient education pamphlets, dose information, pediatric dosing inforamation, drug brand names and drug generic names.

Hundreds of Lexi-Data customers are now integrating Lexicomp reference and transaction drug information into their systems under development. As Matt had said:

"Comprehensive data covers all decision support Meaningful Use requirements:

Compatible with required standards like RxNorm
Supports drug-drug and drug-allergy interaction checking
All data necessary for ePrescribing and CPOE
Additional functionality like dose range checking

Fastest and easiest integration gets you to market faster:

Easy-to-use APIs and web services -- you choose which you want
Superior one-on-one customer service
Most intuitive data structure and fastest implementation

New features set you apart from the competition:

Black Box Warning filters to alleviate clinician alert fatigue
Patient education available in 19 languages

Click the links on this page to find out more about Lexi-Data now!"

Benefits of a Drug Interaction Databse for EHR Vendors and Patient Portals

Thursday, October 27, 2011 by Matt Bennardo

Lexicomp is the seller of Lexi-Data, a transactional drug interaction database for EHR vendors, EMR vendors, HIS systems, ePrescribers, PMS systems, consumer websites, patient portals, and more. Hundreds of Lexi-Data customers are integrating Lexicomp's referential and clinical decision support information into their own systems and products.

Comprehensive data covers all decision support Meaningful Use requirements:

Compatible with required standards like RxNorm
Supports drug-drug and drug-allergy interaction checking
All data necessary for ePrescribing and CPOE
Additional functionality like dose range checking

Fastest and easiest integration gets you to market faster:

Easy-to-use APIs and web services -- you choose which you want
Superior one-on-one customer service
Most intuitive data structure and fastest implementation

New features set you apart from the competition:

Black Box Warning filters to alleviate clinician alert fatigue
Patient education available in 19 languages

Click the links on this page to find out more about Lexi-Data now!

Using Black Box Warnings to prevent adverse drug events.

Monday, October 24, 2011 by Chris Madjerich

Anyone who has been exposed to electronic order entry has experienced the dreaded "alert fatigue". If the goal of electronic prescribing is to improve patient safety and outcomes, alerting clinicians to potential drug interactions or other dosing precautions is necessary. In our current information age, there is a plethora of information available regarding medication safety and potential safety issues with the use of medications. In an attempt to help clinicians sift through all this information, the FDA has established the use of a "Black Box Warning" to call attention to the most important safety issues. A recent study published in the Archives of Internal Medicine reviewed several drug information providers comparing their ability to identify black box warnings and confirmed that Lexicomp is the leader in this area.

In an effort to incorporate this valuable information into the clinician's busy workflow, Lexcomp has recently enhanced their Lexi-Data product to include Black Box Warnings. The Black Box Warnings table allows system vendors to present critical medication safety information from these warnings within a health information system. The data is also structured in a way that will allow the system vendors to filter which alerts are presented, allowing for instance a prescriber to see warning specific to the ordering process and a pharmacist seeing warnings more relevant to the dispensing process.

Improving patient safety requires the use of "intelligent alerting", Lexi-Data has given system vendors the ability to present critical safety information in a meaningful way.

Eliminate Alert Fatigue with Customized Drug Database

Friday, October 21, 2011 by David White

Alert fatigue is related to the barrage of messages provided clinical decision support systems which can overwhelm a provider and cause them to ignore messages. The alerts, while found to be helpful in some cases, can result in a type of "fatigue" whereby the provider, after receiving too many alerts, begins to ignore and/or override the alerts. Receiving too many alerts can result in slowing the provider down rendering the alert useless.

One of the key reasons that clinicians are frustrated with decision support related to drug interaction software is the potential for this alert fatigue. Clinicans do not want to be messaged regarding dosage precautions related to an interaction which has already been recognized and addressed. It is particularly important in the era of electronic prescribing to engineer systems which can present the appropriate information to the appropriate person. Systems need to recognize whether an individual has previously addressed the issue, rather than simply blindly alerting to the presence of two medications within the medicine list. A collaborative effort between drug database providers and application vendors is needed, and discussions to improve the quality of alerts, while decreasing the quantity, are moving forward. These will greatly improve satisfaction with these tools.

Not all clinical information is structured the same!
The more detail that your medication and clinical information vendor provides about crucial alerts, the easier it is for you to implement customization for your users. If every alert looks the same (which is true of what many vendors provide!), then that means that your users will have to go through them all one by one, setting their preferences on warnings and dosage precautions by hand. Then they have to keep their settings up to date as new alerts are added. That's not user friendly design!

By contrast, Lexicomp's implementation of Black Box Warnings (also called Black Boxed Warnings) gives a great deal of flexibility to developers to allow for multi-dimensional customization. Each warning contains information about which clinician the alert is intended for, how severe the alert is, and whether the alert applies only to patients with specific conditions (e.g., pregnancy).

Win customer loyalty by automating alert customization!
This way, you can automate much of the customization without having to ask for input from every individual user. You can simply have the system hide alerts intended for nurses from pharmacists, and vice-versa. Likewise, you can make your system intelligent enough to hide alerts related to pregnancy from male patients. This is the kind of smart implementation that users are looking for to help them aviod alert fatigue and become more efficient and effective clinicians. Talk to Lexicomp today to learn more!

Helping medical specialists qualify for Meaningful Use

Wednesday, October 19, 2011 by Matt Bennardo

Since ONC and CMS permitted specialists to file for exemptions from Meaningful Use guidelines, the challenge has been providing them with cost effective EHR and EMR solutions that meet their needs but are also government certified.

EHR vendors who build systems for specialists may not previously have thought about such functionality as ePrescribing, drug-drug interaction checking, drug-allergy interaction checking, and the ability to print patient education materials. But all these things are required in certified EHR systems -- even if specialists have exemptions from reporting on them.

Lexicomp is one drug information vendor that can help EHR vendors get their products certified for Meaningful Use more quickly, especially now that they have an extensive set of web services calls that provide the most important functionality without the need for on-site database integration. EHRs for specialists like chiropractors, dentists, oncologists, dermatologists, and more now have a new way to provide more value to their users.

What good are patient education leaflets if patients can't read them?

Tuesday, October 18, 2011 by Matt Bennardo

Does your EHR or patient portal include patient education pamphlets? If so, how confident are you that patients receiving the materials get the information they need? For many patients, the problem may be as basic as not understanding the language that the documents are written in.

Lexicomp is a recognized leader in patient education. Their leaflets are used in over a thousand hospitals in the U.S. and Canada. Not only are the leaflets available in 19 common languages, but they are tailored specifically to adult and pediatric patients as well. There can be huge differences in dosing, warnings, and possible adverse drug events among these populations.

Lexicomp's patient education is available for integration into a wide variety of systems -- including EHRs, EMRs, HIS systems, ePrescribing systems, patient portals, consumer websites, PMSs, and more. Contact them today using the links on this page for more information!

Filtering Options Allow for Less Alert Fatigue When ePrescribing

Thursday, October 13, 2011 by Michelle Curren

Say you are a pharmacist filling an order for an adult male. During the eprescribing process, you get alerted that this prescription cannot be given to pregnant women--check. Another alert appears advising this drug cannot be given to children under 12 years old---check. And another, and another---check, check, check all day long! This situation is happening all over the country with pharmacists everyday. Alerts that are not needed for the given criterion should not be shown, this is key for providing excellent health care.

How many drug information providers are making it a point to provide you with the solutions to circumvent this growing problem? Lexicomp has been working to allow filters by intended clinican, severity of warning, and special conditions associated to the alert.

Contact Lexicomp today for more information on how to combat alert fatigue.

Can web services be a low-cost way to EHR Meaningful Use compliance?

Saturday, October 8, 2011 by Matt Bennardo

Now that ONC and CMS allow specialists and dentists to file exceptions from Meaningful Use requirements, many classes of clinicians find themselves able to qualify for incentive money. But even though they may not use much of a certified EHR's functionality, they're still required to implement a fully functional package to qualify.

This is something of a dilemma for vendors of EHR systems for specialists and dentists. How can they provide lightweight versions of functionality that may never be used, while still giving robust coverage of important features like e-prescribing? It's a development puzzle with seemingly no easy solution.

Are web services the answer?
Not every EHR or EMR can be successful relying on web services to fulfill Meaningful Use criteria, but specialists and dentists may be able to reap the benefits. Web services are inexpensive and quick to implement, and don't require you to maintain and update a complicated database of medications and other clinical concepts. Simply request the information you need via the web service when you need it, and it can be delivered to your application.

Lexicomp is one vendor that supplies robust web services to their own database of drug and clinical information. They provide enough functionality to fulfill every Stage 1 Meaningful Use requirement related to drug screening and interaction checking. They also have web services for the delivery of patient education materials.

If you think web services may be beneficial to your development, contact Lexicomp today to learn more.

What are you doing about Electronic prescribing (eRx)?

Sunday, September 25, 2011 by Ryan Smith

It is estimated that each year some 530,000 adverse drug events take place among Medicare beneficiaries alone because of drugs negatively interacting with other drugs the patient is already taking, or insufficient information about the patient’s medical history. The Institute of Medicine (IOM) reported last year that more than 1.5 million Americans are injured annually by drug errors in hospitals, nursing homes and doctor’s offices. These negative drug events may require costly interventions in order to stabilize the patient, including hospitalization.

Electronic prescribing (eRx) has been recognized as an important step in moving health care from a paper-based legacy to a new electronic platform. The use of ePrescribing has been incentivized by the federal government, specifically via the Centers for Medicare and Medicaid Services (CMS).

Lexi-Data is the foundation of Lexi-Comp's clinical decision support architecture. This product 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, Drug Classifications, dose range checking (adult and pediatric) and more.

We are committed to ensuring patient safety.

Are web services the right Meaningful Use solution for specialists and dentists?

Thursday, September 22, 2011 by Matt Bennardo

Since the beginning of the government's Meaningful Use incentive plan, specialists have been in a strange position. Although they were eventually granted the right to seek exceptions from certain measurement criteria that didn't apply to their fields, they are still required to implement fully functional EMR or EHR systems that can do everything the CMS and ONC stipulate.

An increasing number of dentists are in the same boat as well, as state mandates require them to implement systems that include functionality (like ePrescribing) that they may only use occasionally. This means that EMR vendors who create systems for specialists and dentists are now looking for ways to implement the broader functionality required by law without raising prices on their customers who may not see much value in it.

What are web services and how can they help?
Web services are a different method of accessing some of the functionality required by Meaningful Use and state mandates. Instead of implementing and updating a database in-house to drive the functionality, web services allow a vendor to access information remotely only when needed. By using web services, you don't need to expend valuable development resources on non-essential functions. You can also arrange with a vendor like Lexicomp to pay only for the functionality that you'll be using.

When it comes to functions like ePrescribing, dose range checking, interaction checking, and allergy checking, web services aren't appropriate for everyone. Heavy users of those functions will still want to have a local database they can quickly query with reliable redundant back-ups. But for those who consider this functionality a low priority or infrequent need, web services offer a new, more easily implemented, and sometimes less expensive solution to help dentists and specialists meet government requirements.

Contact Lexicomp today for more information!

All in the presentation?

Friday, August 12, 2011 by Mark Bonfiglio

A recent JAMIA study by Bates et al. noted that the strongest factor influencing acceptance of alerts from drug interaction software is the presentation. This was found to have a stronger association than factors such as the setting or level of the alert. In an electronic prescribing environment, there is much concern about alert fatigue. Drug data vendors are often the targets of frustration of clinicians, and there is a reasonable criticism regarding the ability to have more consistency in alerting, the ability to filter to the user, and suppression of "truthful but not useful" alerts. Considering the role these alerts play in preventing adverse drug events, it would seem that at least as much attention should be paid to the way the alerts are delivered.

Black Boxed Warning, EMR, Alert Fatigue -- a new answer

Tuesday, August 9, 2011 by David Wilkof

In the last two years Lexicomp has quickly become a major provider of drug information to EMR companies for clinical decision support. Many of the new EMRs hitting the market are using Lexicomp medicine information for drug interactions, dose range checking, therapeutic dosages, adverse drug advents, electonic eprescring, and more. Lexi-Data has become the popular choice based on top quality information, unparalleled customer service, state-of-the-art data structure and top-notch APIs. Now something new!!

Lexi-Data has introduced a new structure which allows for the customization of Black Boxed Warning to reduce alert fatigue, yet at the same time delivers the warning to the person who needs it most. This information structure is new and as far as we know not available elsewhere.

API and Database Features:

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

This is terrific stuff. So for anyone developing drug interaction software or eprescribing modules, this is something you will want to look into.

Dentistry Practice Management Systems Need Clinical Decision Support

Wednesday, August 3, 2011 by David White

EMR vendors are not the only ones rapidly deploying clinical decision support systems to healthcare providers. Dental professionals are demanding that their practice management systems overcome massive development hurdles in order to comply with Meaningful Use standards.

There is a buzz in the dental technology community about Meaningful Use and incorporating more clinical decision support into the practice management system workflow. If you are searching for the best dental specific drug database to integrate into your dental EMR, turn to Lexicomp. There are very few suppliers of drug data within the dental market and even fewer still that are easy to work with. And if you are looking for an easy-to-use, out-of-the-box ePrescribing tool, trust our partner DoseSpot to deliver the solution. What do all of these companies have in common? They are easy to work with and provide you with the ability to get to the market fast!

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 a dental EMR build. But it's not just about the information. It's about who you select as your partner and who has seamless API's which makes your development easier.

You owe it to your product and your customer to make the right choice.

Clinical Decision Support and Alert Fatigue

Monday, July 25, 2011 by Mark Bonfiglio

One of the key reasons that clinicians are frustrated with decision support related to drug interaction software is the potential for alert fatigue. Clinicans do not want to be messaged regarding dosage precautions related to an interaction which has already been recognized and addressed. It is particularly important in the era of electronic prescribing to engineer systems which can present the appropriate information to the appropriate person. Systems need to recognize whether an individual has previously addressed the issue, rather than simply blindly alerting to the presence of two medications within the medicine list. A collaborative effort between drug database providers and application vendors is needed, and discussions to improve the quality of alerts, while decreasing the quantity, are moving forward. These will greatly improve satisfaction with these tools.