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!
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.
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.
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.
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!
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.
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.
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.
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.
What do these words have in common? "Pediatric dosing information; Medicine lists; Medicine brand names; Drug-drug interaction; Drug-allergy interactions; Drug interaction database; ePrescribing; Patient education."
There are many EMR products under development, many targeting smaller hospitals and ambulatory facilities. There are also a number of other EMR and Practice Management products that are going through major product re-design. Many of these development groups need to confront the decision about what drug information supplier to use. As the title of this posting says "EMR developers are now searching for drug and disease information providers that are easy to work with" (Note: most are not). This might not sound like a tall order, but as it turns out, it is much more difficult than they think. It's about the data as much as it about the quality of the relationship as well as the flexibility and helpfulness of the vendor.
How much will they help in setting up the API's? Do they have a specific pediatric dose range checking product? Do they have patient education leaflets? Are they available in foreign languages?
One drug data provider stands out above else....Lexicomp. If your serious, check them out.
Did you know that Lexicomp provides clinical decision support data needed for patient specific alerts (i.e. drug interactions, allergy, duplicate therapy and dose range checking) and to support sound treatment decisions in EMR products and e prescribing applications?
Lexicomp actively pursues relationships with companies that offer complementary products and services to allow for system integration. Through our HIS vendors such as Epic, Cerner, GE, Meditech, and others, clinicians can link directly to Lexicomp’s superior drug information, enabling them to make even faster, safer decisions while improving patient outcomes at the point-of-care.
Reports are circulating that spending on healthcare IT is set to grow at an annual rate of 24% over the next several years. This is phenomenal growth, and it's tempting to think that rising tides are going to raise everybody's boat. But with the proliferation of EHR vendors we've seen in the past couple of years, that conventional wisdom isn't likely to hold true. How do you make sure that you're one of the rising boats, and not one of the swamped ones?
Development talent is the scarcest resource right nowAmong other things, this boom in healthcare IT means more competition for talented developers with healthcare-specific experience. And the influx of cash means that a few well-funded or well-positioned EHR vendors are going to reap early rewards -- and then will likely start poaching even more top talent from other vendors by offering bigger salaries and more benefits.
Your best move is to protect your IT resources by having them focus only on the most crucial parts of your system -- the parts that will differentiate you in the marketplace. Use a drug information provider with robust APIs, an intuitive data structure, and superior customer service to take the burden off your own development team so they can focus on more important tasks. One such vendor is Lexicomp, who has helped many customers get to market faster after less-than-positive experiences with other medication list vendors.
Another tactic is to forgo building your own eprescribing tool (which can take months to certify anyway), and instead use a standalone module like DoseSpot.
Meaningful Use still rules the day -- but look ahead to Stage 2 and beyondWith the government incentives now beginning to pay out, more and more practices and hospitals are pursuing Meaningful Use certification. To compete, your system will need to meet the Stage 1 requirements like drug-drug interaction checking, drug-allergy interaction checking, and distribution of patient education materials.
But it's not enough to simply check off the existing boxes. Every other EHR vendor is rushing to do the same. Instead, you need to provide value above and beyond the others. Again, a drug information vendor like Lexicomp can help you exceed Stage 1 requirements and put yourself where you need to be for Stage 2 and 3. They offer functionality like dosage range checking for both adults and pediatric patients, detailed patient education pamphlets in multiple languages, and links to some of the best drug and clinical reference services available.
Deploying extra features like these in your system can help make it more likely that you'll be a rising boat when the money starts pouring in.
What do all of these have in common? Well for one thing, they are being driven in part by the demands of Meaningful Use requirements.
Here is just one example of Meaningful Use effect. Some of the demands are actually in place, and many others roll out over the next few years. EPrescribing in Florida looks like it might be taking an interesting turn as free application provided by the State may be going away, or so I have heard. This recently
posted ePrecribing blog described it in greater detail. And
a second blog.
As Meaningful Use requirements have dictated more relevant application of medication and drug data within EMR and EHR systems, the awareness of the nuances of these databases has also gone up. Recognition of the following terms is becoming more commonplace: Drug Reference Database; Dosage Range, Dosing in Pediatrics, Drug Interaction List,
Pediatric Dosage Calculator, Medicine Interaction. Clinical Decision Support Systems, Drug Content, and more.
As state budgets have tightened in the last few months, and look like they will continue to do so in the medium-term future, Florida physicians may have to look elsewhere for electronic prescribing options. I have heard that the state-sponsored eprescribing program in Florida may be going by the wayside. Can someone confirm that?
My colleague, Matt Bennardo, wrote several interesting posts in this regard last week. I would suggest you link over and
give them a quick read. They are quite interesting.
As part of the federal government's Meaningful Use and medical information efficiency programs, eprescribing has been receiving a lot of push in the last year or two. Many of the eprescribing systems utilize Lexi-Data drug content to review possible drug-drug and drug-allergy interactions, dose precautions, pediatric dosing and more. For those of you from Florida (and others), I would definitely give Matt's posting a quick read.
Health information exchanges (or HIEs) have long been the odd duck of the future of healthcare. Their proposed roles have varied from relatively simple (providing a mechanism for exchanging healthcare information among local providers) to complex (actually delivering some clinical decision support systems to their members). Even now there is no consensus on what HIEs should be doing, how they should be funded, and how many there should be.
The truth is that most HIEs are still funded by state and federal grants. These grants are temporary, since it's expected that some viable system of self-support will eventually assert itself. But until there's real evidence that this is happening, it's best to think of the entire HIE model as founded on the shifting sands of government whimsy. As we know all too well, many programs are "ear-marked today, gone tomorrow".
Some states also provide CDS functionality directly -- such as the eprescribing program in Florida. But again, such initiatives exist at the mercy of lawmakers, whose opinions may change without notice. For that reason, all HIS, EMR, and EHR vendors should treat such programs as temporary and not rely on them to provide functionality to their customers.
However, there are also established companies that can provide the same functionality (and have been for years). For drug information to drive clinical decision support, one such vendor is Lexicomp. They also have several partners in the electronic prescribing space that can fill that need with a less capricious solution than government programs. Contact Lexicomp today to learn more about both solutions -- use the phone number or form on this page.
Due to state initiatives, Florida has long been one of the national leaders in eprescribing. Physicians and other prescribers in the state are used to the convenience and improved safety of affordable electronic prescribing. Many clinicians in Florida have likely given little thought to the eprescribing sections of national Meaningful Use legislation, assuming they would easily meet requirements.
But just as Meaningful Use funding seemed to be at risk several times over the past few months, so too are many state healthcare initiatives facing potential cuts. It seems that no program, no matter how popular, is completely safe from defunding these days. What should doctors, dentists, and others in Florida do to protect themselves?
The most obvious answer is to research private eprescribing solutions that can be quickly and affordably integrated into existing systems to make an almost seamless transition and keep prescribers on track to comply with Meaningful Use in 2011 and avoid penalties. Although Lexicomp -- a leading provider of drug information -- doesn't offer an eprescribing solution itself, it does have partnerships with several.
Those in Florida looking for advice on which electronic prescribers to consider are welcome to contact Lexicomp for referrals to some of the best in the industry. Use the phone number or forms on this page to ask for advice.
Because Meaningful Use penalties for eprescribing are tied to Medicare and Medicaid reimbursement, it's physicians who rely on these programs most for their revenues who will feel the pinch first. In states like Florida with large populations of older, retired Americans, the impact will be much greater if doctors fail to implement electronic prescribing in accordance with government regulations.
State programs and laws add another layer of confusion to this situation. Some states, like Minnesota, have enacted laws requiring healthcare professionals to switch to eprescribing sooner than the rest of the country -- even those, like dentists, who write relatively few prescriptions.
Meanwhile, other states are slashing programs that helped doctors use electronic prescribing more cost effectively. All of these changes are forcing some practices to scramble to fill a gap they hadn't expected. So how can doctors, dentists, and others easily find cost-effective and easy-to-use eprescribing solutions?
Lexicomp is an industry leading drug information provider. Although they don't offer their own eprescribing solution, they have several partners in this space that have been meeting the needs of clinicians quickly and affordably across the U.S. If you're confused about which eprescribing solution to use, contact Lexicomp using the phone number or form buttons on this page for advice in navigating this area.
If I had to venture a guess as to what features of Lexi-Data are most in demand by EMRs and their users, I would have to say that it has been:
-- Drug- Drug Interactions
-- Drug - Allergy Interactions
-- Dose Range Checking
-- Duplicate Therapy Checking
But now we are starting to see increased levels of interest in patient education and anything tied to eprescribing. And more and more developers are equally interested in the level of support they will receive from their partner vendor. There are quite often serious challenges that the developers will encounter during the project and it is important that they feel confident their drug data provider will be there when they need help.
I would suggest that either
Lexicomp or Cerner/Multum can deliver what you need when it comes to data. If you are looking for eprescribing, check out
DoseSpot. The DoseSpot folks are highly competent, reliable and knowledgeable.
So far, the government's attempts to move physicians, hospitals, and other healthcare providers to EHR systems have been positive monetary incentives. Not every provider feels that the incentives (and the reporting requirements surrounding them) are worth the headache of EHR implementation, but the government is getting ready to trade its incentive carrots for penalty sticks.
Penalties have long been a part of the legislation on this topic, but they were always eventual penalties to be levied in the future. These days, the future is fast approaching.
The penalties themselves won't be payable until 2012 and 2013, but they will be levied in part based on what happens this year -- in 2011. If docs don't use electronic prescribing at all this year, they're liable to be dinged for the next two years. And the longer they wait, the tougher the requirements get, and the harder it is to get out of the penalty box.
The upshot is that EHR vendors need to be offering their customers full-service eprescribing systems. Otherwise they're leaving money on the table and exposing their customers to possible penalties over the next several years. If you're having difficulty building your eprescribing system or getting it certified, this is the time to seriously consider a standalone module like DoseSpot that can help you get certified faster and give your customers the functionality they need and expect.
Automated screening for drug allergy has been a less than satisfactory experience for most pharmacists. Alerts tend to be very broad, identifying all possible cross-reactivity for medicine list, and the data concerning the presence of an allergy are often records of intolerances rather than true allergy. In the era of electronic prescribing, an allergy alert may prompt a change in therapy, exposing the patient to a drug which may not have been the prescribers first choice. It is important that these alerts be based on quality history, a full understanding of these adverse drug events, and other types of idiosyncratic reactions which may be relayed by patients as "allergic" reactions. The quality of the data, and the sophistication of the alerts, will continue to be limitations to the automated screening, and challenge all healthcare providers.
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