Integrated Drug Data Solutions

As more hospitals are taking up the mantle of electronic medical records, the issue of security continues to plague the industry.  Every day, more hospitals are identified as having security gaps - sometimes glaring, sometimes minor - but always of concern to the administrators, IT professionals, clinicians, and patients of those hospitals. 

As I was musing over what to write in this week's clinical decision support blog post, I recalled a post I wanted to write months ago but somehow never found time to.  So, I'm bringing it out now, a little bit late, but still very relevant.

 I'm a big fan of Johnny Cash.  From his earliest work to his last few "American" recordings, his voice and music have an ethereal, timeless, and somewhat haunted quality that manage to connect and appeal to millions.
 

• Drug Interaction Lists
• Adverse Drug Event Alerts
• Patient Education Pamphlets in 19 Languages
• RxNorm Mapping
• Pediatric Dosage Calculations
• Drug Allergy Interactions
• Clinical Guidelines

Will they work with you as partners, to help you through integration, data structure issues, and making sure your system integrity is never compromised, like Lexicomp?  Or will they sell you their data and walk away?  

As an EHR vendor, you can't afford anything less than perfect alignment between your system and the information that ties into it.   We'll help you make certain that you're combining the best aspects of each and ensure that the output is far greater than the sum of the inputs.  So why not spend a few minutes getting to know Lexicomp?

The centers for Medicare and Medicaid Services (CMS) has paid out nearly $38 million in EHR incentives so far this year.
 

• Drug Interaction Data - we'll provide your system data that enables clinicians to screen for drug interactions, including drug-allergy, drug-drug and drug-food
• RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm 
• Drug Reference Data - integrate drug reference information, such as drug images and black box warnings, into your system
• Patient Education Data - we provide patient education information that allows users to generate patient-specific handouts for medications (available in 19 languages), and conditions and procedures (available in English and Spanish)
• Dose Range Checking - we provide data that enables clinicians to receive dosing alerts for medications, including limits for pediatric patients

 Haven't heard of Brantley Whittington, CEO of the EHR firm Extormity?  Then perhaps you've been living under an HIT rock for the past several months.  Not to worry, he's made a big splash at HIMSS11 this year and the legend will only continue to grow.
 

On February 15, at the request of the Department of Health and Human Services, the National Quality Forum (NQF) has announced the conversion of 113 NQF-endorsed measures from a paper-based format to an electronic "eMeasure" format.

 With over 14,000 providers registering for Meaningful Use incentives, and the GOP considering repealing the law that has set aside funding for EHR adoption, there's never been a more critical time than now to focus on Meaningful Use.

 According a recent Accenture study, roughly 50% of US hospitals are at risk of not meeting federal requirements for meaningful use guidelines.  Most of the CIOs polled agree that their health systems have underestimated the time and cost it takes to implement EMR and clinical decision support systems. With Medicare-based penalties on deck for those that do not meet the MU criteria there's a lot of frenetic activity occurring to make sure systems are implemented quickly.  

 "Not only is the medical community using smartphones and their applications for basic tasks, but they report using them to complete some of the work that would have previously been done on a desktop or laptop computer.  With one of the main focuses in healthcare today centered on the reduction of costs, any tool that can help medical personnel become more efficient is a boon to the industry."  So says Melissa Elder, chief author of a new report from Kalorama Information detailing the state of the current mobile medical app market.

 The current market opportunity for mobile apps in the healthcare enterprise is $100 million and Chillmark Research predicts that within three years this will increase to over $1.7 billion based the rapid evolution of mobile devices, physician demand, and the healthcare enterprise’s need to improve quality and efficiencies.  This leaves little room for debate that the mobile era is officially here and that adoption of mobile apps in healthcare enterprise is only going to continue to proliferate.

Try out the offerings from the Lexi-Comp-Cerner partnership and learn about the integrated clinical decision support systems delivered by two of the most reputable names in the industry.  

 The most recent edition of Healthcare Finance News offers six tips for earning meaningful use incentives:

• Capture the “right” data - Don’t assume that the explicit functional requirements for Stage 1 of meaningful use will provide all the required data elements for earning incentives.  The race is long, and it's not necessarily the fastest that will win.  Keep a level head, inventory what is needed, and identify gaps. 

• Aim for better performance, not just measurement - It’s critical to encourage both documentation needed for quality measurement and compliance with the care recommendations behind each measure. 

• Make sure your electronic health records are certified - Check to make sure the product you are using is on the list of approved versions for achieving meaningful use, published by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT.

• For large health systems, consider implementing EHRs for physician practices first - Large systems, especially academic institutions, are finding they can earn three times more in meaningful use incentives for their ambulatory services than for their in-patient side. Physician incentives can then be used to foot the bill for the hospital's healthcare IT. 

• Don't forget to plan ahead for Stages 2 and 3, which promise to be more difficult - Some organizations are thinking in terms of Stage 1 as the finish line, when, in reality, it's just the first leg of the race. Small physician practices should learn where to get help. Doctors should talk to their admitting hospitals for recommendations. They also need to contact their regional extension center – federal offices set up across the nation specifically to help physicians navigate healthcare IT adoption and meaningful use.

It's no surprise that a majority of hospitals aren't ready for the switch to electronic medical records and that the uptake of technology has not been, nor will be, as rapid as the government hopes. 

Although there are billions of dollars available for care facilities to implement new technologies, such as EMRs, clinical decision support systems (CDS), and clinical information systems (CIS), these are often expensive and time consuming up front, requiring implementation and training of already overworked staff.  This process can take from months to years to reach maturity and often does not show significant gains immediately.  Remember, though, the aim is for better standardized patient care and long term efficiencies within the facility.

With all the headaches associated with the implementation of clinical information systems,  take the guesswork out of at least one part of the process and ensure that your EHR vendor is partnered with a reputable drug information provider.  Lexi-Comp provides drug product information that includes drug classifications by brand and generic name, a comprehensive drug interaction database, pediatric dosing calculators, and duplicate therapy checking.

Learn more about Lexi-Comp's drug information.  

It's been well documented that there exists a worldwide chronic shortage of medical staff.  And according to the World Health Organization, this has indeed become a "crisis."

During this shortage of skilled staff, and especially in light of the considerable reimbursement funds available for technology implementation in hospitals and other care facilities, it makes sense to utilize technology in order to gain as much efficiency as possible within healthcare settings.  Implementation of clinical decision support systems, while expensive, can begin to show benefits almost immediately after implementation and training is complete and will not only increase practitioner efficiency but will also result in considerable long-term savings. 

When evaluating clinical information systems, it's important to ensure that the vendor of choice has a robust drug information resource behind it.  Lexi-Comp offers Lexi-Data, a fully integrated drug database containing drug classifications by medication generic name and brand name, dosage calculators, as well as a comprehensive drug interaction database to flag potential drug interactions and allergies.   

Recently, legislation has been introduced into the House of Representatives to ensure that multi-campus hospitals which adopt clinical decision support systems and meet the appropriate standards for meaningful use of EMR will receive incentive payments commensurate with the number of sites into which they're implementing these HIT systems.  

Under the watchful eye of Rep. Zack Space (D-Ohio), this legislation strives to correct several of the inequities in the American Recovery and Reinvestment Act of 2009 concerning hospital incentives.  The original act treats all hospitals and hospital systems identically and provides only one payment per hospital/system.  This bill will address the issues surrounding higher incremental implementation and training costs for multi-site health systems and afford them opportunities for multiple incentive payouts on a per-site basis.

What do you think?  Should multi-campus hospitals receive additional payments based on the number of sites?   

With the release two weeks ago of the final ruling on Meaningful use of EHR systems, the Center for Medicare/Medicaid Services has released this helpful comparison table highlighting the differences between the original proposed rules for Meaningful Use and the final ruling.

In a recent study of hospital executives conducted by CSC, 67 percent say meeting meaningful use guidelines is their highest priority. For 42 percent of the respondents, helping owned and/or affiliated physicians' practices achieve meaningful use of EHR ranked second on the business agenda.

In a recent study by PricewaterhouseCooper, over 90% of hospital CIOs polled are concerned that they cannot meet government requirements demonstrating meaningful use of electronic health records and clinical decision support systems.  

As alluded to in a previous posting by Chris Madjerich, the Leapfrog Group for Patient Safety has released a report on the safety of electronic prescribing (ePrescribing) systems in hospitals.  In a study of 214 hospitals testing efficacy of their clinical decision support systems using the Leapfrog CPOE Evaluation Tool, the systems, on average, missed half of the routine medication orders and a third of potentially fatal disorders.  From the executive summary: