Page 2 - Integrated Drug Data Solutions

Electronic Medical Records Woefully Underutilized by American Patients

Friday, June 25, 2010 by Matt Snodgrass

In thinking about one of the most important topics in healthcare today - that of the electronic medical record (EMR), ePrescribing, and clinical decision support systems - it somewhat surprising how little the public knows about the discussions surrounding this.

A recent Harris Interactive/HealthDay poll of over 2,000 adults found that less than 10% of the users polled use EMRs to capture medical information, use email to communicate with a doctor, or schedule appointments online. Nearly half were not sure if their primary care doctor even used EMRs for visits or treatments.

Though 71% conceptually agreed with the idea of an EMR, more than half agreed that these should be limited to personal or physician use and should not be provided to other parties. Not surprisingly over 2/3 of those polled would not want insurance companies to be able to access their medical records.

Despite the Obama administration's campaign to expand the use of health information technology, public attitudes toward electronic medical records haven't budged much over the past few years, the poll shows.

As an EMR vendor, it's nearly as important to have patient buy-in as it is to have buy-in from the institution and practitioners. If patients are actively using or wanting to use available technologies, the first steps to getting into a doctor's office or hospital become that much easier!

Full Disclosure of All Adverse Drug Events?

Tuesday, June 15, 2010 by Matt Snodgrass

The Supreme court will be reviewing a case against Matrixx Initiatives, maker of Zicam, to determine whether drugmakers must disclose all adverse event reports, even those that may not show statistically significant evidence that a side effect is actually caused by a specific drug.

Even within prescribed clinical guidelines and therapeutic dosage ranges, it's not uncommon for a pharmaceutical company to receive reports of adverse drug events but these are not always reported as they may not always be tied directly to that particular medication interaction. Matrixx is arguing that it does not have to disclose AE reports unless these actually show the side effects may be caused by using a drug.

There exists a delicate balance for a pharma company in releasing all AEs to the FDA (flooding the review process with potentially irrelevant information) versus using their discretion to determine which of these warrant reporting. Disclosing ALL AEs is a clear indication of putting the welfare of the patient first, while disclosing only those AEs that the company feels are relevant comes down to one thing: sales dollars. We've seen on numerous occasions that allowing a company to police itself where issues of patient safety are concerned doesn't work.

Using GATOR to Assess Health Information Sites

Tuesday, June 8, 2010 by Matt Snodgrass

86% of adult patients use the Internet to answer health-related questions, but less than 42% will consult a healthcare provider to confirm or refute this information, so says a new study published in this month's Journal of clinical Nursing.

It seems that the clarion call of reality cannot be sounded loudly enough and therefore bears repeating: just because it can be found on the Internet, does not make it so. But, "the majority of users accept web-based health recommendations in lieu of professional advice" said Dr. Bryan Webster, part of the research team.

To help combat many of the inaccuracies found online, the team has developed a new set of criteria to a help encourage smarter patient-centric research. The GATOR criteria, as it's known, consists of five components to ensure safe searching. Keeping these five topics in mind as a consumer will ensure that the information you're finding is safe and trustworthy and, as a content provider, will ensure that your site is deemed safe and trustworthy, providing valid information to the consumer.

G is for Genuine

How genuine and independent is the site? Some websites appear genuine, but are there solely to promote the sale of products that claim to enhance health and well-being or to cure disease. Check whether the goals, purpose or mission of the site are clearly stated and beware of web addresses that automatically redirect readers to another address.

A is for Accurate

It is often hard to tell how accurate a website is, which is why it is vital that patients stick to reputable and trusted websites and check any information they have found with their healthcare provider. For example, the researchers found simple searches could throw up millions of options.

T is for Trustworthy

Is the information true and is it reliable? Does the website say where the information they are publishing comes from? Do they quote references? Is the information on the site peer-reviewed by an expert in the field to make sure it is correct and up-to-date?

O is for Origin

Does the information originate from a reliable source? For example, most government, academic and healthcare organizations are managed by reliable sources providing up-to-date information. In contrast, a commercial company may present selected facts to sell their product. Can you contact the website for further information, clarification or verification?

R is for Readability

Is the information presented in a clear, concise way that average members of the public can understand? Patients may have difficulty in obtaining, processing and understanding web-based health information if it is too elementary, technical or advanced. For example, a US study found that 40 million people cannot read complex text and 90 million cannot understand it.

In general, health information sites are not regulated and it falls squarely on the company or individual maintaining the site to determine the validity and safety of that information. Keeping in mind these five simple guidelines when researching health issues online can help to keep you safe and will allow this information to be used to encourage patient-clinician dialogue rather than to act as a replacement for it.

Troubling Increase in Childhood Drug Prescriptions

Thursday, May 20, 2010 by Matt Snodgrass

According to a study released May 19 by Medco Health Solutions, the use of medication in children continues to rise, nearly quadrupling as compared to the rate of increase of the overall population. In 2009, over 30% of all children between 11 and 19 were treated with at least one drug for a chronic condition. Many diseases that were formerly considered "adult" conditions are becoming more prevalent in children, partly due to the skyrocketing rate of childhood obesity.

Over the past nine years, the greatest usage increases were in medications used to treat conditions that have not been traditionally associated with children, such as type 2 diabetes and antipsychotics. The result is that many drug manufacturers are filing patent extensions for pediatric indications. We can expect to see significantly higher lifelong healthcare costs as these young patients enter adulthood, as treatment will have exceeded the 'expected' period.

With the continued increase in prescription drug use in children, more will be concomitantly prescribed multiple medications. As such, it is imperative for practitioners to have an accurate medication list for each of their patients to screen for any potential medication interactions as well as to be aware and make use of pediatric dosage calculators to ensure proper dosing.

On the Adoption of EMR Systems

Friday, May 14, 2010 by Matt Snodgrass

With last year's Health Information Technology for Economic and Clinical Health Act earmarking nearly $20 billion for the implementation of electronic medical record and ePrescribing systems, and no clear federally mandated guidelines on how to do so, it's no surprise that this has been a hot topic among many healthcare practitioners and Electronic Health Record (EHR) vendors.

The bill has been criticized because it has created incentives for implementing systems to improve care (and, as a byproduct, lower costs) instead of adopting new practices to better serve patients. Additionally, non-compliance penalties for failure to implement clinical decision support systems begin in 2015.

EHR systems, by their very nature, are expensive and and can be difficult to implement for private practioners and small group practices. Many states have set up state-wide information exchange such as the Ohio Health Information Partnership, to encourage adoption and help doctors and hospitals determine the most efficient ways to implement these new technologies.

Eventually, these state and regional level health information exchanges, or HIEs, will assist in the creation of a nationwide information exchange.

Starting in October, hospitals can begin receiving incentive monies for the adoption of EMR systmes; doctors can begin receiving these incentives in January. By adopting sooner rather than later, they are eligible for additional 'early-bird' incentives. A second round of incentive payment can be achieved by doctors and hospitals reaching meaningful use of their EHR system within the next five years.

Barcoding Within e-MAR Systems Reduce Medication Errors

Friday, May 7, 2010 by Matt Snodgrass

In a recent study at Brigham & Women's Hospital, researchers found that a barcode system helped reduce medication errors by an astonishing 57%.

The chances of dosage administration errors fell by 42% and the chances that a patient would receive a medication at the wrong time fell by 27%.

According to the study, "Given the high number of doses administered and orders transcribed in any acute care hospital, implementation of the bar-code eMAR could substantially improve medication safety."

Barcoding and other clinical decision support systems are not without their own inherent risks, namely: they're expensive, can be time-consuming to implement, and it can be a challenge to overcome staff resistance to using a new and, initially difficult, technology. The importance of implementing clinical information systems cannot be overstated, however, as the rising cost of medication interaction errors and adverse drug effects top $60 million per year per hospital.