Page 2 - Lexicomp

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!

Companies developing new EMRs for small to medium healthcare settings and drug information

Friday, October 21, 2011 by David Wilkof

Companies developing new EMRs for small to medium healthcare settings often wait too long to consider what drug information provider to use for their product. There are only a few drug information providers and it is advisable to know the pluses and minuses as early in the process as possible. It is not just about drug-drug and drug-allergy interactions. It is not just about drug dosing information, drug nomenclature, dosing precautions, patient education leaflets, branded and generic medication lists.

It is also about which vendor is the easiest to work with. Who will accomodate your needs and not their needs. Who will help you resolve cerifying body issues? Who is the best of the best when it comes to pediatric dosing? Who will provide decision trees for black box warnings? Who will provide easy to use APIs? Who provides ongoing topnotch communication? And who is at the cutting edge? Those are just some of the quesitons you need to answer.

Drug Interaction Checking Critical for EMRs

Friday, October 21, 2011 by Darik Warnke

Medication errors and adverse drug events are serious issues in healthcare. Apprx 770,000 injuries or deaths related occur each year. For this reason and to comply with the certification and meaningful use requirements, every EMR should look at partnering with and providing their customers top rated drug interaction, duplicate therapy, allergy and dose range checking information integrated into their EMR. Lexicomp and the Lexi-Data product can offer this solution.

This information and its quality, customizability, and delivery format can really set your EMR apart from the competition. In 2010 the EMR market grew by almost 13.5% while competition in this area is also growing at a higher than predicted rate. More and more physicians are now starting to look at implementation of an EMR although the rate of adoption has been slowed by the complicated maze of meaningful use. None the less, it is critical that EMRs differentiate and help physicians understand how to navigate through this maze. Drug Data Vendors that are able to offer what others may not can help these EMR companies win more deals. Drug interactions that are cusomizable, dose range checking for specific populations (adult, pediatric, geriatric) duplicate therapy checking and an overall solid patient education offering are areas that can be easily implemeted from Lexi-Data. Lexicomp's expertise and customer service can also help get you up and running fast. The database is easy to work with, available in mutliple formats and even has a web-service set can help start up and established EMRs build the structure needed to help physicians.

For more information visit www.lexi.com/businesses/ehr-vendors/

Drug Information for Meaningful Use

Friday, October 21, 2011 by Ryan Smith

Among the Eligible Professionals who are going for federal incentive payments for Meaningful Use, podiatrists rank high among early adopters. iWatch news recently published an article (http://www.iwatchnews.org/2011/10/12/6941/podiatrists-have-their-foot-door), describing this observation.

Does your EHR meet the certification requirements established by ONC? Lexicomp can help by providing your system key clinical decision support data required for certification. As an integrated component of your EHR, our transactional drug data and reference information support the following Stage 1 meaningful use and certification criteria from ONC's Final Rule.

Lexi-Data is the foundation of Lexicomp's clinical decision support architecture. This product provides clinical decision 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.

Drug interaction databases for pharmaceutical policy and outcomes research

Thursday, October 20, 2011 by Matt Bennardo

For years, Multum Lexicon was the source for researchers to get drug reference and drug interaction data. But where can researchers now get medication lists, pharmaceutical monographs, drug-drug interactions, drug-allery interactions, and more?

Today, there is an enhanced and updated product built on the foundation of Multum Lexicon. It's Lexicomp's Lexi-Data transactional database. Lexi-Data provides drug names (brand name, generic name, and common abbreviations), therapeutic categories, drug classifications, indications, and standard coding such as NDC, J-Codes, and ICD-9. The data in Lexi-Data has been utilized by many universities and research institutions, including research on pharmaceutical policy and outcomes, aging, and more.

Multum is a registered trademark of Cerner Corp.

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.

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

Thursday, October 13, 2011 by Michelle Curren

Web services allow users to request data via the web when they need it, delivering it directly into their application. This is partically useful for those that need an inexpensive and quick to implement solution. One group this could be perfect for include specialists and dentists that were recently allowed to file exceptions from Meaningful Use requirements, as this supplies them with the required data, without the need to maintain and update complicated databases.

When looking for a web service provider, consider Lexicomp who supplies a solution directly to their own database of medicine and clinical information while also fulfilling all Stage 1 requirements! In addition, they have web service delivery of patient education materials!

Drug Interaction Databases for EMR and EHR developers - don't wait!

Thursday, October 13, 2011 by David Wilkof

Many EMR and EHR developers wait too long to begin for looking for a supplier of drug data and drug interaction databases. In some respects it seems like a simple chore. There are only a few drug data providers. But the sooner these developers start, the better. Why so?

First, there is a big difference in data structure among the few providers. Lexicomp happens to have a very simple and logical structure, which does solve some headaches if you come in late into the game. But even if you start in a timely way, simpler and more logical is better.

Second, how comprehensive is the data provided? Consider the following needs: drug-drug interaction, drug-allergy interaction, pediatric dosing information, therapeutic dosing information, brand vs generic, Black-Box Warnings, Patient Education Leaflets in multiple languages, drug classifications, and more. There are many things to consider and work on before submitting your development to the certification process. You obviously don't want any surprises.

In the last 24 months more and more EMR developers have selected Lexicomp as their drug information provider. There are many reasons for that. We encourage you to call early in the process.

Populating patient portals with drug and clinical data

Wednesday, October 12, 2011 by Matt Bennardo

Patients are becoming more involved in their own healthcare, and are increasingly making use of patient portals and consumer-facing websites to do research, follow their progress, and even answer questions they might have previously posed to their physician. At the very least, they are using these sites to be more informed during visits to their care providers so they can get more value from those encounters.

All of this creates an opportunity for innovative developers to provide accurate, reliable, easy-to-understand information to patients via the web. One source for medication and clinical information that can be easily integrated into such sites is Lexicomp.

Lexicomp is a leading provider of drug reference, clinical reference, and patient education leaflets and materials to clinicians. Over a thousand hospitals use Lexicomp's information every day during patient encounters. The information available includes medication lists, drug monographs, drug interaction information (including interactions with common food and natural products), drug allergy information, patient education documents, dose adminstration, warnings, and more.

And Lexicomp's information can be easily integrated into your site in a variety of ways. You can choose to have an installed local database, or to use web services to pull information from Lexicomp's servers as needed. Contact Lexicomp today to find out how to populate your patient portal or consumer website with the information your users are looking for.

EHRs can alleviate alert fatigue with new filtering options

Tuesday, October 11, 2011 by Matt Bennardo

As EHRs and EMRs become more widespread and more integrated into the daily activities of clinicians, concern over alert fatigue gows. This is one of the biggest issue facing developers today. The ideal EHR or EMR will provide the right alerts for the right clinicians, but won't overwhelm them.

Lexicomp is one drug data provider that is taking steps to address this issue. They have added multi-dimensional filtering to a set of Black Box Warning alerts. These filters allow EHR vendors to filter alerts by intended clinician, severity of the warning, and special conditions related to the alert.

For instance, an alert that applies only to pregnant women at the time of medication dose administration wouldn't display for pharmacists preparing the prescription or for male patients receiving the drug. When only relevant alerts are shown to clinicians, they come to value them more. The detail that Lexicomp includes in the alerts allows for smarter targeting. EHRs and EMRs can finally set themselves apart from the competition by helping clinicians solve a problem that is extremely important to them.

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.

Evaluating drug interaction databases in EHR development

Friday, October 7, 2011 by Matt Bennardo

When developing an EHR system, when is the right time to evaluate a drug interaction database? Because there are only a handful of vendors in the market, it makes sense to evaluate their respective offerings several times. Certainly, before you make the final decision to go with any particular vendor, you should talk once more to the other data providers to ensure nothing has changed.

A lot can change in a few months
One vendor that has added a lot of enhancements to their medication and clinical information is Lexicomp. Evaluating their product today versus a year ago would show many differences in capabilities.

Some of the new enhancements include:

New web services calls that allow for implementation of Meaningful Use Stage 1 requirements without an installed database
New Black Box Warnings information that helps alleviate alert fatigue
Expanded patient education leaflets in multiple languages

In an industry like this where things can change quickly but in which product development can sometimes span years, it's important to check in with possible vendors more than once! If you haven't talked to Lexicomp recently, click the links on this page to set up a conversation with them now.

EMR certification requires drug interaction data that is easy to work with

Wednesday, September 28, 2011 by David Wilkof

Many EMR vendors are scrambling to complete their products quickly so they can pass through the various certifying bodies (their choice about who they go to). Often overlooked early in the process is the importance of selecting the best drug information provider. Making the right selection early will save headaches later on.

It is not just a matter of drug data quality, but even more importantly about the structure of the data files and how easy those files are to work with. It's not just about the actual drug reference database, but about the ease of using various APIs and working seamlessly with the data provider. Lexicomp is quickly developing a stellar reputation in this market segment, as is demonstrated by our growing share of the market. There are many things that need to be considered by the EMR vendor in their search for the best provider to work with. Some of these include the quality of pediatric dosage database, dose administation, patient education, Black Box Warning decision tree, and more. If you are at a decision point in the area of drug information, make sure you give Lexicomp a call.

Stardardizing Drug Nomenclature

Wednesday, September 28, 2011 by Mark Bonfiglio

One difficult aspect of drug nomenclature is the complexity of drug concepts. Clinicians speak fluidly about these concepts, flowing from class-based terminology (penicillins) to individual drugs (penicillin) with ease. But drug classifications are not well standardized, and some systems blend pharmacologic concepts with chemical concepts. For example, consider a system which uses "beta-adrenergic receptor blockers" and "fluoroquinolones". One speaks to the pharmacologic target while the other refers to a shared chemical composition. Clinicians understand and interpret these differences, but electronic applications have more difficulty. RxNorm is an effort to standardize these naming conventions for an individual drug. These concepts are generally included in proprietary vocabularies, but there is little consensus among them. These may complicate efforts to establish comparisons on adverse drug events, allergy, and other comparative features among members of a class. Class level groupings are included in SnoMed and may provide a basis of standardization. For this reason efforts to standardize to a single class nomenclature are important and necessary.

Where can university and private researchers get drug information?

Monday, September 26, 2011 by Matt Bennardo

For many years, the primary provider of drug reference and drug interaction information to researchers was Multum's Lexicon product. Today, there is also another product that is built on the foundation of Lexicon. That new product is Lexicomp's Lexi-Data Basic database.

In an earlier post, my colleague Ryan Smith explained how Lexi-Data Basic is now serving the needs of researchers:

"Lexi-Data Basic provides drug information that includes drug names (brand name, generic name, and common abbreviations), therapeutic categories, drug classifications, indications, and standard coding such as NDC, J-Cods, and ICD-9. The Lexi-Data Basic product is powered by the widely known and trusted Multum Lexicon product which has been utilized by hundreds of universities and institutions in the past. Multum is a registered trademark of Cerner Corp."

For more information on Lexi-Data Basic, click the links to fill out the form on this page.

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.

Improving EMR drug information safety with Black Box Warnings

Saturday, September 24, 2011 by Matt Bennardo

With all the focus on improving patient care with electronic medical records, it's strange that most medication and clinical data vendors don't allow developers to meaningfully use Black Box Warnings in their products. But one vendor, Lexicomp, is leading the way with detailed, customizable warnings that add value across the continuum of care.

What are Black Box Warnings and how do they help?
Black Box Warnings (also called Black Boxed Warnings) are the FDA's highest class of medication warning -- it indicates a precaution of the highest concern to patients or clinicians. They get their name from the distinctive black box that surrounds the warning on the packaged information that comes with drugs.

Not all Black Box Warnings are alike. Some are relevant at the time a drug is prescribed, others at the time the prescription is filled, and others when the drug is administered or stored. For this reason, different warnings are most likely to apply to different clinicians (or even the patient) along the continuum of care. Similarly, some warnings are only applicable to patients with special conditions (e.g., pregnancy), and some are considered by clinicians to be "obvious" warnings (e.g., only oncologists may prescribe cancer treatment regimens).

Yet, the information included in these warnings is very important -- so long as they are delivered at the right time to the right people. They can help save lives, reduce liability, and reduce the cost of care.

How do you get Black Box Warnings into your EMR system?
Until recently, there was no good way to get this information in an EMR, EHR, or HIS system. Some drug information vendors offer an indicator on their drug monographs that simply states "YES" or "NO" whether the drug has an associated Black Box Warning. It's still up to every clinician in the continuum of care -- the prescribing doctor, the fulfilling pharmacist, the administering nurse -- to look up those warnings in the drug's packaged inserts to see if they apply to them. This is an unnecessary extra step that could potentially lead to crucial missed information!

Lexicomp offers a better way. With Lexicomp, detailed information is provided about each Black Box Warning. In addition to the full text of the warning and additional context written by Lexicomp's staff of in-house experts, the warnings are all classified to make it easy to customize which ones appear for which clinicians. You can reduce alert fatigue by ensuring that only relevant warnings appear for particular clinicians or patients. Not only will your EMR be improving patient safety, but it will be making life easier for all of your users as well!

EMR vendors address alert fatigue in novel ways

Friday, September 23, 2011 by Matt Bennardo

Alert fatigue has been the big bogeyman of EMR implementation for many users, developers, and vendors. Although clinicians agree that it's important to see alerts, they disagree on how many and even which ones. Many vendors have found that a crucial step in alleviating alert fatigue is to allow clinicians to customize their own alerts to some extent. But can your drug information vendor even support that?

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!