Representations of liquid volume -- mL is our one and only

Medi-Span® offers its drug descriptive data in a variety of formats, including unformatted flat files and data with accompanying application programming interface (API) software. Since the inception of Medi-Span, its data has represented liquid volumes in “mL,” as required by NCPDP Billing Unit Standards. This creates consistency within in data and conforms to most agencies’ standards, but we believe it is also important in promoting patient safety by helping reduce dosing errors.

In 2009, the Institute for Safe Medication Practices (ISMP) issued a white paper for healthcare professionals, electronic medical records (EMR) software developers and pharmacy computer system vendors in an effort to eliminate the use of non-metric measurements, such as “teaspoonful” and “tablespoonful” or associated variations like “tsp,” to prevent medication errors in prescription directions. As supported by ISMP case reports, the disparity between the actual volume measured by using a household teaspoon or tablespoon as well as the possible confusion between the two can easily lead to incorrect dosing, especially in the pediatric population.

Even though Medi-Span has consistently used “mL” in dose screening databases and in drug orders/directions for use (SIG) database that is used during electronic prescribing, in support of the ISMP initiative, we reviewed our clinical database offerings to make sure that no non-metric measurements were included. .

Medi-Span offers dosing-related modules that are embedded into workflow applications for use by clinicians, pharmacists, nurses, and other healthcare professionals.  The dosing-related modules are also used by payers and pharmacy benefit managers (PBM) for processing drug claims. Like all Medi-Span data, the dosing data uses only the metric designation “mL” as a unit of measure for liquids. Vendors that use Medi-Span flat file data in their software are encouraged to use “mL” in any alert messages, just as the Medi-Span APIs use “mL” units for alert messages.

Through our sister brands Lexicomp® and Facts and Comparisons®, Wolters Kluwer Health provides a variety of print and electronic referential drug information offerings. These offerings also use metric units (such as “mL”) in lieu of non-metric units (such as “teaspoonful”) when presenting information about drug products or dosing, thus creating consistent liquid dosing designations across all Wolters Kluwer Health drug information resources.

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Achieving Meaningful Use with Lexicomp Data

When integrated into an EMR, Lexicomp's (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) drug reference content and drug interaction data will help you achieve the clinical decision support component of Meaningful Use.  We have worked with hundreds of EMR vendors to help them go through the process of certification.  Lexi-Data, as an integrated component of an EHR, supports the CMS definition of Meaningful Use:

Lexi-Data supports the use of computerized physician order entry in both inpatient and ambulatory arenas:

  • Provides a drug list of dispensible products
  • Data for drug-drug, drug-allergy and drug-disease interaction screening
  • Data to support duplicate therapy and dose range checking for pediatric and adult patients
  • Data that allows users to generate patient-specific education handouts
    • Medication leaflets in 19 languages for both adults and pediatrics
    • Soon we will have available disease/condition/discharge instruction leaflets
  • Maintenance of active medication and allergy lists
  • Promotes interoperability with its ability to map to standardized vocabularies.

We offer a variety of delivery methods of the data which include: 

 
Web API Solution
  • Our Web API solution empowers integration of all Lexicomp content. Consistent API programming calls save time and allow clinicians to launch from their internal applications into our clinical databases, utilizing whatever delivery platform they choose.
Web Services
  • Our Web Services platform is written for compatibility with Microsoft® .NET™ and Java™ programs. XML data can be obtained via standardized calls and is then processed and returned in real-time. Your application will retrieve and parse the content into your display, making complete customization a reality.

XML Datasets

  • If live Internet calls are not preferred, XML datasets are available for download from an FTP site and incorporated directly into the database.

If you have any questions about Lexi-Data, please contact us!

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Lexi-Data, The Most Preferred Drug Database for EMR Vendors

Are you developing an EMR and trying to get to the market as quickly as possible?  Are you planning on going through Meaningful Use certification?  If you answered yes to either of these questions (or both!), here are a few tips to help you get started in selecting a drug database for your system.

1) Quality of Content - This is very important to consider as it is probably not the expertise of your developers.  Select a drug information vendor that has a strong reputation in the market and trusted clinical information. 

2) Flexibility - Select a vendor that offers flexibility and customization of the content.  For example, customization of drug interaction alerts in your system (your users will thank you!).  Also, consider the different delivery methods that the vendor offers of their content.

3) Simplicity of Data Structure - Select a vendor that offers simplistic data structure that you are comfortable with.  Also, consider the use of an API if it provided by the vendor.  The use of an already developed API will definitely decrease your development speed.

4) Customer Support - Ensure that you have a dedicated support team to assist you if your developers have questions.  A company that strives for excellence in customer service should not charge you for support time.

Lexicomp (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) works with hundreds of EMR and home healthcare companies to help them embed our clinical content into their systems.  We cover all areas of the core clinical decision support functions: drug-drug, drug-allergy, drug-condition, dose range checking, and duplicate therapy screening.  We support several components of Meaningful Use as well.   Lexi-Data is mapped to RXNORM and other standard vocabularies, supports CVX/MVX coding for transmission of immunization records, and contains patient education for medications and diseases.


Please feel free to contact us and one of our representatives would be happy to talk to you about our content and support.

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The best resources for pediatric drug reference data

A posting on the FDA website says, "Most drugs prescribed for children have not been tested for children." At times, only 20 percent of drugs prescribed for children had labeled indications for such uses. Instead, pediatricians often rely on independent studies that demonstrate the effectiveness of "off-label" uses to guide their prescribing.

Drug data that relies on packaged inserts is woefully inadequate!
What this means is that clinical decision support systems (like electronic health records) that include only FDA-approved labeled uses for medications are not helping clinicians prescribe to children and patients. Though more trials are being done with children, they remain expensive and difficult, and are rarely needed to bring a drug to market. There will always be a gap.

To fill that gap, EHR systems must go beyond FDA information and partner with a drug interactions database provider that knows and corrects these shortcomings. Lexicomp is one such drug information vendor. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

Over 30 years ago, pediatric drug references were one of Lexicomp's first offerings. They continue to focus on that area today, carefully combing and evaluating medical literature for effective off-label uses that should be reported alongside FDA-approved labeled uses. Lexicomp also provides pediatric-specific patient education, and even has special dosing for neonatal populations.

No other drug information resource can match Lexicomp's breadth and depth of information on pediatric prescribing!

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Are you e-prescribing yet?

Are you e-prescribing? Eligible professionals who do not become successful e-prescribers by the end of 2012 or successfully submit at least 10 eRx claims by June 30, 2013, will face a 2% penalty for charges submitted in 2014.
 
E-prescribing offers clinicians a powerful tool for safely and efficiently managing their patient's medications. Compared to paper-based prescribing, e-prescribing can enhance patient safety and medication compliance, and  improve prescribing accuracy and efficiency.  Lexicomp (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.) provides the  clinical decision support system (CDS) in order to provide checks for drug-drug, drug-food, drug-disease and drug-allergy interactions, which allows for the EMR to instantly alerts the heathcare professional when a possible problem is found. Lexicomp’s CDS also allows for the EMR to check for therapeutic duplications and atypical dosing requests, lists common drug side effects and provides images of the tablets for ease of reference.
 
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Lexicomp's Patient Education Integrated Into Your EMR

Lexicomp is a recognized leader in providing patient education leaflets that are easy for patients to read and understand. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)Our medication leaflets are trusted and used in over 1,600 hospitals across the country as well as the US Military Health Care System.  They are available in 19 languages in an easy question and answer format.  All leaflets are available in both an adult and a pediatric level, because there can be major differences in dosing, warnings, and possible adver drug events among these populations.  In efforts to assist EMRs and providers in improving patient care, our leaflets can be integrated into these systems and printed off for the patient at discharge.  This encourages patients to better understand their condition, treatment plan, and drug regimen.  

In order to help EMR vendors meet Meaningful Use requirements, we will be coding our disease leaflets to both ICD9/10 and SNOMED terms. Having standardized coding will make it easy to integrate these leaflets within EMRs.   We offer various delivery methods of the content.

If you have an EHR, EMR, HIS system, ePrescribing system, patient portal, or consumer website and are looking to integrate patient education, please contact us today.  

 

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Why do EHR vendors keep picking drug data sources that clinicians don't use?

EHR and EMR vendors have a handful of different sources to pick from when they are integrating medication reference and interactions data into their products. Clinicians have a similar choice to make when they select a drug reference to use on the job.

By and large, the data providers that sell to EHR vendors are different from those that sell to clinicians. This results in clinicians being confronted with inconsistent information. For instance, when their EHR gives them an alert on a possible adverse reaction, they may not be able to locate the same information when they turn to a reference resource.

This is a problem. It harms the credibility of the EHR system and may make clinicians less likely to use it.

There is a solution
Fortunately, there is Lexicomp -- a data provider that offers both transactional data for EMRs, and is also an industry leader in selling reference information directly to clinicians. Thousands of pharmacists, physicians, nurses, dentists, and others are using Lexicomp's drug and clinical information, patient education, interactions, dose range checking, allergy checking and more, every single day.

Clinicians choose Lexicomp because they trust our content. When you choose Lexicomp to power the electronic prescribing or clinical decision support of your EHR system, they will trust your application as well. Contact Lexicomp today to find out how to get their industry-leading drug information into your application. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

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Are you Electronic Prescribing?

Instead of writing out prescriptions on a piece of paper, doctors will perform this function directly into their electronic medical record.  The prescription travels from their computer to the pharmacy’s computer. Electronic prescriptions are sent electronically through a private, secure, and closed network – the Surescripts network.

 
Surescripts' e-prescribing services allow physicians to electronically send prescriptions from their offices to more than 54,000 retail pharmacies and six of the largest mail order pharmacies.  In addition, Surescripts provides physicians with electronic access to their patients' prescription benefit and medication history. 
 
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 database 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. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)
 
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Electronic Prescribing


ePrescribing
 

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 database 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. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

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Using Black Box Warnings to prevent adverse drug events.

Adverse Drug Events
 

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. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

 
In an effort to incorporate this valuable information into the clinician's busy workflow, Lexicomp has recently enhanced Lexi-Data 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. 

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Drug Interaction Checking Critical for EMRs


Adverse Drug Events

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 Lexi-Data can offer this solution. 

(Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

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/
 

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

Drug Nomenclature

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.

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Populating patient portals with drug and clinical data


Drug Information for Patients

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. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

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.

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EHRs can alleviate alert fatigue with new filtering options

Alert Fatigue

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. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

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.

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Finding clinical reference & drug interaction data for patient portals & websites

Drug Interaction Data

Consumers are increasingly taking an active role in their own healthcare -- a trend which can only result in better care. A key source of information for these patients are consumer-facing websites that include clinical and medication information. But those sites must of course get their information from somewhere.

Lexicomp is one such provider of information to consumer-facing medical websites. They specialize in best-in-class pharmaceutical information -- including indications, interactions (with other drugs, natural products, and more), possible allergies, dosing for adults and children, precautions and warnings, and more. Lexicomp also offers patient education leaflets in a variety of languages. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

What's more, Lexicomp supplies its information in a variety of formats, including access through convenient web services. Web services allows you to pull specific Lexicomp information into your website without the hassle of maintaining an on-site database. This solution requires less development and maintenance, and means that your users always have up-to-date information. It's a perfect solution for consumer-facing websites looking to expand their content offerings. Contact Lexicomp to learn more today.

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What are you doing about Electronic prescribing (eRx)?

ePrescribing

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 solution 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. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

We are committed to ensuring patient safety. 
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Clinicians look for pediatric dosing guidance from EMRs


Dosing in Pediatrics

Pediatric dosing continues to be a major concern among clinicians in almost all practice settings. In fact, those who do not regularly treat children often have the most questions about proper dosing and treatment. One area where EMR, EHR, and HIS systems can meaningfully differentiate themselves is in providing this information.

Physicians, pharmacists and nurses know that children are not simply "little adults". Besides different dosage precautions, children may require different administration or routes -- and for some cases may receive completely different medications. Different patient education leaflets are also needed when treating children.

For these reasons, it's important to partner with a drug information vendor that is well regarded in pediatrics. Lexicomp is the drug reference vendor of choice among U.S. pediatric hospitals, and has specialized in this area for decades. Most clinicians will see children as patients at some point in their work, and they know that this vulnerable population requires special care. Using Lexicomp as a drug vendor can help put their concerns to rest and add value to their EMR, EHR, or HIS system. 
(Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

 

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Interested in speeding up clinical decision making for physicians, nurses, and pharmacists without disrupting their workflow?

What agony when a clinician’s workflow is interrupted because they need to confirm clinical information such as a correct dose, REMS Information (Information about FDA approved Risk Evaluation and Mitigation Strategies is included in Medication Guide, REMS Components and Prescribing and Access Restriction fields),  or to find and print patient education materials. 


Our easy-to-implement Integration solutions integrate seamlessly within any hospital’s EMR, CPOE, pharmacy system, or Web portal, connecting clinicians directly Lexicomp’s trusted drug information. 
Lexicomp has integration established with many of the well know health care information system providers such as Cerner, Epic, Eclipsys, Meditech, Siemens and GE which provides one-click access to Lexicomp drug reference content such as drug monographs, patient education material which is available in 18 languages, pediatric dosing, and more. 
We have a number of options available for the integration of Lexicomp Online content which include web based URLs (APIs), Web Services, or XML Datasets. (Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

Web API Solution
  • Our Web API solution empowers integration of all Lexicomp content. Consistent API programming calls save time and allow clinicians to launch from their internal applications into our clinical databases, utilizing whatever delivery platform they choose.
Web Services
  • Our Web Services platform is written for compatibility with Microsoft® .NET™ and Java™ programs. XML data can be obtained via standardized calls and is then processed and returned in real-time. Your application will retrieve and parse the content into your display, making complete customization a reality.

XML Datasets

  • If live Internet calls are not preferred, XML datasets are available for download from an FTP site and incorporated directly into the database.
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Does your community pharmacy have the tools to check pediatric doses?

Having a sick child can be a challenging and stressful time for any parent.  A sick child also presents challenges for health care professionals as well as health information systems as it relates to prescribing medications.  For a number of medications, pediatric dosage calculations are based on weight.  Having a weight available in the community pharmacy setting is often challenging, however this is only the first step in being able to validate the correct dosage range.  The second piece necessary to accurately check the validity of a pediatric prescription is having the correct information in your pharmacy system. 

All too often, community pharmacy systems are not equipped with the necessary drug reference database to accurately evaluate a pediatric dose.  For over 15 years, pediatric practitioners have been using Lexicomp's Pediatric Dosage Handbook and more recently, our electronic versions to prescribe and validate pediatric dosing.  Now, this information has been transformed into a data set that can be integrated into pharmacy systems to allow your HIS to help you validate these critical doses.  For more information, visit http://www.lexi.com/businesses/ehr-vendors/(Note: The Lexicomp solution Lexi-Data referenced in this post has been replaced by newer Medi-Span solutions as of January 2013.)

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Even more EHR growth than expected!!

Back in January of this year, I wrote about the steady increase of Electronic Health Records/Electronic Medical Records with the market projected to be at $3.8 billion in 2015.  Now, according to this report, "The U.S. EMR market is expected to grow from $2,177 million in 2009 to $6,054 million in 2015."  This number is almost double!! 

 
 

What I said back in January continues to apply today, as it is still not too late to get your software certified with trusted drug data.  Don't wait until the end of your development process to worry about: medicine interactions, a drug reference database, pediatric dosing, dose ranges and more.  But it's not just about the information.  It's about who you select as your partner and who has seamless APIs to make your job easier.  


So leave the drug content to us and know you have made the right decision.
 

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