As more clinicians begin using EMRs and EHRs in more settings, alert fatigue is becoming a bigger and bigger issue. Many clinicians expect their EMR system to be smarter, and not to bombard them with alerts that they consider unimportant or irrelevant.
But an EMR's alert filtering is only as good as the data behind the system. And most data is woefully inadequate for this job because it's one-dimensional. Often, the only filter that EMR developers can apply is based on an alert's "severity". But severity is not the whole story.
Why severity alone isn't enough
Some drug interactions may have severe results, but be very uncommon. Others may be common but very mild. Filtering on severity alone is likely to leave clinicians with a frustrating partial view of the real risks of prescribing a medication to their patients.
Luckily, Lexicomp has three-dimensional filters:
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Severity -- How severe is this interaction?
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Risk -- How likely is this interaction?
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Reliability -- How much evidence is there for this interaction in literature?
Taking all these dimensions together means that your EMR can finally start to be smart in the way that clinicians expect it to be. These qualities are what cinicians think about when they assess whether an interaction or adverse reaction is one they want to look at more closely.
Contact Lexicomp today to learn more about the different dimensions of filtering that are available on interactions, and how they can help you alleviate alert fatigue for your users.
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 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, supports Surescripts Certification, Drug Classifications, dose range checking (adult and pediatric),
Patient Education, and more.
By now it is not a surprise, more and more EMR and EHR business owners and general managers are turning to Lexicomp to solve their drug information needs. In a few short years, Lexicomp has been the fastest growing provider of drug information to the EMR market. This didn't happen by accident. It came as a result of Lexicomp's three-legged trifecta approach to providing drug information to EMR and EHR developers -- of any size!
What are three aspects?
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Top quality data
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Elegant data structure with easy to use API's
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The best customer and development support you can find anywhere. (It makes your work so much easier)
In addition to supplying the expected information such as drug-drug and drug-allergy interactions, adverse drug events, RxNorm mapping, generic drug lists, drug nomenclature, and more. Lexi-Data also offers an incredibly easy to use data structure and APIs! Although, perhaps more importantly, Lexicomp is unparalleled in its customer service and providing assistance in the development process. If you are developing a new EMR and need a drug information supplier, make sure that Lexi is on your list.
And if you are thinking about building your own ePrescribing module, I call your attention to a posting my colleague Matt Bennardo published last week:
As EHR vendors find their products growing and signing up more users, many start to think about moving from using a third-party eprescribing solution to building their own. The reasons for making this switch are many:
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As your user base grows, eprescribing fees grow too
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Bring features in-house makes it easier to respond to specific customer needs
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A third-party solution is a risk, as you never can be sure what will happen in the market
One of the first steps in building your own eprescriber is to find a data provider who can supply you with medication lists and other information that Surescripts requires to certify your tool. Lexicomp is one such provider. They've been focused on providing drug data direct to clinicians for over thirty years, but now they can also supply you with database-ready information to power an eprescriber.
Lexicomp's customers have used their data to certify EMRs and EHRs with ONC testing bodies like Drummond, CCHIT, and Infogard. Their customers have also certified eprescribers using Lexicomp data with Surescripts. And best of all, Lexicomp's flexible pricing and easy implementation allows firms of all sizes to get up and running smoothly and quickly.
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.
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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
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RxNorm Mapping - we promote interoperability through mapping to industry standard RxNorm
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Drug Reference Data - integrate drug reference information, such as drug images and black box warnings, into your system
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Patient Education - 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)
Contact Lexicomp today for more information!
How to reduce "alert fatigue' and at the same provide the system framework to improve outcomes? That is the question that most system developers have been struggling with for over a decade. It is difficult enough for a large hospital wide EMR to achieve this goal. How much more difficult for ambulatory EMRs?
In the last few years, Lexicomp has become a major provider of drug information used by ambulatory and smaller hospital EMRs. As part of Lexi's entry into this market, they have now included a unique aspect of their drug-drug interaction rating system, which defnitely could help in improving "alert fatigue." My colleage, Mark Dachille recently said the following about "alert fatigue:"
"Another aspect that can prove beneficial is what types of alerts you choose to show users. Lexicomp has recently rolled out another aspect of drug-drug interaction within it's Lexi-Data product called risk rating. By utilizing risk rating along with the more commonly known drug interaction severity, more impactful and actionable alerts can be provided to clinicians which will ultimately improve patient care and reduce alert fatigue for clinicians.
Whether you are building a complete EMR, ePrescribing application, or mobile medical app utilizing drug interaction software, proper integration of the data is the key. Taking the time and utilizing the right product that is easy to integrate and provides meaningful alerts will ultimately lead to product you can be proud of."
In speaking with a number of EMR developers and in reviewing many products which integrate clinical decision support utilizing commercial drug database, a few things have become apparent. One of the the biggest challenges is to integrating clinical decision support for functions like drug-drug, drug-allergy, drug condition interaction checking in a meaningful way that is not disruptive to a clinicians workflow. Many times just throwing alerts at clinicians can lead to alert fatigue and eventually alerts will be ignored. In my experience, having a clinical resource to help with development will pay big dividends in the end.
Another aspect that can prove beneficial is what types of alerts you choose to show users. Lexicomp has recently rolled out another aspect of drug-drug interaction within it's Lexi-Data product called risk rating. By utilizing risk rating along with the more commonly known drug interaction severity, more impactful and actionable alerts can be provided to clinicians which will ultimately improve patient care and reduce alert fatigue for clinicians.
Whether you are building a complete EMR, ePrescribing application, or mobile medical app utilizing drug interaction software, proper integration of the data is the key. Taking the time and utilizing the right product that is easy to integrate and provides meaningful alerts will ultimately lead to product you can be proud of.
Are you heavily involved in making the critical decisions for EMR development and the need to include the best drug information, along with the best vendor support?
Several weeks ago I wrote:
Are you the owner or manager of an ambulatory EMR company? What keeps you up late at night? Worried about getting your product to the market as quickly as possible and keeping your costs under control? Worried about certification? No doubt you have some thoughts about reducing medical errors by including the best drug information and internal built-in logic. More and more EMR and EHR business owners and general managers are turning to Lexicomp to solve their drug information needs.
In a few short years, Lexicomp has been the fastest growing provider of drug information to the EMR market. As I said in a previous post:
In addition to supplying the expected information such as drug-drug and drug-allergy interactions, adverse drug events, RxNorm mapping, generic drug lists, drug nomenclature, and more. Lexi-Data offers an incredibly easy to use data structure and API's and most importantly, Lexicomp is unparalleled in its customer service and providing assistance in the development process. If you are developing a new EMR and need a drug information supplier, make sure that Lexi is on your list.
And if you are thinking about building your own ePrescribing module, I call your attention to a posting my colleague Matt Bennardo published last week:
As EHR vendors find their products growing and signing up more users, many start to think about moving from using a third-party eprescribing solution to building their own. The reasons for making this switch are many:
-
As your user base grows, eprescribing fees grow too
-
Bring features in-house makes it easier to respond to specific customer needs
-
A third-party solution is a risk, as you never can be sure what will happen in the market
One of the first steps in building your own eprescriber is to find a data provider who can supply you with medication lists and other information that Surescripts requires to certify your tool. Lexicomp is one such provider. They've been focused on providing drug data direct to clinicians for over thirty years, but now they can also supply you with database-ready information to power an eprescriber.
Lexicomp's customers have used their data to certify EMRs and EHRs with ONC testing bodies like Drummond, CCHIT, and Infogard. Their customers have also certified eprescribers using Lexicomp data with Surescripts. And best of all, Lexicomp's flexible pricing and easy implementation allows firms of all sizes to get up and running smoothly and quickly.
Contact Lexicomp using the links on this page today for more information.
Why I am repeating a headline from last week and some similar content? Because it seems to resonate with those folks who are making the critical decisions on their EMR development and their need to include the best drug information, along with the best vendor support.
As I wrote:
Are you the owner or manager of an ambulatory EMR company? What keeps you up late at night? Worried about getting your product to the market as quickly as possible and keeping your costs under control? Worried about certification? No doubt you have some thoughts about reducing medical errors by including the best drug information and internal built-in logic. More and more EMR and EHR business owners and general managers are turning to Lexicomp to solve their drug information needs.
In a few short years, Lexicomp has been the fastest growing provider of drug information to the EMR market. As I said in a previous post:
In addition to supplying the expected information such as drug-drug and drug-allergy interactions, adverse drug events, RxNorm mapping, generic drug lists, drug nomenclature, and more. Lexi-Data offers an incredibly easy to use data structure and API's and most importantly, Lexicomp is unparalleled in its customer service and providing assistance in the development process. If you are developing a new EMR and need a drug information supplier, make sure that Lexi is on your list.
Some of my colleagues have asked me to re-post my blog from last week. So I will do so.
Are you the owner or manager of an ambulatory EMR company? What keeps you up late at night? Worried about getting your product to the market as quickly as possible and keeping your costs under control? Worried about certification? No doubt you have some thoughts about reducing medical errors by including the best drug information and internal built in logic. More and more EMR and EHR business owners and general managers are turning to Lexicomp to solve their drug information needs.
In a few short years, Lexicomp has been the fastest growing provider of drug information to the EMR market. As I said in a previous post:
" In addition to supplying the expected information such as drug-drug and drug-allergy interactions, adverse drug events, RxNorm mapping, generic drug lists, drug nomenclature, and more. Lexi-Data offers an incredibly easy to use data structure and API's and most importantly, Lexicomp is unparalleled in its customer service and providing assistance in the development process. If you are developing a new EMR and need a drug information supplier, make sure that Lexi is on your list.
Are you the owner or manager of an ambulatory EMR company? What keeps you up late at night? Worried about getting your product to the market as quickly as possible and keeping your costs under control? Worried about certification? No doubt you have some thoughts about reducing medical errors by including the best
drug information and internal built in logic. More and more EMR and EHR business owners and general managers are turning to Lexicomp to solve their drug information needs.
In a few short years, Lexicomp has been the fastest growing provider of drug information to the EMR market. As I said in a previous post:
" In addition to supplying the expected information such as drug-drug and drug-allergy interactions, adverse drug events, RxNorm mapping, generic drug lists, drug nomenclature, and more. Lexi-Data offers an incredibly easy to use data structure and API's and most importantly, Lexicomp is unparalleled in its customer service and providing assistance in the development process. If you are developing a new EMR and need a drug information supplier, make sure that Lexi is on your list."
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 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, supports Surescripts Certification, Drug Classifications, dose range checking (adult and pediatric), Patient Education, and more.
As EMRs and EHRs incorporate more and more functions, they are going to be giving more advice and warnings to their users. A very real concern among many developers of health informatics systems is "alert fatigue" -- the idea that too many irrelevant alerts will annoy users. And worse, that a flood of useless alerts will cause users to ignore all alerts and warnings, rendering the system's automated checks pointless.
The only way to limit alert fatigue is to be more intelligent about when alerts are shown, and to whom. The key problem is not "too many alerts" -- it's "too many
irrelevant alerts". There are two strategies that can help with this.
1. Allow users to customize their own alertsEach user of your system likely has their own login which is theirs alone. This means that savvy EHR vendors can make it possible for clinicians to customize their own alerts. When an alert is shown, they can select whether they want to see the alert again -- in effect, controlling the information they see by telling the system not to show them alerts they consider irrelevant.
2. Intelligently manage alerts by types of users and circumstancesAnother strategy is for the system to do some of this work ahead of time. If an alert applies only to administration, the system would know to show the alert to the prescribing doctor or the compounding pharmacist -- but instead only to the administering nurse. Likewise, if an alert applies only to pregnant women, the system would know not to show it if the patient in question is a man. This strategy relies on knowing things about your users (e.g., what kind of cilnician they are) and the circumstances of the encounter to anticipate which alerts may be irrelevant.
The most successful EMRs will likely use a combination of both approaches. But the second strategy can help alleviate alert fatigue immediately -- your users don't have to manage their own preferences to see the benefits. However, it also relies on detailed drug interaction databases able to finely slice alerts for you. Lexicomp is one medication information vendor that is innovating in this arena, and creating complex filters for many of its alerts and warnings.
Lexicomp's
drug interaction database has grown by leaps and bounds over the past few years. Now used by hundreds of EMR, EHR, HIS and other healthcare vendors, it is the information behind medication reference and clinical decision support for tens of thousands of physicians.
What makes Lexicomp the preferred choice?
- Easier implementation when compared to other data sources
- Superior customer service for all customers, regardless of size
- Full support of Meaningful Use Stage 1 clinical decision support requirements
- New innovative features like patient education in multiple languages
- Flexible delivery, including robust APIs and web services
More and more healthcare information vendors are discovering that Lexicomp can save them development time, making the road to certification and market faster and smoother. Find out today if Lexicomp can do the same for you!
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.
In an effort to incorporate this valuable information into the clinician's busy workflow, Lexcomp has recently enhanced their Lexi-Data product 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.
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 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.
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/
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.
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.
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.
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