Lexicomp has now released the second phase of a comprehensive web services solution to EMR developers to access drug information. For those EMR and Practice Management systems that do not want to store drug information in their product, they now have an option. In the second phase, Lexicomp has released web services to include a proprietary Black Box warning decision tool to reduce alert overload. Phase II also include dose range checking (DRC) and 12 new searching tools.
For EMR developers that have need for any of the following drug nformation or tools in their product, Pediatric Dose Range Checking (Lexicomp is the leader in this area); Patient Education Materials; Drug Interaction Software; RxNorm Mapping; Medicine Lists, Generic Drugs; Dose Information; ePrescribing, and more--- they should call Lexicomp.
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!
In the last several years that have been more and more EMR entrants into the ambulatory marketplace. As part of the development of these products they have been required to include drug information as part of their clinical decision support solution. Lately there have been more requests to provide this drug and medicine information by way of web services calls rather than embedding the data directly into the product. Often times there might be limitations on the EMR's development team and accessing this drug information through web services call could be the simpler solution.
Lexicomp recently released web services calls for drug information that would cover Meaningful Use Stage 1. So for EMRs in the development stage looking for:
One of the key reasons that clinicians are frustrated with decision support related to drug interaction software is the potential for 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.
What do these words have in common? "Pediatric dosing information;Medicine lists; Medicine brand names; Drug-drug interaction; Drug-allergy interactions; Drug interaction database; ePrescribing; Patient education."
There are many EMR products under development, many targeting smaller hospitals and ambulatory facilities. There are also a number of other EMR and Practice Management products that are going through major product re-design. Many of these development groups need to confront the decision about what drug information supplier to use. As the title of this posting says "EMR developers are now searching for drug and disease information providers that are easy to work with" (Note: most are not). This might not sound like a tall order, but as it turns out, it is much more difficult than they think. It's about the data as much as it about the quality of the relationship as well as the flexibility and helpfulness of the vendor.
How much will they help in setting up the API's? Do they have a specific pediatric dose range checking product? Do they have patient education leaflets? Are they available in foreign languages?
There have been thousands of articles written discussing why EMR adoption rates have been so low and why physicians especially have been resistant to moving into the electronic age. Little return on the initial investment, lack of efficiency in the system and no improvements in patient outcomes have been listed as reasons for reduced adoption rates.
One key element to the lack of efficiency and little improvement in patient care is due to the number of alerts that are generated when trying to use these systems. As a pharmacist, I enter in hundreds of medication orders in a shift and it is rare that I do so without receiving an alert from my HIS telling me about a drug interaction or duplicate therapy. These alerts although technically accurate, often involve medicine interactions that are so minor or irrelevant to hospital medicine.
If an HIS truly wants to improve patient care and become an indispensable part of medicine, it must provideclinical decision supportthat can accurately and appropriately give clinicians therapeutic alerts that are relevant and can help improve patient care. That is the goal of Lexi-Data. For more information about Lexi-Data, check out www.lexi.com.
What do all of these have in common? Well for one thing, they are being driven in part by the demands of Meaningful Use requirements. Here is just one example of Meaningful Use effect. Some of the demands are actually in place, and many others roll out over the next few years. EPrescribing in Florida looks like it might be taking an interesting turn as free application provided by the State may be going away, or so I have heard. This recently posted ePrecribing blog described it in greater detail. And a second blog.
As Meaningful Use requirements have dictated more relevant application of medication and drug data within EMR and EHR systems, the awareness of the nuances of these databases has also gone up. Recognition of the following terms is becoming more commonplace: Drug Reference Database; Dosage Range, Dosing in Pediatrics, Drug Interaction List, Pediatric Dosage Calculator, Medicine Interaction. Clinical Decision Support Systems, Drug Content, and more.
As we attempt to incorporate more technology into medicine through the use of HIS, it brings to light the need for more than just a simple medication list. Health information systems are now being asked to help improve patient outcomes by performing other clinical decision support functions that go beyond a pick list. If we truly want to improve patient outcomes, it is important that our HIS provide relevant clinical guidance especially in a critical population such as pediatrics. Calculating pediatric doses is not always an easy task and having data in your HIS that can perform pediatric dosing calculations can be an invaluable tool in improving patient outcomes.
Lexicomp has a long standing reputation of providing this valuable and often difficult dosing information in the Pediatric Dosage Handbook. For over 20 years, we have been providing neonatal and pediatric dosing based on available literature and current clinical practice. More recently this information has been transformed into Lexi-Data's Pediatric Dosage Range Checking application. This content can be used within an HIS to provide guidance to your clinicians on appropriate dosing for this difficult and vulnerable population.
Matt Bennardo had a great post last week regarding a study which showed the connection between EHRs and their improvement on pediatric care.
With several pediatric calculators on the market, how can one tell which to trust? A reference book can be helpful, yet many other considerations should be taken into account. It is vital to screen drug interactions with the full medicine list of the child along with their maturation. Having all this information readily available with an EMR can vastly work to reduce errors. When dealing with pediatrics, especially neonatal patients, attention to detail and continually updated, unbiased information is best. Lexicomp has all the options to achieve improved safety for patients of any age.
These options include:
Pediatric Dosage Calculations in both transactional information for the clinical decision support systems and reference materials designed for clinicians.
Automated screening for drug allergy has been a less than satisfactory experience for most pharmacists. Alerts tend to be very broad, identifying all possible cross-reactivity for medicine list, and the data concerning the presence of an allergy are often records of intolerances rather than true allergy. In the era of electronic prescribing, an allergy alert may prompt a change in therapy, exposing the patient to a drug which may not have been the prescribers first choice. It is important that these alerts be based on quality history, a full understanding of these adverse drug events, and other types of idiosyncratic reactions which may be relayed by patients as "allergic" reactions. The quality of the data, and the sophistication of the alerts, will continue to be limitations to the automated screening, and challenge all healthcare providers.
Several weeks ago I wrote a blog posting that included a list of drug information considerations for EMR vendors that were launching new products or looking to improve their current products. As I wrote:
More and more EMR vendors and hospital EHR/HIS systems are attempting to improve their drug information to further enhance clinical decision support. Below are just a few areas where having the right medicine data can make all the difference in the world.
Drug Interaction Lists
Adverse Drug Event Alerts
Patient Education Pamphlets in 19 Languages
RxNorm Mapping
Pediatric Dosage Calculations
Drug Allergy Interactions
Clinical Guidelines
Drug Interaction Software
Drug - Drug Interactions
Drug - Allergy interactions
There are very few drug information providers in the marketplace that have both quality data and a top notch,customer-oriented support staff.Cerner/Multum and Lexicomp top the list.Lexicomp offers a unique blend of top quality information coupled with the finest internal support anywhere. Your IT guys will love you for going with Lexicomp -- a long-term partner in your road to success.
More and more EMR vendors and hospital EHR/HIS systems are attempting to improve their drug information to further enhance clinical decision support. Below are just a few areas where having the right medicine data can make all the difference in the world.
Drug Interaction Lists
Adverse Drug Event Alerts
Patient Education Pamphlets in 19 Languages
RxNorm Mapping
Pediatric Dosage Calculations
Drug Allergy Interactions
Clinical Guidelines
Drug Interaction Software
Drug - Drug Interactions
Drug - Allergy interactions
Lexicomp is a unique blend of top quality information coupled with the finest internal support anywhere. Your IT guys will love you for going with Lexicomp -- a long-term partner in your road to success.
You know the old line, "Just because I'm paranoid, doesn't mean they aren't after me." Well, the same holds true for my assessment of integrating drug data and medicine data into EMRs, EHRs, HISs, etc. I guess, I would say it like this, "Ok, I admit I'm biased, but that doesn't mean I am wrong." Biased about what? That Lexicomp, a recent arrival in the drug data marketplace, is growing fast based on its quality of data, quality of support, quality of data structure, and affordable pricing.
We are in a fast changing marketplace, which makes the advantages of Lexicomp even more pronounced. As I said several months ago in one of my posts:
"America is a great country. I wouldn't be surprised if there were more EMRs (and related systems) in development in the United States than the rest of the world combined. Cultural and marketplace paroxysms create stress and discomfort, and at the same time result in major breakthroughs and great new products. That is what is going on this country, day by day. The great scramble is on. There is much pressure to do things quickly and get to the market rapidly before the doors begin closing."
Does the drug information you're using provide only the bare-bones basics, or will they provide access to enhanced functionality like:
Drug Interaction Lists
Adverse Drug Event Alerts
Patient Education Pamphlets in 19 Languages
RxNorm Mapping
Pediatric Dosage Calculations
Drug Allergy Interactions
Clinical Guidelines
Lexicomp will work you and be a partner in your efforts for growth and success.
Over the past decade, the number of reports of adverse drug events has been on a dramatic rise. The FDA currently uses an Adverse Event Reporting System (AERS) which has seen a large increase on the number of reports coming in. In fact, researchers at the University of Maryland School of Pharmacy revealed in a new study of adverse events linked to medications─compiled by the FDA since 1969─that 55 percent have been reported to the agency in the past decade.
Drug makers are required by federal regulations to report possible health problems possibly linked to their products, but reporting by doctors, patients, and others is voluntary. New safety warnings and technology making reporting easier could play a part in this increase in reports, but there may be other contributing factors. With the current US populations aging, more and more people are taking multiple medications to treat multiple medical conditions. This has been most apparent when I have spoken with a few nursing home and assisted living facilities who have relayed that a number of their patients currently have a medicine list of over 10 medications and some are as high as 20. With all of these medication being taken together, it stands to reason that additional adverse drug events are reported.
There is drug information software available to help with checking medication lists for things like drug food interactions, drug-drug interactions, drug-allergy interactions, and drug-condition interactions that could potentially help reduce these adverse drug event reports. In fact, software like Lexi-Data from Lexicomp has been included in a number of applications including EMRs, EHRs, analytic tools, and ePrescribing solutions with the intent of screening in real time for adverse events while medication are being prescribed. Also, new patient education materials that are easily understood by the patient can help reduce things like drug-food interactions by informing the patient of the potential.
While software systems generally rely on case studies or published information to screen for adverse drugs events, the increase in the number of reports to the FDA will hopefully help to identify additional adverse drug events that have yet to be identified, leading to better outcomes for patients in the future.
Several weeks ago I pointed out that an EMR or EHR vendor (or inside hospital HIS development team) overlooks some critical factors in making choices about drug data suppliers. No doubt the quality of the drug data is important, but that is just the beginning. These developers should be equally, if not even more, concerned about what I would call "softer" factors. such as:
1) Structure of the data (how easy is it to map to and identify?)
2) Availability and simplicity of the APIs offered by the vendor
3) How responsive is the drug information provider during the development period (this will provide a major clue into how the long term relationship will work).
These might sound like simple things, but in the end, they are the most important things. Do your due diligence. Several years ago there were only a couple of drug data suppliers available. Now with the addition of the very well established drug information provider, Lexicomp, these development companies have a choice. Lexicomp has provided clinical decision support for three decades. It provides drug reference solutions to nearly 1500 hospitals in the United States, along with all divisions of the U.S. Military. The Vancouver study released last year, rated Lexicomp Online as the most preferred drug database.
If you are looking for drug information or medicine data, Lexicomp can help by providing a medication list that includes both generic, brand name, and over-the-counter drugs. By providing drug interaction screening including drug-drug, dose range checking, and duplicate therapy screening, Lexicomp can help EHR vendors meet a number of Meaningful Use requirements. The Lexi-Data product delivered by Lexicomp is also mapped to RXNORM and contains patient education which is another check box on the Meaningful Use requirements list.
Here are some of the qualifications that drug reference and drug interaction data must meet to qualify:
-- Must allow for specific clinical decision support functions, including drug-drug and drug-allergy interaction checking
-- Must have consumer-facing patient education materials
-- Must be compliant with the RxNorm (a medication list maintained by the National Library of Medicine)
-- Must include comprehensive reference information for the US including drug generic name, drug brand name, drug classifications, and eventually clinical dosage guidelines for calculating pediatric and adult doses
When looking for drug information that meets all these requirement, pick one that will partner with you to meet your needs, whether they be speed to market, budgetary, or customer service.
This is what one of Lexicomp's satisfied customers has to say:
"We spent months researching and investigating the competition. Lexi-Comp business partnering and licensing division gave us the tools we needed to test it in our application to assure our clinicians that we had a reliable and trustworthy source. Their responsiveness to inquiries and requests sold us on a solid partnership we could count on."
For too long, there were few choices of drug information providers for EMR, EHR and HIS vendors. It's not only a question of the quality of the drug and medicine information provided, but even more so it is an issue of the:
1) Structure of the data (how easy is it to map to and identify?)
2) Availability and simplicity of the APIs offered by the vendor
3) How responsive is the drug information provider during the development period (this will provide a major clue into how the long term relationship will work).
These might sound like simple things, but in the end, they are the most important things. Do your due diligence. Check around.
Lexicomp provides drug reference solutions to more than 1500 hospitals in the United States, along with all divisions of the U.S. Military. The Vancouver study released last year, rated Lexicomp Online as the most preferred drug database.
If you are looking for drug information or medicine data, Lexicomp can help by providing a medication list that includes both generic, brand name, and over-the-counter drugs. By providing drug interaction screening including drug-drug, dose range checking, and duplicate therapy screening, Lexicomp can help EHR vendors meet a number of Meaningful Use requirements. The Lexi-Data product delivered by Lexicomp is also mapped to RXNORM and contains patient education which is another check box on the Meaningful Use requirements list.
The HITECH Act (commonly known as "Meaningful Use") has some specific requirements for drug reference and drug interaction data which can be used to qualify for incentive money. There aren't many vendors that can provide such specific information, so it's important to shop around to every available seller. Lexicomp and Multum are two vendors that offer qualifying data.
Here are some of the qualifications that drug reference and drug interaction data must meet: -- Must allow for specific clinical decision support functions, including drug-drug and drug-allergy interaction checking -- Must have consumer-facing patient education materials -- Must be compliant with the RxNorm (a medication list maintained by the National Library of Medicine) -- Must include comprehensive reference information for the US including drug generic name, drug brand name, drug classifications, and eventually clinical dosage guidelines for calculating pediatric and adult doses
Both Lexicomp and Multum meet all of these criteria and more. Shopping around to different vendors may give you options that better fit your budget, development environment, support needs, or timeline. But always be sure to ask vendors if their information has been used yet by any EMR, EHR, or HIS vendors who have certified for Meaningful Use under the HITECH Act.
Haven't heard of Brantley Whittington, CEO of the EHR firm Extormity? Then perhaps you've been living under an HIT rock for the past several months. Not to worry, he's made a big splash at HIMSS11 this year and the legend will only continue to grow.
Early Tuesday, at HIMSS11 Extormity, whose tagline is "Expensive, Exasperating, and Exhausting", announced the launch of their newest solution, Manacle: the Shackled Patient Portal. Said Whittington, "If you like tethered portals, you're going to love being shackled."
According to a press release regarding their data security protocols, "Extormity is now storing patient records in the last place anyone would think to look – old 8-track tapes," Whittington explained. "Every night, we download medical data from our servers onto recycled REO Speedwagon, Styx and Chuck Mangione 8-tracks, and we store them in a rusted Trans-Am with T-tops parked in our back parking lot."
Extormity is obviously a fake entity, but they make light of some of the very real pains felt by providers: prohibitive EMR costs, systems that alter workflow, and general turmoil.
In light of all the pains faced by providers trying to implement an EMR or EHR system, isn't it nice to know that there's a REAL company out there offering a REAL product that performs as designed: smoothly, efficiently, and easily? Lexicomp's content integrates seamlessly into various systems offering medicine lists, dosage precautions, pediatric dosage calculations, drug classifications, drug interaction lists, and more.
Take a few minutes to learn more, we promise it will be worth your while. If not, perhaps Manacle is the tool you're seeking after all.
According to a recent article from American Medical News, "Total EMR spending, which is expected to grow from $1.9 billion in 2009 to $3.8 billion by 2015, is about twice the growth rate analysts are seeing over the health information technology market and the general IT market, said Judy Hanover, research director of provider IT strategies for the Framingham, Mass.-based market research company and co-author of the report."
What is the best way to ensure more clients? Make your EMR the most efficient and best value for them. There are lots of things to consider when building an EMR, but drug information adds value no matter what. Drug information is the foundation upon which safe decisions are made; decisions that involve pediatric dosages, drug classifications, drug and medicine interactions, and medicine lists.
If you happen to be in Orlando next week, be sure to stop by booth #6653 to learn more about a great drug database provider.
Haven't heard of Brantley Whittington, CEO of the EHR firm Extormity? Then perhaps you've been living under an HIT rock for the past several months. Not to worry, he's made a big splash at HIMSS11 this year and the legend will only continue to grow.
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