In the last two years Lexicomp has quickly become a major provider of drug information to EMR companies for clinical decision support. Many of the new EMRs hitting the market are using Lexicomp medicine information for drug interactions, dose range checking, therapeutic dosages, adverse drug advents, electonic eprescring, and more. Lexi-Data has become the popular choice based on top quality information, unparalleled customer service, state-of-the-art data structure and top-notch APIs. Now something new!!
Lexi-Data has introduced a new structure which allows for the customization of Black Boxed Warning to reduce alert fatigue, yet at the same time delivers the warning to the person who needs it most. This information structure is new and as far as we know not available elsewhere.
API and Database Features:
Incorporates not only the BBW as published within the package insert, but also pulls contextual or supporting information as written by Lexicomp clinical experts
Each summary is broken down and tagged as separate messages / instructions
Each message is paired to a recipient user category – this allow for differentiating where in the workflow of an EMR the message may be displayed
Can be filtered for a more specific and targeted set of messages to clinician/recipient groups, as defined for their site
This is terrific stuff. So for anyone developing drug interaction software or eprescribing modules, this is something you will want to look into.
Adverse drug events may be dose-related or idiosyncratic. Dose related events can be avoided by observing dosage precautions such as adjustment for age, organ impairment, or concurrent drug therapy (drug interactions). However, even at a therapeutic dosage, some events may occur which are unpredictable, such as allergic reactions.
In the electronic prescribing era, drug allergy can be the subject of over-alerting, as some records of allergy represent intolerance (such as an upset stomach) as opposed to a true immunologic event. Inaccurate representation of allergy may lead to selection of an alternative (and potentially less efficacious) therapy.
It is important to document the nature of a reaction which has been reported by a patient, and to analyze this information with respect to potential for recurrence and cross-reactivity among agents. Until records are capable of differentiating reactions of concern from those which are less severe the ability to screen for drug allergy will continue to be less than optimal.
Several institutions, as well as drug data vendors, have constructed dose range checking content. In many cases, the institutions have learned that this can be a difficult process to complete and maintain. Reliance on a drug reference book such as the Pediatric Dosage Handbook to create these data technically is outside of the terms of use, and leaves open the issue of maintenance and timely modification as new information appears in the literature.
Without a valid model to identify, acquire, evaluate, and publish. Dosage precautions which are not actively supported by this type of surveillance typically fall out of date rather rapidly. Pediatric dose calculations can be limited, and therapeutic dosages which are supported in the literature may be identified as outside the range. This type of over-alerting is a source of frustration. Lexicomp has worked with its partners to transform the content of the Handbook into a database with associated APIs to execute dose range checking for pediatrics. In addition, these data are actively modified in conjunction with the normal process of maintaining this publication. In this way, the user can integrate dose range checking simply, with the assurance that the data are continuously updated and expanded.
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. One thing the developing EMR company should not worry about is their selection for a provider of drug and medicine information.
There are only a few suppliers available. The EMR companies should decide based on which company will be the easiest to work with to facilitate the data integration, with appropriate support, APIs, and quality data. Check into Multum (part of Cerner) and Lexicomp.
These companies are experienced and respected in providing dosage precautions, pediatric dosing information, drug interaction software, clinical guidelines, Meaningful Use information, therapeutic dosages, drug-drug interaction, drug-allergy interaction and more. Make sure you make the right choice. You have other more important things to worry about.
According to iHealthBeat, "a coalition of 25 interested consumer groups said that ONC should resist pressure from health care providers to scale back requirements (Health Data Management, 2/28).
The consumer groups and unions expressed support for several issues, including:
Transitioning all "optional" criteria in Stage 1 to "required" criteria in Stage 2;
Advancing key criteria that have an impact on quality and safety, such as electronic prescribing and medication reconciliation;
Improving collection of advance directives (CMIO, 2/28); and
Providing patients with online access to their health data, as well as secure messaging capabilities."
It is unclear how much will be required if government dollars dry up. But regardless, medical institutions and vendors need to keep pushing forward. It will be too difficult to turn the spigot on and off. This theme kept coming through at HIMSS.
Specifically in the areas of EHRs, EMRs, HIS', ePrescribing and more, they need to keep moving forward in their efforts to include drug-drug interaction, drug-allergy interaction, therapeutic dosages, medicine interactions, dosage administration, dosage precautions, medication brand names and generic names, pediatric dosage calculations, and eprescribing. Regardless of what the specific requirements will look like 12 months from now, there is no doubt that these changes will improve patient outcomes. Whether you go to Lexicomp or to Multum, find a vendor that will be your solution partner to help you through minefields. APIs are rarely just plug and play. Having the right partner will make a big difference.
I am in Orlando at HIMSS. It is a huge show with many lectures, many exhibitors and 30,000 people. It takes 8 minutes to walk from one end of the hall to the other. The main special exhibit for the show is centered around interoperability. There is progress being made in this area, but one area that remains difficult, and will prove more difficult and elusive over time, is to provide interoperability regarding drug database information, drug-drug interactions, drug-allergy interactions, dose administration, therapeutic dosages. This will become a major win when it is finally accomplished.
Drug databases often have application programing interface tools that can alert a user to maximum or minimum dosages on a given medication. What can be even more valuable is the functionality to provide medication dosage precautions at the time of order entry and or the time of medication administration. There is much debate as to whether electronic medical records or drug database APIs should provide dosing ranges or actual expert dosing.
While expert dosing may be a desired tool, one must be cautious in evaluating the system behind such a tool as it will only be as accurate and sophisticated as its logic allows. Criteria that should be considered for either expert dosing or dose range checking includes renal and hepatic functionality of the patient, as well as the typical height, weight, age and sometimes sex.
Alerts that may result from the dose range checking of an order may contain more that the typical therapeutic dosage information, but may also contain some actionable medication dosage precautions. Does the drug require lab testing previous to administration or during it's use? Would the drug be better absorbed if the patient takes it with meals? Planning to include this type of information during the build of the EMR, and subsequently baking it into the maintenance process of adding new drugs, is essential.
My colleague, Matt Bennardo, recently wrote a blog about discovering alternatives to the traditional providers of drug information data for EMRs and EHRs. He suggested that HIMSS this year will offer some choices to customers who are desperately looking beyond their few limited choices of the past.
Lexicomp showed last year at HIMSS and started getting the attention of many EMR companies. Throughout the course of 2010 this translated into many new customers and strong partnership relationships.
As Matt wrote:
"More EMRs are calling Lexi-Data their “preferred choice” every month Many of our customers have told us that they’ve made the switch because they found Lexi-Data delivered:
Better quality information with faster updates and fewer mistakes
A more clinically relevant focus that their end users valued
Easier implementation and more powerful functionality
Superior customer service
Unique content not available elsewhere, like Lexicomp’s industry-leading Pediatric Dose Range Checking
Lexicomp will be exhibiting at HIMSS 2011 in Orlando, Florida, from February 21 - 23. Stop by for a visit at Booth #6653 and learn more about the choices you have in drug information databases!"
So if you are looking for dosage administration, drug brand and generic names, therapeutic dosage information, medicine lists,or pediatric dosing information for EMRs, Emergency Room EMRs, EHRs and HIS systems, stop by the booth to learn more.
According to the Government Health IT, as of January 6 there have been 4,000 healthcare providers that have registered for the EHR incentive program. Also, according to the Centers for Medicare and Medicaid Services spokesman, Joseph Kuchler, “We expect that number will continue to increase daily.” With as many as 4,000 already started the registration process and more to follow, there are lots of opportunities to gain business. What will make your EHR stand out from the crowd?
Healthcare providers that need a complete EHR are looking for drug data that will enhance and improve patient safety. What better drug information than from a trusted company that's been developing content for over 30 years? Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp will also provide the service and support to allow you to move quickly in the fast paced environment.
Recently, I posted the blog below and since then, it seems the scramble to gain Meaningful Use dollars through ePrescribing is on. The first reimbursements for this MU compliance occurred this week for medicaid reimbursement. EMR companies that are quickly trying to get certified by early 2011. ePrescribing and Meaningful Use are the mantras of the day, and one area that should not be overlooked is the inclusion of selecting the right drug data and working with the right drug information supplier.
"Quoting a colleague of mine: 'A recent article by HealthData Management summarizes that, 'The new law mandates use of electronic prescribing by Jan. 1, 2011. Prescribers and dispensers must use either the Health Level Seven messaging standards or the National Council for Prescription Drug Programs’ SCRIPT standard to transmit prescriptions and prescription-related information. The law does not mandate use of electronic health records. But to ensure EHR systems are interoperable, they must be CCHIT-certified. Further, the EHRs must meet the e-prescribing provisions of the law.'
Looks like ePrescribing will become a widespread reality within 2 years. There will likely be some business opportunities for some small companies to fill in the gap between ePrescribing as part of robust EMR systems and those that just need a tool to facilitate ePrescribing, without integration into their system.
As more companies look for opportunity in the business "seams," they will need to work with a drug database company to close the loop. And if they want to do it quickly and work with a vendor who serves as a partner, and not just a supplier, more and more are turning to Lexicomp.
Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp will also provide the service and support to allow the vendor to move quickly. With this quickly changing marketplace, working with a drug interaction software company to facilitate the product launch is imperative. If you are looking for a stand alone online ePrescribing application, I would strongly suggest taking a look at DoseSpot. They have a great product."
ePrescribing is gaining momentum. Partly this is due to more hospitals, doctors and dentists aiming to be compliant. In several states, this is happening because of state mandates.
There will likely be some business opportunities for some small companies to fill in the gap between ePrescribing as part of robust EMR systems and those that just need a tool to facilitate ePrescribing, without integration into their system.
There is a mad scramble by companies and start-ups to fill this compliant gap as soon as possible. Whether they know it or not, they will need to work with a drug database company to secure compliance. And if they want to do it quickly and work with a vendor who serves as a partner, and not just a supplier, more and more are turning to Lexicomp. Lexicomp is becoming a force in the delivery of drug data for those firms that are now (or will become) involved in the ePrescribing sector.
Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp also takes the time to work with their customers to resolve situations in a timely way.
EMRs should work with a drug interaction software company early in the process to avoid any late surprises in the certification process.
Also, if you are looking for a stand alone online ePrescribing application, I would strongly suggest taking a look at DoseSpot. They have a great product.
The medication generic name is only one way to specify a therapeutic dosage. If a compound is available in multiple dosage forms a particular generic name may have a number of specific dosage ranges. For example, an extended release product which is dosed once daily may have a very different dosage range than its immediate-release counterpart. At the very least the acceptable frequency of administration is very different. Differences in bioavailability between products as well as salt forms may need to be addressed through separate dosage ranges. The drug brand name unfortunately is also not a simple relationship to the generic drug. For example, a brand name can be applied to an ophthalmic product and a systemic tablet. Additional differentiators (such as route) would need to be included in any review prior to dose administration.
Last week I posted the blog below and I've sensed that it has resonated with the marketplace -- particularly EMR companies that are quickly trying to get certified by late 2010 or early 2011. ePrescribing and Meaningful Use are the mantras of the day, and one area that should not be overlooked is the inclusion of selecting the right drug data and working with the right drug information supplier.
"Quoting a colleague of mine: 'A recent article by HealthData Management summarizes that, 'The new law mandates use of electronic prescribing by Jan. 1, 2011. Prescribers and dispensers must use either the Health Level Seven messaging standards or the National Council for Prescription Drug Programs’ SCRIPT standard to transmit prescriptions and prescription-related information. The law does not mandate use of electronic health records. But to ensure EHR systems are interoperable, they must be CCHIT-certified. Further, the EHRs must meet the e-prescribing provisions of the law.'
Looks like ePrescribing will become a widespread reality within 2 years. There will likely be some business opportunities for some small companies to fill in the gap between ePrescribing as part of robust EMR systems and those that just need a tool to facilitate ePrescribing, without integration into their system.
As more companies look for opportunity in the business "seams," they will need to work with a drug database company to close the loop. And if they want to do it quickly and work with a vendor who serves as a partner, and not just a supplier, more and more are turning to Lexicomp.
Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp will also provide the service and support to allow the vendor to move quickly. With this quickly changing marketplace, working with a drug interaction software company to facilitate the product launch is imperative. If you are looking for a stand alone online ePrescribing application, I would strongly suggest taking a look at DoseSpot. They have a great product."
Quoting a colleague of mine: "A recent article by HealthData Management summarizes that, 'The new law mandates use of electronic prescribing by Jan. 1, 2011. Prescribers and dispensers must use either the Health Level Seven messaging standards or the National Council for Prescription Drug Programs’ SCRIPT standard to transmit prescriptions and prescription-related information. The law does not mandate use of electronic health records. But to ensure EHR systems are interoperable, they must be CCHIT-certified. Further, the EHRs must meet the e-prescribing provisions of the law.'"
Looks like ePrescribing will become a widespread reality within 2 years. There will likely be some business opportunities for some small companies to fill in the gap between ePrescribing as part of robust EMR systems and those that just need a tool to facilitate ePrescribing, without integration into their system.
As more companies look for opportunity in the business "seams," they will need to work with a drug database company to close the loop. And if they want to do it quickly and work with a vendor who serves as a partner, and not just a supplier, more and more are turning to Lexicomp.
Not only will Lexicomp provide all the basic drug data information such as: drug interactions; drug-allergy interactions, therapeutic dosages, drug classifications, dosage administration, pediatric drug information, and more; but Lexicomp will also provide the service and support to allow the vendor to move quickly. With this quickly changing marketplace, working with a drug interaction software company to facilitate the product launch is imperative. If you are looking for a stand alone online ePrescribing application, I would strongly suggest taking a look at DoseSpot. They have a great product.
The number of physicians utilizing eprescribing as their main method for writing prescriptions is increasing. Why? First, because it is more efficient. Second, government mandates will soon require that eprescribing be used to maximize reimbursement. So how many people are using eprescribing?
According to Surescripts, operator of a national eprescribing network, more than 200,000 office-based prescribers in the United States now use electronic prescribing technology. As part of these eprescribing applications, the practitioner is expecting robust drug information to be included. Issues of drug interactions, therapeutic dosages, drug nomenclature, pediatric dosing charts, pediatric dose calculations, medication brand names, duplicate drug therapy and more, are all part of the information that practitioners are looking for when they use an eprescribing tool.
If you are a physician, you should be checking into EMR alternatives the allow for eprescribing. When the mad scramble to comply starts in a year or two, you don't want to be in the fray. Not only that, there will be incentives for those early adopters.
Check out Lexi-Comp or Cerner/Multum as possible providers.
As the push for meaningful use continues, more and more clinicians of different backgrounds (physicians, nurse practitioners, pharmacists, etc.) will be using electronic systems to document patient care, write medication orders and make critical therapy decisions. Using electronic systems can hopefully improve patient care and outcomes through highly relevant clinical decision support tools such as drug interaction screening, dosage range checking, allergy screening and other safety alerts. The reality is that these tools must be able to not only provide meaningful and relevant alerts, but should also provide clinicians with the ability to further research the area of concern with trusted reference content. Too many times a clinical warning message that is displayed in an HIS system does not provide enough context to the user to make better therapeutic decisions.
As HIS system vendors navigate their way through the certification maze, it will be important to not settle for inferior clinical reference data to augment these systems. Those millions of clinical alerts that fire everyday are only as good as the information behind them.
More and more EMRs are scrambling around to secure drug data to include their product. Some of the EMR vendors are looking to do this after they have received certification and some are doing this as part of their certification process. One area that they might be overlooking involves the APIs (and the concomitant support provided) that the drug data vendor provides. Many EMR developers decide they want to do this in-house. Some decide they want to do this to save money, while others decide to do this because their IT staff wants to own the entire process. But there is a problem with this. Even if they are IT experts, they are not experts in the management of this drug data.
Whether their EMR product includes drug-drug or drug-allergy interactions, pediatric dosing charts, medication or generic brand names, therapeutic dosages drug classifications, medicine lists, dosage administration, duplicate therapy, clinical guidelines, or more; the EMR vendor does usually have the internal experience and expertise to manage this information.
You are better off working with your vendor, whether it be Lexi-Comp, DoseSpot, or Cerner/Multum and relying on the APIs they offer. It will be faster, less error-prone, eat up fewer resources and keep more folks in the organization happy.
What will hospital information and practice management systems look like in 2014? Will it be a radical shift, "encouraged" by government requirements? Or will the government have to retrench a bit from their demands because of the difficulties - both financial and developmental - that smaller hospitals will encounter? Hard to say, but there is a great deal at stake - including money, disruption, lost time, turning off patients etc.
EMR and EHR developers, hospitals and group practices have a lot on their plates. One area that tends to be an afterthought is the integration of drug information into the various systems. Many of these systems need drug data to generate medicine interactions, dose administration, pediatric dose calculations, therapeutic dosages, drug classifications and drug lists. There are only few providers of this information. The key is to select the provider who will provide the greatest support in integrating this data into your system. One that will help from assisting in clinical guidelines to eprescribing to drug nomenclature.
To convert raw data into a system that will like a drug interaction database for clinical decision support, means you need to look beyond just the data. You need to discern who will be the easiest vendor to work with and will hand hold if necessary. Sometimes going with the biggest provider is the best, other times, when customer support is critical to a successful implementation, it is best look to look long term.
The number of physicians utilizing eprescribing as their main method for writing prescriptions is increasing. Why? First, because it is more efficient. Second, government mandates will soon require that eprescribing be used to maximize reimbursement. So how many people are using eprescribing?
According to Surescripts, operator of a national e-prescribing network, more than 200,000 office-based prescribers in the United States now use electronic prescribing technology. As part of these eprescribing applications, the practitioner is expecting robust drug information to be included. Issues of drug interactions, therapeutic dosages, drug nomenclature, pediatric dosing charts, pediatric dose calculations, medication brand names, duplicate drug therapy and more, are all part of the information that practitioners are looking for when they use an eprescribing tool.
Are you developing an EMR or EHR and need to make sure you have a top source of drug information? There are actually just a few providers of this information, including Lexi-Comp and Cerner/Multum. Make sure you don't wait to the end of your development process to decide which provider you are going with.
It's no secret that achieving meaningful use, per government guidelines, can feel about as elusive as finding Moby Dick. Wading through the pages of certification guidelines can seem like a never-ending battle, but it's not impossible. You've got partners all along the way to assist you and Lexi-Comp is here to help.
With both the Drummond Group and CCHIT releasing their first groups of Stage One approvals this week, the certification race has officially begun. And while getting certified may not be the hardest part of the development process, it's certainly one of the most important.
Part of the certification requires that an EHR system include information on drug interactions, therapeutic dosages, drug nomenclature, pediatric dosing charts, pediatric dose calculations, medication brand names, duplicate drug therapy and more. Don't take a chance on the drug product information that's powering your system, ensure that you're using the most comprehensive and easily integrated data available: Lexi-Data.
Powered by Compendium