For the past two years, we have been using Lexi-Comp Online with AHFS as our drug information database. Prior to that time, we had used another database for a number of years. While it was a thorough database with a variety of valuable features, we found our staff’s limited utilization of those features did not justify the product’s overall cost. After a six-month evaluation of three vendors’ databases, we ultimately selected Lexi-Comp Online for its ease of use, the accuracy of its drug information, and its total cost. In addition, Lexi-Comp updates the online database nearly every day.
Our IT department provided Lexi-Comp with our intranet’s ISP (Internet service provider) addresses, allowing us to push the software out over a Citrix server and grant access on all of our hospital’s networked PCs within a short period of time. Even our off-campus behavioral health unit and cardio rehab center have access to the Lexi-Comp Online database. No user name or password is required to access the database; users simply click the Lexi-Comp icon on their PC desktop or use an intranet hyperlink to enter the database. Our contract with Lexi-Comp also included a number of PDA licenses. Our pharmacists now access a condensed version of Lexi-Comp Online from their Palm Pilots, Pocket PCs, and BlackBerry devices while working on the nursing units.
The program’s point-and-click technology is very intuitive; if you can navigate the Web, you can navigate the Lexi-Comp system. Most clinicians leave Lexi-Comp Online open on their desktops all day and, if a question comes up about a particular drug, they have a concise and complete answer in moments, without having to look for and leaf through a printed resource. This immediate access to information allows pharmacists to rapidly provide answers to clinicians’ questions, ensuring that appropriate care is given to our patients in a timely manner.
We have actively encouraged a variety of users throughout our system to utilize the drug information database. Our nurses appreciate the ease and efficiency with which they are able to find answers to basic questions about dosing and side effects, for example. Our emergency department utilizes the database for toxicology information and tablet and capsule identification. Off-site physicians can also access Lexi-Comp through online “portals,” where they can also view lab results, radiology reports, and other data from our hospital information system.
We have included our approved therapeutic interchanges in the Lexi-Comp database, and, having recently transitioned to an electronic formulary, are beginning to indicate whether items are on or off formulary in the database, as well. From their Lexi-Comp interface, clinicians will be able to readily see if a drug is on or off formulary and if an automatic interchange is available.
In the first year of using Lexi-Comp Online, we realized a savings of approximately $42,000 over our previous vendor’s subscription charges — funds that can be used to hire an additional FTE or purchase computer equipment or software. Later this year, we will discontinue our use of our previous vendor’s patient education tools and begin using Lexi-Comp’s PALS disease-specific patient information leaflets, which guide patients in continuing their treatments post-discharge. We estimate that change will allow us to realize an additional $15,000 in savings. Such an impact on the bottom line is simply too significant to turn down.
While cost is a major consideration for any hospital during the purchase of a drug information database subscription, there are other critical questions to answer: Who will use the database? What kind of information will they require? Will information be easy to access and understand for end users in various departments — not just the pharmacy? With this last question in mind, make sure your end users have the opportunity to weigh in on the drug information databases your facility considers under for purchase.
No one drug information database will be perfect in every scenario, thus the need for a drug information specialist or clinical coordinator to provide in-depth, detailed drug information to clinicians. However, for over 90% of our clinicians’ questions, Lexi-Comp Online fits the bill.
Stephen E. Melvin, PharmD, BCPS, is the pharmacy clinical coordinator for Bay Medical Center. A board-certified pharmacotherapy specialist, he has worked for Bay Medical Center for 15 years.
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