The value of drug information software lies in the ease of access and depth of information it provides to clinicians throughout the hospital. Given the range of solutions available, when choosing a product, you often must decide between features, as functions and capabilities are not uniform. For example, a resource that excels at providing quick access to doses and a list of adverse effects may not simultaneously excel at providing in-depth mechanism-of-action information. As with any technological upgrade, it is important to compare your needs to the functions of the software to find the best match.
While determining the best software product is dependent on the specific needs of your institution, there are some basic features that always should be evaluated. For starters, the search feature should provide the data you are looking for quickly; be easy to navigate with intuitive steps; and present the data segmented into levels of sophistication. To determine the product’s accuracy, review the references used to support the data. While no resource is perfect, this will give you insight into the software’s reliability. Once you have identified vendors with reliable information, it is time to look at how the features compare.
In addition to drug monographs, consider systems that supply dosing calculators and comparative tables. Real-time data is available with some products, including information on discontinued drugs, links to patient assistance programs, and contact information for manufacturers. Information on look-alike/sound-alike products and investigational drugs can also be beneficial. We find the drug identifier feature to be particularly helpful; once the drug’s shape, color, and markings are entered into the system, you can use the pictures to identify the drug with confidence. This feature is particularly useful in ambulatory settings and when identifying a patient’s medications from home. Clinicians will appreciate the ability to incorporate an online formulary that immediately identifies a product’s formulary status. In addition, drug interaction resources should be able to screen large lists of drugs rapidly. Look for search features that are forgiving when it comes to spelling.
Your patient mix also will help drive your choice. For example, if you have a significant pediatric population, the sophistication of the calculators will be important, and poison centers will require a toxicology module with appropriate documentation. Consider your end users as well, whether you choose a resource with brief summaries or one with more detailed explanations depends on their preferences.
Of course, cost is also a consideration given the wide range of pricing attached to these products. While pricing is generally based on the bed size of the hospital, university-affiliated facilities may be able to share the cost with the university library.
Surveying clinicians is a good way to determine which features they value most. Ask them to rate the importance of available features such as type of information desired, index quality, drug identification tools, and ease of search processes. In addition, request that they submit common questions they would need answered by the solution.
To thoroughly assess the systems, task a multidisciplinary group to build familiarity with each product via the system tutorial and then have them compare how each product navigates through a few standard queries. The standard queries should address drug interactions, adverse effects, dosing options (including off-label), IV compatibility, and disease state data. The review group should then rate each product by accuracy of information, speed of access, and intuitiveness of the database for each query.
Involve the IT department early in the selection process as you will need their input to ensure proper system requirements are in place. Internet-based databases provide more universal access than those that must be downloaded from a CD-ROM, and some databases require a login with every access, while others can be set up by IP address to bypass this step. Facilities with (or that are considering) CPOE will want to ensure clinical information can be directly accessed within the CPOE system, as requiring clinicians to log into a second database to access the drug information data is not productive. Compatibility with handheld devices is another good option, as data can be accessed easily on rounds without pharmacists having to carry or find a computer.
Most drug information software solutions will provide multiple benefits to your operation, so the decision-making process should largely revolve around finding the functions that best fit your facility. The results from the multidisciplinary test group, the evaluation from IT of the integration process and accessibility considerations, and total cost for installation and support should provide a clear choice of the best vendor for your needs.
Erin R. Fox, PharmD, is the manager of the drug information service at the University of Utah Hospitals and Clinics in Salt Lake City, Utah. She has previously served as a clinical pharmacist. Erin received her PharmD at the University of Utah and completed a specialized residency in Drug Information at the University of Utah Hospitals and Clinics. Her areas of professional interest include drug information, drug shortage management, evidence-based medicine, and internal medicine.
Well-trained users will understand all of the features available with the software, including how to access more detailed content, thus precluding a blitz of calls to pharmacy requesting help. A good training program will help maximize the numbers of users accessing the system and ensure that they use it to its fullest capacity.
There is value to using multiple drug information systems simultaneously to provide redundancy. We use three different drug information systems. When all three resources agree, there is an added level of confidence in the data. In addition, we find many clinicians prefer different systems depending on the type of query they have. To ensure ease of use, our clinicians can access the databases either through CPOE, the drug information service, or the pharmacists’ homepage on our intranet and all three of our databases are linked at these points of access.
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