PDAs Help Pharmacists Deliver The Best Care, Anywhere

Author: Wendy K. Bodine, Assistant Editor

Pharmacists are busier than ever today, and they need to stay on top of the latest technological advances in order to keep up with increasing patient demands. One of these advances is the ability to track patients' medical information online from any location using personal digital assistants (PDAs). This capability is essential when dealing with high-risk patients, when medication changes may need to occur quickly at any time.

Thomson Healthcare (Greenwood Village, Colo) has set out to meet the needs of the modern pharmacist with innovative software solutions. William Lawson, MD, vice president of client solutions, discussed the benefits of working with Thomson Healthcare.

"The technologies and solutions that we provide to hospital pharmacies are just as valuable in the retail setting," Dr. Lawson said. "In the hospital, we provide detailed drug information, drug-interaction alerts and tools, patient-education information, mobile/PDA access to all our referential content, and even pill-identification tools."

"These same solutions are being introduced to the retail pharmacist? with the same goal of providing the best evidence-based clinical information at the point of care," he added. "The goal is to automate repetitive manual processes and free up the?pharmacist to be more of a hands-on clinician and less of a bookkeeper."

One of Thomson Healthcare's newest advances is the Medication Reconciliation Solution, a Web-based interface that simplifies the process of collecting and monitoring patients' medication lists from the time they are admitted until they are discharged. The system integrates data from local community pharmacies, insurance companies, and previous hospital visits to compile a comprehensive list of a patient's current medication profile.

At each stage of a patient's treatment, caregivers can choose to continue, discontinue, or modify the dosages of current medications or add other medications by way of a visual reconciliation process. When the patient is discharged, medication orders can be sent directly to the patient's home pharmacy and to his or her primary care provider.

The Medication Reconciliation Solution helps manage a patient's medication list through a number of features. The system keeps an electronic list of the patient's current home medications and automatically checks for allergies, duplications, interactions, and warnings when new medications are ordered. If a patient does not know the name of his or her medicine but can describe it, the system has a drug-identification tool that provides images, descriptions, and imprint codes to aid in establishing the identity of mystery drugs. The application is linked directly to comprehensive evidence-based drug information from Thomson Healthcare.

The Pharmacy Interventions Solution from Thomson Healthcare applies technology to allow the hospital pharmacist to automatically identify at-risk patients most in need of interventions and then puts all clinical data within the pharmacist's reach at the point of care. It provides the pharmacist with desktop and handheld access to up-to-date patient data (medications, demographics, laboratory results, and reports) and to clinical reference data. In addition, it offers a tracking tool for monitoring the progress and results of all the interventions initiated by the pharmacy.

The Formulary Advisor Solution eliminates the need to enter formulary updates manually. Everything is done online, so that the formulary manager can spend less time administering and communicating changes. The pharmacist on rounds can get online and handheld PDA access to the up-to-date formulary with links back into the DRUGDEX System (a Thomson Healthcare referential content product) for more detailed information. Pharmacists who use the Formulary Advisor show less time spent on administration and confirming which drugs are or are not on the formulary and, ultimately, more time spent with patients?resulting in better patient care.

Another company that is working to help pharmacists help their patients better is Lexi-Comp Inc. Based in Hudson, Ohio, the company was founded to create custom reference handbooks for clinical laboratories. It has since expanded its content base and technology solutions to provide real-time information at the point of care in knowledge areas that include pharmacology, interactions, diagnostic procedures and laboratory tests, pharmacogenomics, poisoning and toxicology, dentistry, infectious diseases, and patient education.

Information is delivered on a variety of electronic platforms. They include Lexi-Comp ON-LINE, ON-HAND, ONDESKTOP, and ON-WEB. All of these platforms can be integrated for hospitals and health systems through the Lexi-Comp Knowledge Solution.

"Lexi-Comp ON-LINE uniquely integrates industry-leading databases and enhanced searching technology to deliver time-sensitive clinical information at the point of care," said Daniel Krinsky, MS, RPh, Lexi-Comp's director of corporate training and development. "The interface eliminates the need to navigate through multiple pages or make unnecessary mouse clicks."

Lexi-Comp ON-LINE provides access to drug-information databases, an interactions- analysis application, patient advisory leaflets for drugs and disease states, a drug-identification program, a medical-calculations module, and many other features.

Lexi-Comp ON-HAND delivers very similar content to what is offered online, but through various mobile devices with Palm OS, Pocket PC, and BlackBerry operating systems.

The company's most comprehensive drug database is Lexi-Drugs, an easy-touse record of more than 1600 drug monographs supporting over 8000 US and Canadian medications. Its content addresses many patient populations and clinical specialties such as pharmacy, internal medicine, cardiology, oncology, psychiatry, and anesthesiology. The monographs provide up to 55 fields of information, among them adverse reactions, US and Canadian brand names, contraindications, dosing, special alerts (including new FDA warnings), medication- safety issues, pharmacodynamics/ kinetics, and brand names from >75 countries.

Another key database is Lexi- Interact, a tool for checking patient profiles for drug, food, herbal, and alcohol interactions. This program performs an analysis of a patient's entire drug and natural-product profile to identify potential interactions. Fully referenced and evidence-based, this application facilitates a patient-specific risk-to-benefit assessment. Analysis results offer a detailed overview of the interactions, with fields such as risk rating, patient management, class exceptions, discussion, and references.

Lexi-Comp ON-DESKTOP is a comprehensive collection of the company's medical-reference databases and integrated modules. Shipped to subscribers on a single CD-ROM for Microsoft Windows or Mac OS, ON-DESKTOP provides instant access to >70,000 pages of current clinical information in a concise and easy-to-read format. Users point and click to find answers regarding diagnosis, treatment, and other clinical decisions.

A subscription to ON-DESKTOP includes 1-click updates through the Internet during the subscription period. The benefit of this platform is that access does not require continuous Internet connectivity; users can download updates when connectivity is available. This is an ideal solution for consultant pharmacists and those who use a laptop with inconsistent Internet access.

Lexi-Comp provides daily updates to its drug monographs through continuous peer review that includes consultants and reviewers from client hospitals, 135 outside authors, and an onstaff team of pharmacists. The Knowledge and Academic Solutions are used at hundreds of institutions, and the ON-HAND software is utilized by thousands of clinicians throughout the world. Lexi-Comp also publishes a comprehensive handbook library of more than 40 reference titles, including the Drug Information Handbook, the Pediatric Dosage Handbook, and the Geriatric Dosage Handbook.

Both Thomson Healthcare and Lexi-Comp are dedicated to providing pharmacists with the newest software to help them stay abreast of all the medication requirements of their patients. With the aid of modern medicationinformation systems, pharmacists can keep up with their patients' needs as quickly as they arise.