By Shelly Morvay, PharmD

COLUMBUS CHILDREN’S HOSPITAL IS A FREE-STANDING PEDIATRIC AND Level 1 trauma center located in Columbus, Ohio. In 2003, we researched potential medical and clinical information providers and chose LexiComp, Inc. because of its top-rated content, customization tools, and ability to meet the needs of our health care providers and patients. The company’s online formulary capabilities, print formulary publishing, online databases, and other value-added features help us ensure medication safety and improve patient care throughout our facility.

When choosing a resource provider, it was a priority for us to have our formulary information available online where pharmacists, physicians, nurses, and other health care workers could have easy access from any workstation in the hospital. Lexi-Comp made this possible through its FormuLink Online system. With this program, our administrator can update the formulary regularly, so we can assure the most up-to-date information is available at the point-of-care. Through LexiComp, the hospital formulary is also available on our handhelds, which is extremely useful when counseling patients.

Along with the implementation of our electronic formulary, we have also maintained a system that has worked well for us over the years: Our pharmacy department continues to receive printed formulary handbooks, Lexi-Comp’s Pediatric Dosage Handbook, Drug Information Handbook, and other LexiComp titles that are helpful as quick desk references.

We also have access to Lexi-Comp Online—a suite of 14 databases that include Pediatric Lexi-Drugs (of particular interest to us) and the adult Lexi-Drugs. Lexi-Comp updates these databases daily, so our health care providers have the most current information available. Like our formulary, Lexi-Comp Online is available on our hospital’s Intranet, allowing us to access the program from any computer system and through various handheld platforms. Lexi-Comp’s comprehensive databases make it easy for our pharmacists to verify pediatric use and dosage indications, and it is most often used during the physician-order verification process or when a physician calls upon a pharmacist to recommend a dose.

Lexi-Comp Online is very intuitive and user-friendly. Beyond dosing verification, other features of this online library help us meet our medication safety goals. In addition to identifying potential look-alike/soundalike issues using the Medication Safety Field, the databases offer vital information on contraindications, drug reactions and interactions, and overall patient safety. We particularly like LexiInteract, an application that allows the user to analyze a patient profile for potential interactions. We simply enter a list of drugs prescribed to a patient and the Lexi-Comp program cross-references any combination to determine if there is potential for a drug-to-drug, drug-to-natural product, or food-todrug interaction. The program then rates the interactions using a severity scale and offers recommendations for patient management.

Lexi-Drug ID, another great value-added benefit of Lexi-Comp Online, assists us in identifying medications based on imprint, color, dosage form, and shape through color photographs of actual tablets and capsules. This is an excellent safety check during the fill process should a pharmacist need to visually verify a drug.
The Lexi-PALS and Pedi-PALS patient-advisory leaflets are also useful tools for our clinicians. They can be accessed through the drug monographs within Lexi-Comp Online, printed, and then given to the patient or the patient’s family to take home and use as a reference. These leaflets are particularly helpful in working with patients for whom English is not their first language, as they can be printed in 18 different languages.

Finally, Lexi-Comp Online provides us with a means to track caregiver usage of the program. It shows us statistics on how often each of its different databases and features are being utilized, and we have noted that over time, usage has steadily increased. Our staff members are becoming more and more comfortable with this resource and are increasingly realizing its value in patient care.

For the past five years, Shelly Morvay, PharmD, has served as the clinical coordinator for medication safety in the pharmacy department of Columbus Children’s Hospital in Ohio. She received both a BS in pharmacy and a PharmD degree from the Ohio State University.