By: John Ginn, MD.
John graduated from Memorial
University Medical program in 1988. He has 15 years
of experience in general practice, emergency medicine,
OR assisting and health informatics. Currently he has
narrowed down his clinical work to the OR and spends
a majority of his time working in Health related computer
technologies. He resides in Halifax where he has an
appointment at Dalhousie
Universities' Faculty of Medicine Health Informatics
Division. He has authored or co-authored several
ongoing research projects at Dalhousie and other Canadian
Universities relating to Health Informatics. One of
is designed as a Web Portal for Physicians and Chronic
Disease Patients. He is also co-founder of a US based
health related software company (SalveoSystems
Having graduated Medical school during the 80's and recalling
the days of the book laden lab coat, I welcomed with much enthusiasm
the recently ushered in era of PDA digitally laden reference "texts".
I remember compiling my "little black book" (not the
dating one, although one could easily do that with your PDA) of
concise drug referenced information that I accumulated from mentors,
teachers, experience or from various texts. I would use the pocket
sized ring binder to categorize the information to keep at my
fingertips. It was a frightfully time consuming action that required
constant updating and limited me from the more important tasks
such as the usual things people expect (eating, sleep and the
like). I recall some industrious individuals who would have extra
pockets sewn into their lab coats in order to increase the book
to jacket ratio.
Reviewing the Lexi-Complete
offered me a glimpse back to that time and an opportunity to consider
the difference this newer era of digital reference material can
offer clerks, interns, residents, practicing physicians and nurses.
|When Lexi-Complete is installed,
it falls under two application icons - the "Interact"
icon launches Lexi-Interact (drug and herbal interactions)
while the "Lexi-Comp" icon launches all other database
applications. Interact is a drug interaction checker designed
to be used in concert with LexiDrugs to alert you to potential
drug interactions. While operating within the Lexi-Complete
set of databases there is a capability of linking between
all installed Lexi databases on your PDA. This enables you
to seamlessly jump between the databases to logically follow
queries pertaining to the topic of choice. Also, for those
of us that accumulate unique personal notes about drugs or
other topics there is a built in User Notes section that allows
you to write your own notes about individual drugs or topics
of interest. This gets linked to the topic or drug of your
The following reference databases are part of the "complete"
software package: (hypertext links are included in order to review
The "Drugs" Section:
The Lexi-Comp drug databases are possibly the most up-to-date
PDA reference in terms of current drugs available. These deal
primarily with drugs but are so well integrated with the other
databases that they appear seamless. From the main index area
(located at the upper right section of the screen) you can choose
from three index categories; Main, Pharmacological and Special
Alerts. With frequent online updates the Special Alert area
is quite valuable to practicing physicians. I believe that these
features make Lexi-Drugs the most attractive for those who need
a reference for daily clinical use; however, some experts feel
it may be less ideal for students, who are in the process of acquiring
knowledge on drug use and action. For instance, the Pharmacological
index is very thorough and extensive in categorizing the drugs
available. For the student first learning these categories, it
may be almost too extensive thereby making it less user friendly.
Is a drug reference database that actually contains
several databases. You are encouraged on the Lexi-Comp website
to choose one of these four to install. I decided to throw caution
to the wind and install all of these so I could troubleshoot the
disastrous events I was warned of. Actually, there were no problems
and no real benefits to installing all. I eventually kept the
Comprehensive plus specialty and the International versions on
different options to download and install include. (BTW, Canadian
medications are included!)
The essential installation provides the most
frequently used fields of information and is intended for users
who need to save a little space on their PDA.
The comprehensive installation provides more
detailed information for each drug monograph.
· This option also has an optional International version
download containing an International Brand Name Index from 58
The comprehensive plus specialty field includes
the most complete source of drug information available from
I decided to randomly search several medication concerns and
drugs in order to test the database. Unfortunately, there were
omissions for some and difficulty locating others. For example;
Despite Canadian alerts from Health Canada,
I was unable to locate Diane-35 within the listing for Acne
Medications, special alerts or Contraceptives. This drug has
received much airplay recently in Canada due to the usage more
as an OCP than a severe acne drug despite Health Canada's warning
of avoiding usage for OCP. It is an internationally prescribed
drug but was not located within the databases provided.
Also locating Accutane as an Acne drug was difficult.
It was not listed under Acne products, where I expected to find
it, but after some searching I did find it in the special alerts
Is based upon Lexi-Comp's Drug Information
Handbook for Dentistry, which covers over 6800 drug products.
Each monograph has 20 fields of information and gives detailed
information that is specific to dentistry such as: Local Anesthetic/Vasoconstrictor
Precautions, Effects on Dental Treatment, and Drug Interactions.
From my past experience as an ER physician there
were occasions when working in rural areas that I had to understand
issues of dental importance. There may have been occasions when
I could have used this database.
I was interested to see that acne products were
covered under the dental category but there was no Special
Alert categorization for the dental drugs.
Is designed specifically for registered professional
nurses and upper-division nursing students requiring a complete
reference for administration, monitoring, patient education,
It includes a wide variety of the most common
natural products, as well as over-the-counter products and foods
This database covers over 175 of the most commonly
used natural products in 6 different categories - including
herbs, vitamins, minerals, nutraceuticals, glandulars, and amino
acids. Up to 15 key fields of information are provided, including
Dosage and Standardization, Reported Uses, Active Forms, Plant
Part, Pharmacology, General Warnings, and References.
With the rapid rise of individual's interest
in alternative and natural therapies it is no wonder that this
category is included within the Lexi-Complete series. This is
a valuable and quick tool for physicians to have available.
There are so many potential interactions and uses for this category
of "medications" that it would be fool hardy to dismiss
or ignore it.
Is a quick drug reference for health care workers
dealing with ingestions and poisonings.
I especially like the ability to index items
listing special alerts
Contains over 1,400 medicinal, non-medicinal,
biological, diagnostic tests/procedures, antidotal, and herbal
Is one of two main application icons in Lexi-Complete and includes;
Detailed patient management suggestions
Discussion of published reports and potential
Full reference citations
Identifies the greatest number of potential
interactions compared to any other available references
Over 3000 brand names
Includes interactions data on the most commonly
It allows the user to select various medications, analyze their
potential interactions and review these interactions according
to three rating schemes (these ratings allow you to quickly appreciate
how to respond to the potential interactions);
Reliability Rating: Indicating the quantity
and nature of documentation for an interaction.
Risk Rating: Indicating the type of action
to be taken in response to the data.
· A - No known interaction
· B - No action needed
· C - Monitor therapy
· D - Consider therapy modification
· X - Avoid combination
Severity Rating: Indicating the reported
or possible magnitude of an interaction outcome.
The Medical Text Reference section:
The integration features of the Lexi-Comp software are quite
useful for practical application of the digital format of information
to health related practice. For instance, within the Griffith's
database the following navigation tools allow you to "jump"
to appropriate information in other databases that are pertinent
to the current topic:
1. "Jump" - displays the drop down field
list and includes a dynamic jump feature that moves the
8 fields you access most frequently to the top of the
2. "Back Arrow" - returns you to the
3. "H" - provides a history of the topics
viewed in the Lexi-Comp Reader
4. "Title Bar" - activates the menu option
allowing to add/edit a note or return to the Installed
5. "Topic Link" - provides linking to
Is a popular medical reference database for
students and practicing clinicians.
It provides comprehensive and concise information
on over a thousand topics under the data fields of Basics, Diagnosis,
Treatment, Medications, Follow up and Miscellaneous.
This text was ideal to use in PDA format due
to the editing features of the original paper based version.
To facilitate quick, easy information retrieval each author
in charge of chapter content wrote to the same overall general
outline which emphasized lists and a design avoiding lengthy
Is indexed to Main, Medication and ICD-9 CM
Is designed for healthcare professionals involved
in the diagnosis and treatment of patients with infectious diseases
This portion of the reference combines Diseases
Syndromes, Organisms, Diagnostic Tests, and Antimicrobial Therapy
into one database with the ability to cross reference to other
It is indexed into categories of Main, Antimicrobial
Therapy, diagnostic tests and Syndromes & Organisms
Is a reference for clinical lab and diagnostic
Has two index displays: the main screen and
the keyword screen
It contains over 1200 laboratory tests, internal
medicine, and diagnostic radiology procedures all listed alphabetically
Each test contains up to 32 fields of information
and is easily accessed through either an alphabetical or key
This is probably my favourite database among
the Lexi-Comp series. It combines two reference texts (The
Laboratory Test Handbook, and Diagnostic Procedures Handbook).
By choosing a diagnostic category all the pertinent tests associated
with that category is listed alphabetically.
Is indexed in the following 4 screens; abbreviations
(alphabetical), definitions, drugs and extras.
The extras consist of dangerous abbreviations,
lab test panels and suggestions, additions & corrections
(this is just an address to send your ideas for additional suggestions
to someone else).
Since the purchase of the complete package involves an annual
subscription to updates, any updates or database(s) added to the
Lexi-Comp On-Hand Library during your annual subscription are
included as part of your original subscription costs.
These types of suite reference programs have high storage requirements
therefore you must have additional expansion capabilities to use
them. I tested this Lexi-Comp Palm OS version of the program on
Clié PEG-T665C with a 64Mb memory stick. The two prc
application files (Interact and Lexi-Comp) are installed on the
handheld internal memory while all the pdb databases are stored
on the memory stick. There were very short lag times accessing
card data but no major problems with usage in this format. I missed
the presence of a medical calculator here that would integrate
with dosaging within the program. This would have been a convenience
but again posed no major problems.
The $225.00 USD price is a hefty cost to students. For most licensed
health practitioners the burden is eased since this would be a
tax deductible cost. For students considering purchasing this
product, don't forget to save the receipt and claim it on your
first year's taxes when you complete your studies. The convenience
to the student of maintaining a lower jacket to book ratio and
skipping the extra sewn on pockets (or else using them for snacks
and beverages) is substantial. Less stuff to carry and more reference
information at your fingertips when you need it.
The only strong negative I would have for this package is the
registration-licensing process of the software. After doing such
a fine job on integrating the databases for practical use it is
a shame that the ID process is so tedious and time consuming.
After downloading the applications and databases and installing
each of these on the PDA/memory stick you have to obtain and then
key in a different registration code/key for each installed database.
I see how this could benefit the company but for anyone purchasing
the suite of programs there should be an easy one step option
to load and register the suite on one PDA. I would have found
it a nice benefit to have easy integration and access to a medical/drug
dosage calculator from within the program.*
System Requirements Include:
Palm OS 3.0 or higher
25Mb free space for the PC
Works on Handspring expansion cards, Sony Memory
Sticks and Palm Cards!
Internet download required
John can be reach by email
* EDITORS NOTE: Lexi-Comp will be implementing a
streamlined registration process and adding a medical calculator
in future editions of this application