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 these (HealthInfoRx) 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 Inc.).

 

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 choice.

 

The following reference databases are part of the "complete" software package: (hypertext links are included in order to review additional information)

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.

— Lexi-Drugs Platinum

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 the PDA.

The 4 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 countries
• The comprehensive plus specialty field includes the most complete source of drug information available from Lexi-Comp.
  

• 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 area.

• A pediatric drug dosing reference
  

• 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, and dosing.

• 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 agents

• Detailed patient management suggestions
• Discussion of published reports and potential mechanisms
• 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 used herbs
  

• 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 list. 2. "Back Arrow" - returns you to the Index 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 Books Menu 5. "Topic Link" - provides linking to another database

 

• 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 text.
• Is indexed to Main, Medication and ICD-9 CM categories.

• 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 databases
• It is indexed into categories of Main, Antimicrobial Therapy, diagnostic tests and Syndromes & Organisms

• Is a reference for clinical lab and diagnostic information
• 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 word index
• 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).

• 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

Lexi-Complete Palm OS ... Lexi-Complete Pocket PC ... All Products from Lexi-Comp