Frequently Asked Questions
Drug identifiers for all new Multum products are now present
here.
An
explanation of the drug update process may help your process.
These instructions apply to Windows 2000, Windows 2003, and Windows XP.
Each
month, Multum distributes a "Drug Update" CD, which contains the
cumulative clinical data for all of Multum's services (Allergy, Interactions,
etc.) The clinical content for each of the services (except Patient
Education Leaflets) is stored in a series of object oriented database files that
are marked with a ".dat" file extension.
When
the drug update "setup" program (usually found in the root directory
of the CD) is run, it first checks to see if the latest Multum server patch is
installed. If the patch is not
installed, the user is prompted with a warning message.
(Note: The drug update cannot be applied without the latest patch, which
is also included on every drug update CD.)
After the user installs the patch, the drug update setup program can be
re-run. The transfer of the new
clinical content from the CD to the server machine is completed by the setup
program, but the server's transition to the use of the new files must be done
manually (by a person).
Once
the database files are written to the server machine by the drug update setup
program, someone must manually run the Multum Service Monitor program, and
instruct the Multum servers to use the new data.
Because the data contained in the database files is tightly coupled, all
of the database files must go into use at the same time (all or nothing); i.e.,
the namedb.dat version "38" file cannot be used with the xrefdb.dat
version "37" file. The
process of insuring that all of the data is used (or none of the data is used)
is coordinated by the Multum Service Monitor and Multum Service Manager
programs.
To
apply the new data files to the Multum servers, the Multum Service Monitor
program is run, the "machine name" (shown in the tree control) is
right-clicked, and the "Update Servers" menu item is selected from the
popup menu. Clicking "Update
Servers" sends a message to the Multum Service Manager, and begins the
process of switching database versions.
The Multum Service Manager "tells" each of the Multum servers
that it should validate the new database files.
Each server individually attempts to re-initialize itself with the new
data, and reports the result back to the Multum service manager.
If all of the Multum servers report that the data is valid, the Multum
Service Manager "tells" each server to commit, which results in the
servers use of the new data for all future API calls.
Herbal and nutraceutical products are included in our database. Complete allergy, interaction, and therapeutic duplication information is
available for all products. In addition, the most commonly used products
have patient education leaflets.
Here is a quick test you can do from the client PC to the server to check that
interactions is working.
Go
to the Multum directory. In the [version] directory, go to the exec folder.
Double click on intdriver executable.
click okay (the host name does not have to be entered so leave this
blank). Load Generic Drug Name Drug
List.
Choose
acetaminophen and warfarin (set one as index and add the other as concomitant
medication)
You
should receive the interaction information.
Leaflets
are available for about 60% of the generic drug names in our database. This 60%
covers all drugs that are normally prescribed and/or dispensed to outpatients.
The drugs that do not have leaflets include drugs that are usually used only in
an inpatient setting (such as gentamicin injection or vincristine), drugs that
are obsolete (such as paraldehyde), and most drugs that do not require as
prescription (such as Nyquil). Some commonly used over the counter drugs, like
aspirin or acetaminophen do have patient information because they are commonly
prescribed and dispensed in a pharmacy. The leaflet is meant to give patients a
guide to taking their medication at home.
These
drugs cross all therapeutic categories and there is no pattern for their
distribution across categories, just that the drug is currently prescribed to
outpatients.
Our
selection of patient leaflets is used by one of the largest mail order
pharmacies in the United States, who feel that the available content covers
>99% of the drugs they dispense. We are happy to consider suggestions for
additions to our leaflets and will add it to our offerings if the drug is
found to be a candidate for this process.
This
can be checked by looking in the registry path: "[HKEY_LOCAL_MACHINE\SOFTWARE\MULTUM\SERVICE\[version]]".
There should be a string value that says "Patch03", and the patch
application date.
To
run the Multum Service Monitor on a remote machine, you will need two files: (1)
ServiceMonitorControl.ocx and (2) ServiceMonitor.exe.
Once
the files are copied to the remote machine, the OCX will need to be registered
with Regsvr32.exe.
The SDK’s hardware requirements are dependent on a number of
factors. Some of these include the
number of concurrent client users in the environment, the number of calls made
to the SDK server
components during peak load, and the nature of the calls made by your software
to the SDK servers.
For stand-alone systems (single user environment where the client and server
components run on a
single physical machine), the minimum hardware recommendations are:
• 500 MHz CPU
• 512 MB RAM
• 1 GB HD
For multi-user environments of up to 500 concurrent users (client-machines), the
minimum hardware
recommendations are:
• 1+ GHz CPU
• 1 GB RAM
• 1 GB HD
For multi-user environments of up to 2500 concurrent users (client-machines),
the minimum hardware
recommendations are:
• 3+ GHz CPU
• 2 GB RAM
• 1 GB HD
Please note that these are minimum system requirements. Heavy load testing shows
that the greatest
benefit in throughput for the SDK is achieved by (1) the addition of physical
memory, and (2) increased
CPU speed in that order.
For larger-scale installations, multiple physical machines positioned behind a
load-balancing device may
be appropriate.
Multum has created a
comprehensive suite of clinical information concerning dose range checking.
Multum’s dose range checking service provides a tool to help reduce adverse
drug events by preventing unsafe medication orders. Dose range check analyzes a
medication order to determine whether the order exceeds the single or daily high
dose, is below the single or daily low dose, or exceeds the recommended
treatment period. These ranges can be based on patient age, weight, or body
surface area, and renal function, or liver function.
Dose Range Check reviews:
1. High, Low, or maximum daily dose
2. High, Low or maximum single dose
3. Dosing Frequency
4. Maximum life-time dose
5. Renal impairment dosage adjustments
6. Liver impairment dosage adjustments
7. Pediatric dosage ranges
8. Normal adult dosage ranges
9. Geriatric dosage ranges
Patient-specific data allows Multum’s dose range checker
to provide a more tailored dose range check for the patient. If patient-specific
data is unavailable, dose range check provides a range based on a normal adult.
A dosage comment can be displayed
indicating that:
1. This order is OK to be given to the
patient with this condition
2. This order should not be given to the
patient with this condition
3. This order should not be given in
this dosage form to the patient with this condition.
| 
