see also MedDiscussion

RxNorm, VA Class work

main tickets are #1048, #1246

We build i2b2 hierarchy connections (black arrows) based on information from Epic clarity and RxNorm (blue/purple arrows, where purple signifies alternatives; i.e. either gcn_seqno or ndc code).

Earlier (Nov 2011) Notes

A useful source is Epic Training companions for Clarity Summer 2009 CLR209 Inpatient chapter 6 and CLR205 Ambulatory Chapter 6.

On Epic userweb, another thing that may be useful is searching reports for shared clarity reports.

 https://sites.epic.com/searchcenter/Pages/default.aspx

These reports require a crystal reports and you can download a 30 day trial at SAP

 http://crystalreports.com/

Attaching some sample reports which are kinda cryptic to figure out how to tease out the SQL.

Now with 1.6 we can exploit the modifier_cd column in observation fact. Need to think about which kinds of modifiers we want to use.

Classic examples from Harvard:

• Dose
• Route
• Frequency

Consider adding the following

• Total Dose Ordered (for the encounter)
• Total Dose Administered (for the encounter)
• Average Daily Dose Ordered(for the encounter)
• Average Daily Dose Administered(for the encounter)
• Type of Medication
  • Normal Order
  • Pharmacy Dispense
  • Inpatient or possibly Clinic administration
  • Infusion adjustment (bonus points for some linkage from medication order to the flowsheet)
  • Home medication (historical med?)
  • Outpatient prescription
  • dispense fill record from external pharmacy (PBM SureScripts?.)
  • discharge medications
  • the closest version to this in clarity is the ORDER_CLASS_C which can be
• Parent Medication order for a dispense
• Parent Medication for an administration
• PRN
  • PRN order given
• potential to couple home med to normal order if explicit in Epic for going from home med to continuation during hospitalization or ED visit
• potential to couple normal order to discharge medication list if explicit in Epic