...
Include the route in the drug name (ie. oral, IV, IM, topical,inhalation drug, etc). In the example of ISONIAZID 100 mg TAB, the drug route would be oral, so it should be Isoniqzid 100 mg tablet (oral).
Representation of Drugs
Roger believes that there is a fair level agreement that there are four levels of granularity in the classification of drugs for EMR purposes. Level 1 (most general) is a category (e.g. Pain Medication, HIV Anti-retrovirals) which is used to narrow the universe of drugs. Level 2 is the active ingredient(s) which the drug contains, which is what the doctor is trying to specify for the patient. Level 3 is level 2 plus strength (the amount or concentration of each active ingredient in the drug) and form (tablet, liquid, intravenous fluid, etc.). This is what should be on the prescription, along with quantity, frequency, refills and other instructions; this should be stored in the EMR. Level 4 is level 3 plus manufacturer and lot number. This is what the pharmacist/nurse actually dispenses/administers and should be recorded in the pharmacy system (outpatient) or drug administration record (inpatient). Level 3 is the level at which a facility's formulary (the list of drugs it keeps available) is specified. Levels 2 and 3 are based on the organization of a standard nomenclature known as RxNorm, and other standard vocabularies also focus on these levels.
Names in the standard vocabularies are specified as chemical names (e.g. at level 2, stavudine/lamivudine/nevirapine), although they may be known at the facility otherwise (e.g. d4T/3TC/NVP or Triomune or Regimen 1a). We try to encourage people to use the standard nomenclature, with other names maintained as synonyms. We do this by guidance in the wiki and by encouraging the use of the MVP concept dictionary. But we don't require it or validate against it. If a facility wants the fully-specified name (at level 3) to be Triomune 30 rather than stavudine/lamivudine/nevirapine 30mg/150mg/200mg, we allow it. If a facility wants to have separate entries for Triomune and stavudine/lamivudine/nevirapine, we allow it. If a facility wants to let the doctor prescribe Regimen 1a (level 2) rather than Regimen 1a(30) or 1a(40) (level 3), we allow it. In general, our approach has been for the most part to allow the clinic to go on doing what it has been doing rather imposing change upon them, even though we (and substantially all the authoritative literature) are in agreement that prescribing at level 3 using standard ingredient names and strengths is the best at reducing drug administration errors.
| Gliffy | ||
|---|---|---|
|