Marshfield is over 90% mapped to the GPC medications ontology using the following process, based on Nathan's work: 1.) GCN Seq Num / First Databank match, 2.) NDC match, 3.) Medex match for native medications codes. We used RxMix to convert to Semantic Clinical Drug Component (SCDC) and Semantic Clinical Drug Form (SCDF).
Our biggest issue is how to handle medications that map to multiple SCDC or SCDF codes... we're currently dropping those, since the count is low. Not ideal, but we haven't phased out the separate "orders" ontology based on native codes. Medex: http://knowledgemap.mc.vanderbilt.edu/research/content/medex-tool-finding-medication-information Thanks, Laurel From: [email protected] [mailto:[email protected]] On Behalf Of Phillip Reeder Sent: Wednesday, February 18, 2015 5:34 PM To: Apathy,Nate; Russ Waitman Cc: [email protected] Subject: Re: Medication Mapping Issue I'm wondering if it would make sense to have a screen sharing session so that we can look at a few use cases where we're having issues mapping into the terminology. On a related note, the ACT project has an rxNorm terminology that is fairly similar to the current GPC medication hierarchy, with the addition of ingredients. For UTSW, this allows me to place the "ZOLOFT ORAL" (with it's multiple GCN's) into the ingredient folder so that someone could search for "Sertraline" and get both "ZOLOFT ORAL" and the more specific child terms, vs having to select multiple leaf/folders and dragging them over. It may be something we(GPC) want to look at adopting, instead of using our own. It doesn't completely solve my issue because I don't know which GCNs are at the correct level, but if we limited to ingredient level, it looks very accurate. Phillip From: <Apathy>, Nate <[email protected]<mailto:[email protected]>> Date: Wednesday, February 18, 2015 at 2:37 PM To: Russ Waitman <[email protected]<mailto:[email protected]>> Cc: "[email protected]<mailto:[email protected]>" <[email protected]<mailto:[email protected]>> Subject: RE: Medication Mapping Issue Hi all, We've been exploring a similar issue with medication mapping to the central RxCUI ontology proposed by KUMC. Though we're not an Epic site, we are in the middle of transitioning from NDC to RxCUI/RxNORM as our primary medication terminology in order to align with GPC. We've done several mappings using different versions of mapping content from NDC to RxCUI, and our closest match (to the ontology) merits about 2,300 matches with the RxCUI ontology out on Babel, which contains about 5,500 RxCUI codes. We have 11,000 unique RxCUI codes from our mappings using the USNLM mapping content, so we're not getting a good amount of those represented with the current GPC RxCUI ontology. The real kicker is that those 2,300 matches only represent about 1.5% of the total volume of medication data that we have, so while it is about half of the ontology, it's significantly less representative of the total amount of potential data that could be represented if all of our codes were matched in the ontology. We're wondering if the ontology is at a specific level of granularity that we haven't accommodated in our mappings, which is making our terms misalign with the precise codes used in the GPC RxCUI ontology. Any help would be greatly appreciated! Thanks for raising this question, Phillip! Nate Apathy Solution Manager: i2b2, Cerner Research From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of Russ Waitman Sent: Wednesday, February 18, 2015 1:29 PM To: Bonnie Westra Cc: [email protected]<mailto:[email protected]> Subject: Re: Medication Mapping Issue Somewhat similar to Nathan's experience incorporating the MedEx NLP work for meds here in KC to RxNorm that is documented in the HERON code and informatics.kumc.edu<https://urldefense.proofpoint.com/v2/url?u=http-3A__informatics.kumc.edu&d=AwMF-g&c=NRtzTzKNaCCmhN_9N2YJR-XrNU1huIgYP99yDsEzaJo&r=uOh5Q3hepVRzk8WwKUjG80B3swu7bu8ArEfLHUfXY1U&m=2jqKMv3zAo-ZqlOBIJLdpdOLG2dk18Skla3R7OgVwbk&s=v3FTqCdPhYkkqSG4CFEcQsNtcSW6nZzPOQc85wngH6M&e=> wiki Russ On Feb 18, 2015, at 12:46 PM, Bonnie Westra <[email protected]<mailto:[email protected]>> wrote: Using the NLM app for mapping medication data to RxNorm, we developed a set of rules when there was no NDC or Medispan code available for mapping. The bottom line is that when there is missing data, we ended up with a more generic RxNorm codes. When we had sufficient details, we were able to map to a more specific code. Bonnie Bonnie L. Westra, PhD, RN, FAAN, FACMI Associate Professor, University of Minnesota, School of Nursing & Institute for Health Informatics Director, Center for Nursing Informatics Location - WDH 6-155 P - 612-625-4470, Fax - 612-625-7091 email - [email protected]<mailto:[email protected]> Mail - WDH 5-140, 308 Harvard St SE, Minneapolis, MN 55455 On Wed, Feb 18, 2015 at 12:18 PM, Phillip Reeder <[email protected]<mailto:[email protected]>> wrote: We have medications in our clarity_medication table that are not as specific as the GPC Medication hierarchy. For example, we have a medication called "ZOLOFT ORAL" This has multiple GCNs associated with it for the 25MG, 50MG, and 100MG versions, and the oral concentrate version. And the current medication mapping code adds the medications under all of the versions. I'm guessing we have this issue because we have been running Epic at UTSW for 10+ years. Do any other GPC epic sites have a similar issue? 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