Hi Russ:

Re: OMOP CDM v5, you've got it right; the DRUG_TYPE_CONCEPT_ID is used to
record the provenance of the DRUG_EXPOSURE record, to allow you to
distinguish between prescriptions written vs. filled vs. patient-reported
medication history, etc.  For 'fills', most people are using the standard
concept for 'dispensed'.  Here's a quick list of concepts available:

38000177 Prescription written
38000178 Medication list entry
38000179 Physician administered drug (identified as procedure)
38000180 Inpatient administration
44787730 Patient Self-Reported Medication
44777970 Randomized Drug
38000175 Prescription dispensed in pharmacy
38000176 Prescription dispensed through mail order
43542356 Physician administered drug (identified from EHR problem list)
43542357 Physician administered drug (identified from referral record)
43542358 Physician administered drug (identified from EHR observation)


Cheers,

Patrick

On Mon, Dec 14, 2015 at 1:42 PM, Russ Waitman <[email protected]> wrote:

> Hi GPC-DEV, PCORnet, OMOP colleagues (I have met recently), and the i2b2
> community,
> Nathan Graham, Jiaxi Quan, Tamara McMahon, and I are looking over the data
> that we’re now getting from Surescripts into Epic here at KUMC.
>
> They turned on the feature here in the Spring and now we have 14.6 million
> events on 184,000 patients since May of 2014.
>
> As we look at the data,
> 3.4 million were marked as fills, 5.9 million as claims, and 5.3 million
> were null.
>
> In our data, nothing links back to a parent order in Epic.
>
> We’re initially thinking of tagging these facts with a modifier.
>
> “SureScripts Dispensed”
> with then 3 sub-modifiers:
> “SureScripts Dispensed (Claim)"
> “SureScripts Dispensed (Fill)"
> “SureScripts Dispensed (Unknown)”
>
> (Note:I want to loop back with folks at Epic/Surescripts regarding what
> null means).
>
> *PCORnetCDM *
>
> We looked at the PCORnet CDM to see if there were any fields we need to
> load in CDM 2 or 3 related to attribution and CDM3 PRESCRIBING table has
>
>
> RX_BASIS
> RDBMS Text(2)
> SAS Char(2)
> 01=Dispensing
> 02=Administration
> NI=No information
> UN=Unknown
> OT=Other
> Basis of the medication order
> PCORnet
>
> But that really doesn’t let you know if the source of the info was a fill
> or a claim.
>
> I know the SCILHS people are mapping to CDM 3 now
> https://github.com/hms-dbmi/i2b2-to-PCORNET-CDM
>
> but don’t seem to see any source modifiers for i2b2 in SCILHS that cover
> how they are loading the PRESCRIBING.RX_BASIS field
>
> Jim Campbell in GPC had noted that the RX_BASIS field in the PCORnet CDM
> was inconsistent with the guidance on most EHR dispensing records.
>
> *OMOP*
>
> Now when we look at OMOP v5
> https://github.com/OHDSI/CommonDataModel/blob/master/OMOP%20CDM%20v5.pdf
>
> It looks like they code the source of the med in a Drug_exposure table
> using the drug_type_concept_id
>
> drug_type_concept_id Yes integer A foreign key to the predefined concept
> identifier
> in the Standardized Vocabularies reflecting the
> type of drug exposure recorded. It indicates how
> the drug exposure was represented in the source
> data: as medication history, filled prescriptions, etc.
>
> But, I couldn’t easily find a standard vocabulary used by OMOP that would
> specify the types of dispense record.  I searched
> http://omop.org/VocabV4.5 for “fill” and didn’t find anything.  It seemed
> to mainly hold ATC and RxNorm which to my knowledge don’t specify the
> terminology to attributing fill versus claim versus order, etc.
>
> If anyone has a standard vocabulary for OMOP that’s commonly used, we’d
> ideally like to see if we can move in the direction of harmonizing the
> attribution of these medications facts.
>
> BTW, I presented the nominees for the PCORnet Data Committee and hope the
> names should be announced at the face to face PCORnet meeting Wednesday.
> So, stay tuned for more info on the PCORnet Data Committee shortly,
>
>
> Russ Waitman, PhD
> Director of Medical Informatics
> Assistant Vice Chancellor for Enterprise Analytics
> Associate Professor, Department of Internal Medicine
> University of Kansas Medical Center, Kansas City, Kansas
> 913-945-7087 (office)
> [email protected]
> http://www.kumc.edu/ea-mi/
> http://informatics.kumc.edu
> http://informatics.gpcnetwork.org – a PCORNet collaborative
>
>
>
>
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