We found that some of our ordered medications are not mapped by GCN to rxnorm using the shared mapping script. It turns out that these medications are actually mixtures of medications that use a mixture template to order them. The data for what is actually in the med order ends up in the order_medmixinfo table. For example: "XXX Chemo Infusion" from the medication order turns out to be "XXX Chemo Solution" + "Overfill Volume for IV Infusions" + "Sodium Chloride 0.9% IV".
We have a simple generic code associated with the primary medication but I'm not seeing how to convert get that to an RXNorm Code. The "XXX Chemo Solution" does map to RXNorm. But the ingredients in the template associated with the medicine id also can change over time. In the case above, the template went from 2 to 3 ingredients at some point. I believe the filler was added to the mix. But that indicates that they are not static templates which further complicates the mappings process. I'm considering using the simple generic code to find another similar medication and then taking it's ingredients for my mapping. Another alternative would be to use the medmixinfo to create 3 new observations in i2b2 which represent the 3 components of the mixture. Has anyone else looked at this? Phillip ________________________________ UT Southwestern Medical Center The future of medicine, today.
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