Nancy,
This is exactly what I am working on. My plan is this:
1. Query the user to establish an exclusion list. This is because the VA PRODUCT file is full of things that I don't want on my forumulary, such as bedpans and heplock solutions. The good news is that each of the items in the VA PRODUCT file is given a drug class. There is a class for antimicrobials, another for chemotherapy drugs etc. And there are subclasses etc for further detail. So if the user specifies that they don't want chemotherapy drugs in their local formulary, we can filter those out.
2. I will then take all entries in the VA PRODUCT file, and use that to fill the DRUG file, which is the local forumulary file.
The problem I am having is that my VA PRODUCT file is quite old. For example, it contains REZULIN, which was taken off the market at leat 5 years ago.
But this is going to be an Achilles heel for VOE. Drugs can't be prescribed until they are entered into VistA. So if a drug rep comes around and promotes the latest sleep aid, "Rozerem", and you want to try it, well forget it until there is an entry in the VA PRODUCT file, that can then be copied into the DRUG file.
And I don't think that local users (such as myself) will be able to make our own entries in the VA PRODUCT file. I think this file is supposed to be the same on all installations of VistA. And it contains links to the INGREDIENTS file (I believe) that ensure proper drug interaction testing.
So for right now, I am working on the VA PRODUCT --> DRUG file automation. I'll have to figure out some solution to this more fundamental problem later...
Kevin
On 11/23/05, Nancy Anthracite <[EMAIL PROTECTED]> wrote:
I did a little research on the web looking for the national formulary, which
used to be available there but the link seems not to be good any more. So I
found a report from the GAO from 2001 and reading between the lines, I do not
think the National Formulary is going to be as complete as you might think.
The VA probably does the same thing as some of the large public hospitals and
HMOs do and stock one or two items in a class of drugs and the contract goes
to the lowest bidder. That may not even be the same drug that is the least
expensive at your local pharmacy. Then there are the formularies of the
various insurance companies. If it is possible, it would be nice to populate
the drug file with the national drug file. I don't know what the fields
are. Are they even a close match?
On Tuesday 22 November 2005 06:16 pm, Cameron Schlehuber wrote:
Load the VistA FOIA into a scratch account and pick up the table entries
from that. Double-check but I think that as part of the National Drug File
set of tables, the Names and IENs should be the same as what you have in
your VA PRODUCT file as they are only to be edited centrally by VHA.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Kevin
Toppenberg
Sent: Tuesday, November 22, 2005 3:12 PM
To: [email protected]
Subject: Re: [Hardhats-members] How do I get an up to date VA PRODUCT file?
I think what you are describing is file #50, the DRUG file, that seems
to be the local formulary file. But I am pretty sure that the VA
PRODUCT file contains every possible pharmacy item known to man. And
this is used then to populate file#50.
Kevin
On 11/22/05, Mike Schrom <[EMAIL PROTECTED] > wrote:
> Kevin,
>
> There may not be a single, all inclusive drug list. Different VA
> hospitals have very different formularies. We frequently see patients
> from other parts of the country asking for refills of prescriptions
> obtained at their home VA that are not listed in our VISN2 Vista order
> list. The local IRM people may load data with input from the local P&T
> committee. Once a drug is in the file it stays there, even if it's taken
> off the list, but many new drugs don't show up unless they are added to
> the local formulary.
>
> Mike
>
> Kevin Toppenberg wrote:
> > I am (still) trying to work with the pharmacy system. It may be good
> > for pharmacist, but it is being quite a headache for me.
> >
> > As a review, the file that contains every possible pharmacy item is
> > the VA PRODUCT file (50.68). If a drug is not in this file, then a
> > physician will not be able to order it.
> >
> > This means that for every new drug that comes on the market, one must
> > somehow upgrade this file and then "install" the new additions to the
> > sytem.
> >
> > This area is rife for a pharmacy support contract, which Mark has
> > gearing up to provide.
> >
> > But in the mean time, I want to explore working with this myself. But
> > I want a current VA PRODUCT file.
> >
> > So where do I get an up to date one. I am guessing that the answer is
> > via the patch stream. But I'm not clear on exactly how to procede. I
> > looked on the VDL and found several different documentation areas, and
> > wasn't sure which way to go. I read the one on installing the
> > "NATIONAL DRUG FILE", but it seemed to be more about converting from
> > the old system to the new, than about keeping one's VA PRODUCT file up
> > to date.
> >
> > Thanks
> > Kevin
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