Sunday, March 13, 2011

Drug Vocabulary Improvements

NLM’s RxNorm standard clinical drug vocabulary is now more accurate and contains better connections between the National Drug Codes (NDC) and the standard nonproprietary names of medications as recommended for use in EHRs.

NDCs are product identifiers assigned by manufacturers and packagers of drugs in the U.S. They are published on medication labels and packages and are often used in pharmacy inventory control and for dispensing and billing for drugs. If a single manufacturer issues the same medication in packages of different sizes, each size has a different NDC. If more than one manufacturer produces the same medication, then each manufacturer has to assign different NDCs.

In contrast, the RxNorm vocabulary creates standard names and identifiers for the combinations of ingredients, strengths, and dose forms that exist in drugs marketed in the U.S. Doctors include this information when they write a prescription because they often don’t know the specific product that will be used to fill the prescription.

All medication products that contain the same active ingredients, the same strengths, and the same dose forms have the same RxNorm standard name. This standard name is connected to other information in RxNorm that can be used within EHR systems to improve patient safety.

Accurate and complete connections between NDC product codes and RxNorm standard names and identifiers have many potential uses within an individual patient’s EHR. These include the use of an NDC on a medicine bottle to speed standard data entry or to trigger an alert written in the RxNorm standard that could prevent a medication error.

At present, there is no single source that contains the NDCs for all medications currently marketed in the U.S. RxNorm has included NDCs provided by FDA, VA, and also from Cerner Multum and Gold Standard drug information sources for a number of years. RxNorm now includes a revised filtered version of the NDC data that segregates obsolete NDCs from those currently in the marketplace.

For the first time, data to be contributed to RxNorm by First Data Bank, a provider of drug databases widely used in the healthcare industry in the U.S. will improve the utility of drug vocabulary produced by NIH.

Douglas Fridsma MD, PhD, the head of Standards and Interoperability within the Office of the National Coordinator (ONC) applaudes First DataBank’s expanded contribution to RxNorm. He said, “This is a great example of the private sector taking action to ensure that health data standards have the coverage they need to support meaningful use of EHRs, provide robust clinical decision support, plus produce efficient health information exchange.”