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RxNorm Overview

RxNorm Overview. John Kilbourne MD National Library of Medicine kilbourj@mail.nlm.nih.gov. Topics. Where does RxNorm data come from? Organizing the data A current issue we are addressing. Where does RxNorm data come from?. ‘Source’ names: same or different?.

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RxNorm Overview

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  1. RxNorm Overview John Kilbourne MD National Library of Medicine kilbourj@mail.nlm.nih.gov

  2. Topics • Where does RxNorm data come from? • Organizing the data • A current issue we are addressing

  3. Where does RxNorm data come from?

  4. ‘Source’ names: same or different?

  5. Source names vs. normalized name Ranitidine 15 MG/ML Oral Solution (normalized name) • SY: ranitidine 15 MG (ranitidine hydrochloride 16.8 MG) per ML Oral Solution • SY: ranitidine 75 MG per 5 ML Syrup “Ranitidine Hydrochloride 15 MG ORAL SYRUP” “Ranitidine Hydrochloride 16.8 MGORAL SYRUP” “Ranitidine Hydrochloride 75 MG ORAL SOLUTION”

  6. RxNorm and its sources • Free dataset published monthly (with weekly FDA adds) by NLM • Also a browser and API access to the data • Data sources aggregated and organized • FDA: Structured Product Label – SPL (DailyMed) • First Databank • Multum • MicroMedex • Gold Standard • Medi-Span • VA: NDF-RT and VANDF • SNOMED CT

  7. Path of data for RxNorm

  8. NLM-authored data • RxNorm content determined by the source data • Devices, drug classes, radiopharmaceuticals out of scope • Standalone non-commercial names and codes for e-prescribing and other uses

  9. Endorsement and use of RxNorm • Center for Medicare and Medicaid Services (CMS) • Formulary Reference File • Clinical Quality Measures (CQMs), Meaningful Use Value Sets • Office of the National Coordinator (ONC) • Standard for medications and medication allergies • Required for Electronic Health Record (EHR) certification • National Council for Prescription Drug Programs (NCPDP) • SCRIPT e-prescribing standard • Formulary and Benefit standard • Veterans Affairs – Department of Defense (VA-DoD)

  10. Organizing the data

  11. RxNorm building blocks: term types (TTYs) • SCD: Center of the universe for RxNorm • Ingredient + strength + dose form • Azithromycin 250 MG Oral Tablet • SBD: SCD + Brand name (BN) • Azithromycin 250 MG Oral Tablet [Zithromax]

  12. Packs • GPCK: Collection of SCDs • {6 (Azithromycin 250 MG Oral Tablet) } Pack • {30 (Aspirin 325 MG Oral Tablet) / 30 (Pravastatin Sodium 20 MG Oral Tablet [Pravachol]) } Pack • BPCK: GPCK with a suffix • {6 (Azithromycin 250 MG Oral Tablet [Zithromax]) } Pack [Z-PAKS] • {30 (Aspirin 325 MG Oral Tablet) / 30 (Pravastatin Sodium 20 MG Oral Tablet [Pravachol]) } Pack [Pravigard 325/20]

  13. Multiple levels of description SCDDiazepam 5 MG Oral Tablet SCDC Diazepam 5 MG SCDF Diazepam Oral Tablet SCDG Diazepam Pills SBD Diazepam 5 MG Oral Tablet [Valium] SBDC Diazepam 5 MG [Valium] SBDF Diazepam Oral Tablet [Valium] SBDG Valium Pills BN Valium IN Diazepam

  14. Counts of TTYs SCD20,094 SBD 11,068 GPCK 413 BPCK 337 IN 9237 MIN 3848 PIN 2184

  15. “One-to-many” issues Adenosine 3 MG/ML Injectable Solution Adenosine 3 MG/ML Prefilled Syringe 1 ML Adenosine 3 MG/ML Prefilled Syringe 2 ML Adenosine 3 MG/ML Prefilled Syringe 4 ML Adenosine 3 MG/ML Prefilled Syringe

  16. Wrap-up • RxNorm is derived from other drug data • Drug classes, devices, radiopharmaceuticals out of scope • Endorsed and used by CMS, ONC, NCPDP, VA, DoD • RxNorm organized by ‘TTY’; SCD is the center of the universe; SCD, SBD, GPCK, BPCK can be administered

  17. Thank you John Kilbourne MD kilbourj@mail.nlm.nih.gov

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