1 / 18

Building a National Medication Reference Terminology:

Building a National Medication Reference Terminology:. VA Experience with NDF-RT Presented to HL7 Government SIG By Steven Brown & Michael Lincoln, Department of Veterans Affairs In collaboration with NLM, FDA, NCI and Apelon. Why a Common Drug Reference Terminology?.

waylon
Download Presentation

Building a National Medication Reference Terminology:

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Building a National Medication Reference Terminology: VA Experience with NDF-RT Presented to HL7 Government SIG By Steven Brown & Michael Lincoln, Department of Veterans Affairs In collaboration with NLM, FDA, NCI and Apelon

  2. Why a Common Drug Reference Terminology? • Improve use of drug information by single systems • Improve sharing of drug information by adding semantic understanding to the syntax defined by HL7 messaging between systems

  3. VA National Drug File (NDF) • Centrally maintained file of drug products • Distributed to 128 VA Medical Centers • Incorporated into VistA Pharmacy Applications • ~ 80,000 Entries • Maintained and used via “M Globals” • VA Product File • VA Active Ingredient File • More than a decade of experience…

  4. NDF Uses Within VA • National standard listing • Local formularies mapped to NDF standard • Interaction and Order Checking • Consolidated Mail Outpatient Pharmacy • > 7 sites, 57 million prescriptions/year

  5. NDF Product File • Product Names • AMOXICILLIN 250MG/CLAVULANATE K 125MG TAB • Form, Strength, Product Identifier • Linked to: VA Drug Class : • AM052 “penicillins, amino derivatives” • Linked to: Active Ingredients

  6. NDF - Issues • Maintenance • 4000 NDC level edits per month • Done largely by hand • Mapping local formularies to NDF • Manual process • Required for CMOP • Decision Support – class based • CN101 “Opioid Analgesics” vs. CN103 “Non-opioid analgesics”

  7. NDF Reference Terminology (RT) • Enterprise Architecture project • Goal – to evaluate the use of modern terminology techniques to increase functionality, improve quality and decrease costs

  8. Rossi Mori First Generation Terminology • Traditional Paper-Based Terminological Systems with lists of phrases and codes. • E.g. ICD9, CPT

  9. Rossi Mori Second Generation Terminology • Second Generation Terminology • Compositional terminological systems built according to a categorical structure and a cross-thesaurus with predefined values for each category. • E.g. LOINC

  10. Rossi Mori Third Generation Terminology • Reference Terminology – • A terminology where each term has a formal definition designed for data aggregation and retrieval. • Formal terminological systems represent concepts with symbols and rules that create a computable structured and coded system • e.g. SNOMED RT, NDF RT

  11. Advantages of Formal Terminology • Computer-based tools • Reduced Maintenance Costs • 90% reduction in MED Maintenance effort • Reduced Mapping Effort • 60% automated matches to formalized version of LOINC • Comparable Data • Supports Aggregation

  12. Reference Terminology Creation • Create a model of use case-based definitional attributes • Create a reference hierarchy for each definitional attribute • Define concepts using terms from reference hierarchies

  13. Simplified NDF RT Model Database Links DKB Ids, CUIs, Mesh Structural ID Chemical Structure Mechanism of Action Active Ingredients Strengths Dose Forms Route of Adm. (HL-7) Therapeutic Use Clinical Drug Pharmacokinetics National Drug Codes (NDCs) Identity Key Gray = Chemical Green = Clinical Pink = Commercial Blue = Functional Yellow = External

  14. Sample MoA Hierarchy Receptor Interactions Channel Agents Transporter Agents Enzyme Interactions ABC Transporters Organic Ion Transporters Sialin Transporter LST-1

  15. Sample Definition AMOXICILLIN 250MG/CLAVULANATE K 125MG TAB • Has_form: tablet • Has_active_ingredient: Amoxicillin • Has_strength 250 mg • Has_MoA: cell wall synthesis disruption • Has_active_ingredient: Clavulanate • Has_strength 125mg

  16. NDF RT Progress to Date • NDF in terminology development tool • Model Created • Reference Taxonomies • Done: Route, Form, Strength, Structure • Under development : MoA, Physiologic Effect, Therapeutic Intent and Pharmacokinetics • Concept Definition • Algorithmic initialization • Human review • Input from NLM, HL7, FDA, NCI, Apelon

  17. NDF RT – Next Steps • Sample Applications demonstrating value • Expand Project beyond VA • NLM, FDA, NCI, Regenstrief, ??? • Freely available to others for reuse

  18. NDF RT Model Chemical Structure Class Database Links DKB Ids, CUIs Structural ID Mechanism of Action Active Ingredients Strengths Dose Forms Route of Adm. (HL-7) Therapeutic Use Clinical Drug Finished Dosage Form Pharmacokinetics Appearance Product Identity Key Gray = Chemical Green = Clinical Purple = Commercial Blue = Functional Yellow = External Brand Names Packaged Product National Drug Codes (NDCs) Kit

More Related