Country / Region
EMEA
Tags
Clinical Practice, Implementation, Mapping, Patient safety
We will show how SNOMED CT Clinical Drugs are used to represent generic information about medicines to enable substance based prescription, including how adjustments are made to accomodate clinical needs where regulatory data falls short.
Description
The scope of the project was to facilitate substance based prescription. For this, the SNOMED CT was applied. The Norwegian Catalogue for Drug Information delivers regulatory pharmaceutical data on brand level, brand identifiers. In order to bridge the gap between regulatory information and clinical needs, a service was set up to generate a map set. The scope of the service excluded blood products, vaccines, and medications with more than three active ingredients.
Scope
The basis for the substance based prescription is the Clinical Drug level in SNOMED CT.
All Clinical Drugs contain the relationships Has manufactured dose form, Count of base of active ingredient, Has precise active ingredient (PAI), Has basis of strength substance (BoSS), as well as information about strength numerator and denominator values. These relationships are the foundation for connections for decision support.
An automated map generator produces weekly one-to-many maps between one Clinical Drug and one or more brand identifiers from The Norwegian Catalogue for Drug Information, to continuously include new brand identifiers entering the market. This automated map set presently comprises about 8000 maps.
Several refinements are done manually or semi-automatically to the map set after generation. Maps where all relationships of the brand identifier except for PAI are identical, are redirected to the same Clinical Drug. Brand identifiers identified by clinical experts to represent products used for both injection and infusion are likewise redirected to the corresponding Clinical Drug with dose form "...for infusion or injection". Additionally, some manual adjustments are done without pre-defined rules, due to clinical needs requested by clinical experts or experts in the NRC.
A set of pharmaceutical products with spesific substances, mechanisms of action and/or dose form formulations are excepted from substance based prescription. Maps containing such Clinical Drugs are removed from the map set before distribution.
How SNOMED CT will be used
The possibility for substance based prescription by use of SNOMED CT made it a relevant terminology for medication purposes. Furthermore, using SNOMED CT for multiple modules in an EHR facilitates decision support based on relationships in the terminology and thus a coherent health service.
Why SNOMED CT will be used
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