Drugs in OpenMRS

Hello all,

While writing the import processors for SubstanceAdministration for OpenMRS I hit a few snags that I’d like to get an opinion on:

  1. How should I represent an interval dose quantity. Currently it is possible to represent a dose of “1 tablet”, or “2 mg” in a DrugOrder however there are some SubstanceAdministrations that have doses represented as a range (between 10 mg and 20 mg). I don’t know how I would represent this, any insight would be helpful. OpenMRS 1.10 seems to kind of fix this by allowing me to just use free text, however that will be a nightmare when I do the QED interface.

  2. It will be nearly impossible for me to reliably “autocreate” drug concepts in OpenMRS, the CDA just doesn’t contain enough information (mostly the form code and dosage per from). I can autocreate drug concepts however they don’t really “mean” anything at the moment other than just being a label (for those cases where the content creator doesn’t codify drugs). I would like to pre-populate OpenMRS with either RxNORM, NDC, FDDC, CVX codes however I don’t really see an easy way to do this. The process I’m using for looking up drug concepts is:

Find Reference Term -> Get Concept from Reference Term -> Find Drug from Concept

Are there any existing packages out there that already have one of these drug code lists already mapped into the OpenMRS database?

  1. A substanceAdministration can have a mood code of either INT or EVN meaning “intent to administer” and “administration event” respectively. How I’m interpreting this is that INT = DrugOrder that is still active with expiration date of effectiveTime.high (if provided) and EVN = DrugOrder that ?? I’m not too sure how to represent an administration that did occur. My instinct is that an order that is complete would suffice, however I’m not sure if this is the correct way to represent, any guidance would be helpful.

Cheers

-Justin

Hi Justin,

Unfortunately, I can’t be of much help here. For number 1 I’m not sure if that is a scenario that OpenMRS supports. Perhaps they should and we could start the discussions with them? For number 2, I don’t know of any dictionary that already has these. Perhaps the OpenMRS community may know of some. For number 3, I think a completed drug order would do the trick. But, maybe this is something that OpenMRS should make specific. Again, the OpenMRS community may be able to suggest a way forward here or we could try drive this to be added to OpenMRS.

I’d suggest re-posting this message to the OpenMRS developer mailing list to get their opinions of these, they may have though some of these out before or perhaps these can be used to affect change in OpenMRS.

Cheers,

Ryan

···

On Thu, Jul 31, 2014 at 11:30 PM, Justin Fyfe justin.fyfe@ecgroupinc.com wrote:

Hello all,

While writing the import processors for SubstanceAdministration for OpenMRS I hit a few snags that I’d like to get an opinion on:

  1. How should I represent an interval dose quantity. Currently it is possible to represent a dose of “1 tablet”, or “2 mg” in a DrugOrder however there are some SubstanceAdministrations that have doses represented as a range (between 10 mg and 20 mg). I don’t know how I would represent this, any insight would be helpful. OpenMRS 1.10 seems to kind of fix this by allowing me to just use free text, however that will be a nightmare when I do the QED interface.
  1. It will be nearly impossible for me to reliably “autocreate” drug concepts in OpenMRS, the CDA just doesn’t contain enough information (mostly the form code and dosage per from). I can autocreate drug concepts however they don’t really “mean” anything at the moment other than just being a label (for those cases where the content creator doesn’t codify drugs). I would like to pre-populate OpenMRS with either RxNORM, NDC, FDDC, CVX codes however I don’t really see an easy way to do this. The process I’m using for looking up drug concepts is:

Find Reference Term -> Get Concept from Reference Term -> Find Drug from Concept

Are there any existing packages out there that already have one of these drug code lists already mapped into the OpenMRS database?

  1. A substanceAdministration can have a mood code of either INT or EVN meaning “intent to administer” and “administration event” respectively. How I’m interpreting this is that INT = DrugOrder that is still active with expiration date of effectiveTime.high (if provided) and EVN = DrugOrder that ?? I’m not too sure how to represent an administration that did occur. My instinct is that an order that is complete would suffice, however I’m not sure if this is the correct way to represent, any guidance would be helpful.

Cheers

-Justin

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

Thanks Ryan,

I have managed to answer two of my questions. I found the 1.10 API to be much better for drug orders and #2 & #3 were solved. It looks like the 1.10 standalone has RxNorm already bundled with it so it makes it easy to just create Drug concepts from the RxNorm concept that was already mapped. Once I have something demonstrable I’ll post to the openMRS dev forum with my final mapping to validate the mappings I’ve made.

I still have to test this import processor, especially the more wonky administrations like tapered doses, split doses and conditional doses.

Cheers

-Justin

···

Hi Justin,

Unfortunately, I can’t be of much help here. For number 1 I’m not sure if that is a scenario that OpenMRS supports. Perhaps they should and we could start the discussions with them? For number 2, I don’t know of any dictionary that already has these. Perhaps the OpenMRS community may know of some. For number 3, I think a completed drug order would do the trick. But, maybe this is something that OpenMRS should make specific. Again, the OpenMRS community may be able to suggest a way forward here or we could try drive this to be added to OpenMRS.

I’d suggest re-posting this message to the OpenMRS developer mailing list to get their opinions of these, they may have though some of these out before or perhaps these can be used to affect change in OpenMRS.

Cheers,

Ryan

On Thu, Jul 31, 2014 at 11:30 PM, Justin Fyfe justin.fyfe@ecgroupinc.com wrote:

Hello all,

While writing the import processors for SubstanceAdministration for OpenMRS I hit a few snags that I’d like to get an opinion on:

  1. How should I represent an interval dose quantity. Currently it is possible to represent a dose of “1 tablet”, or “2 mg” in a DrugOrder however there are some SubstanceAdministrations that have doses represented as a range (between 10 mg and 20 mg). I don’t know how I would represent this, any insight would be helpful. OpenMRS 1.10 seems to kind of fix this by allowing me to just use free text, however that will be a nightmare when I do the QED interface.
  1. It will be nearly impossible for me to reliably “autocreate” drug concepts in OpenMRS, the CDA just doesn’t contain enough information (mostly the form code and dosage per from). I can autocreate drug concepts however they don’t really “mean” anything at the moment other than just being a label (for those cases where the content creator doesn’t codify drugs). I would like to pre-populate OpenMRS with either RxNORM, NDC, FDDC, CVX codes however I don’t really see an easy way to do this. The process I’m using for looking up drug concepts is:

Find Reference Term -> Get Concept from Reference Term -> Find Drug from Concept

Are there any existing packages out there that already have one of these drug code lists already mapped into the OpenMRS database?

  1. A substanceAdministration can have a mood code of either INT or EVN meaning “intent to administer” and “administration event” respectively. How I’m interpreting this is that INT = DrugOrder that is still active with expiration date of effectiveTime.high (if provided) and EVN = DrugOrder that ?? I’m not too sure how to represent an administration that did occur. My instinct is that an order that is complete would suffice, however I’m not sure if this is the correct way to represent, any guidance would be helpful.

Cheers

-Justin

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

Ok great, glad you had success there.

Cheers,

Ryan

···

On Tue, Aug 5, 2014 at 12:47 PM, Justin Fyfe justin.fyfe@ecgroupinc.com wrote:

Thanks Ryan,

I have managed to answer two of my questions. I found the 1.10 API to be much better for drug orders and #2 & #3 were solved. It looks like the 1.10 standalone has RxNorm already bundled with it so it makes it easy to just create Drug concepts from the RxNorm concept that was already mapped. Once I have something demonstrable I’ll post to the openMRS dev forum with my final mapping to validate the mappings I’ve made.

I still have to test this import processor, especially the more wonky administrations like tapered doses, split doses and conditional doses.

Cheers

-Justin

From: Ryan Crichton [mailto:ryan@jembi.org]
Sent: Tuesday, August 05, 2014 4:53 AM
To: Justin Fyfe
Cc: openhie-shr@googlegroups.com
Subject: Re: Drugs in OpenMRS

Hi Justin,

Unfortunately, I can’t be of much help here. For number 1 I’m not sure if that is a scenario that OpenMRS supports. Perhaps they should and we could start the discussions with them? For number 2, I don’t know of any dictionary that already has these. Perhaps the OpenMRS community may know of some. For number 3, I think a completed drug order would do the trick. But, maybe this is something that OpenMRS should make specific. Again, the OpenMRS community may be able to suggest a way forward here or we could try drive this to be added to OpenMRS.

I’d suggest re-posting this message to the OpenMRS developer mailing list to get their opinions of these, they may have though some of these out before or perhaps these can be used to affect change in OpenMRS.

Cheers,

Ryan

On Thu, Jul 31, 2014 at 11:30 PM, Justin Fyfe justin.fyfe@ecgroupinc.com wrote:

Hello all,

While writing the import processors for SubstanceAdministration for OpenMRS I hit a few snags that I’d like to get an opinion on:

  1. How should I represent an interval dose quantity. Currently it is possible to represent a dose of “1 tablet”, or “2 mg” in a DrugOrder however there are some SubstanceAdministrations that have doses represented as a range (between 10 mg and 20 mg). I don’t know how I would represent this, any insight would be helpful. OpenMRS 1.10 seems to kind of fix this by allowing me to just use free text, however that will be a nightmare when I do the QED interface.
  1. It will be nearly impossible for me to reliably “autocreate” drug concepts in OpenMRS, the CDA just doesn’t contain enough information (mostly the form code and dosage per from). I can autocreate drug concepts however they don’t really “mean” anything at the moment other than just being a label (for those cases where the content creator doesn’t codify drugs). I would like to pre-populate OpenMRS with either RxNORM, NDC, FDDC, CVX codes however I don’t really see an easy way to do this. The process I’m using for looking up drug concepts is:

Find Reference Term -> Get Concept from Reference Term -> Find Drug from Concept

Are there any existing packages out there that already have one of these drug code lists already mapped into the OpenMRS database?

  1. A substanceAdministration can have a mood code of either INT or EVN meaning “intent to administer” and “administration event” respectively. How I’m interpreting this is that INT = DrugOrder that is still active with expiration date of effectiveTime.high (if provided) and EVN = DrugOrder that ?? I’m not too sure how to represent an administration that did occur. My instinct is that an order that is complete would suffice, however I’m not sure if this is the correct way to represent, any guidance would be helpful.

Cheers

-Justin

You received this message because you are subscribed to the Google Groups “Shared Health Record (OpenHIE)” group.
To unsubscribe from this group and stop receiving emails from it, send an email to openhie-shr+unsubscribe@googlegroups.com.

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org


Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org