Utilizing RxNorm to Support Practical Computing Applications: Capturing Medication History in Live Electronic Health Records

TL;DR

This study demonstrates how RxNorm can be effectively integrated into a live EHR system to improve medication data capture, highlighting implementation strategies, challenges, and potential for future enhancements.

Contribution

The paper presents a practical approach to adapting RxNorm for real-time medication data entry in a large-scale outpatient EHR system, including implementation insights and evaluation.

Findings

RxNorm is functional for live EHR medication entry with adaptations.

The system achieved high-speed input/output and maintained data integrity.

Future improvements can enhance search and user experience.

Abstract

RxNorm was utilized as the basis for direct-capture of medication history data in a live EHR system deployed in a large, multi-state outpatient behavioral healthcare provider in the United States serving over 75,000 distinct patients each year across 130 clinical locations. This tool incorporated auto-complete search functionality for medications and proper dosage identification assistance. The overarching goal was to understand if and how standardized terminologies like RxNorm can be used to support practical computing applications in live EHR systems. We describe the stages of implementation, approaches used to adapt RxNorm's data structure for the intended EHR application, and the challenges faced. We evaluate the implementation using a four-factor framework addressing flexibility, speed, data integrity, and medication coverage. RxNorm proved to be functional for the intended application, given appropriate adaptations to address high-speed input/output (I/O) requirements of a live EHR and the flexibility required for data entry in multiple potential clinical scenarios. Future research around search optimization for medication entry, user profiling, and linking RxNorm to drug classification schemes holds great potential for improving the user experience and utility of medication data in EHRs.