Difference between revisions of "Drug Database Service"

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== **Work in Progress** ==
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#REDIRECT [[Drug Database]]
 
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Held for Gwen Moscoe, Pharm.D., attending BMI 512 for Winter 2011.
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Pharmacy Information Systems (PIS) and Computerized Provider Order Entry ([[CPOE]]) systems have been in existence for 40 years.  A basic element of PIS or [[CPOE]] applications is the drug formulary file.  In the most basic form, the drug formulary file is a simple database of drugs, strengths, dose forms, routes, frequencies, and other fields detailing relevant features of a drug.  Basic PIS and [[CPOE]] drug formulary files can be, and initially were, populated entirely locally at each site that implemented a PIS or [[CPOE]].  As PIS and now [[CPOE]] became more prevalent, and especially with the advent of clinical decision support within these systems, the creation of an entire drug formulary file, including all the features needed for clinical decision support such as drug-drug and drug-allergy interaction checking, became unfeasible.
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[[http://www.informatics-review.com/wiki/index.php/Clinical_Decision_Support_--_CDS]Clinical decision support] requires coded databases which allow automated cross referencing of tables which link drugs to other drugs which might react, are duplicates, or with allergies or other data elements such as labs.  With the numbers of available drug agents in 2010, these databases are massive.  An examination of the vendor-provided ([[First_DataBank]]) tables underlying the MedsManager (McKesson) PIS at one organization (PeaceHealth SouthwestMedical Center, Vancouver, WA) yielded 1,291,248 coded drug interaction pairs.  Individual sites generally do not have the resources to maintain such massive tables locally, and fortunately they do not have to.
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Many vendors such as [[First_DataBank]], Multum, and Medispan now provide database services which can be integrated into PIS and other products which involve medications ([[CPOE]], [[Barcoded_Medication_Administration]], etc).  These databases provide the basis for entering drugs into the site-specific drug formulary file.  They also provide the tables necessary for applications to cross reference drugs entered in to a PIS or [[CPOE]] system with other existing drugs which might interact or duplicate, with allergies existing on the patient profile, or with labs which might cause concern.  Other features such as dose-range checking are also possible with these commercial databases.
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Internal links:
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[[RxNorm]]
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[[First_DataBank]]
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[[Drug-Drug_interaction]]
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[[Drug-Allergy_Interactions]]
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[[Alert_Fatigue]]
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[[Clinical_Decision_Support_--_CDS]]
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Internal links to create
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MediSpan
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Lexicomp
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Micromedex
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Multum
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External links/References
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[http://www.multum.com/VantageRx.htm Multum]
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[http://www.medi-span.com/drug-information-products.aspx Medi-Span]
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[http://www.firstdatabank.com/ First DataBank]
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[[Category:CDS]]
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Latest revision as of 18:07, 4 September 2014