Difference between revisions of "Drug Database Service"

Revision as of 01:48, 9 January 2011

**Work in Progress**

Held for Gwen Moscoe, Pharm.D., attending BMI 512 for Winter 2011.

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.

[[1]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.

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.

Internal links: RxNorm First_DataBank Drug-Drug_interaction Drug-Allergy_Interactions Alert_Fatigue Clinical_Decision_Support_--_CDS

Internal links to create MediSpan Lexicomp Micromedex Multum

External links/References Multum Medi-Span First DataBank