Does RxNorm work?

@stephenwaite rather than continue to wait for the next release of OpenEMR, is it possible to get this RxNorm fix sooner by deploying the changed files – is that just a case of downloading library/standard_tables_capture.inc from github and deploying that?

yes, the above link is for v5.0.2

Thanks @stephenwaite I deployed that file in OpenEMR 5.0.2 (patch 3) on Debian; cleared the entry in standardized_tables_track; did Administration > Other > External Data Loads > RxNorm > Install and appeared to install OK:

“Installed Release
Name: RXNORM
Revision: Standard
Release Date: 2020-07-06”

Administration > Lists > Code Types: RXCUI is automatically enabled for “Drug”

Administration > Lists > Code Types: RXCUI says “External: No” and there is no Rx to choose from in the drop-down list.

However I cannot find anything from RxNorm using:
Patient demographics > Edit Medications > Add Medications > Coding > RXCUI Medication > Search for: Salbutamol

I see nothing in the Apache error log.
Is there anything else I need to do or does this look like a continuation of the bug?
Thanks

hi @PeteBoyd, there’s prob another issue related to the script reading the now loaded table.

If I can be of help in troubleshooting this further then please let me know. We’re eager to get RxNorm integrated. Thanks

I tested this again but with OpenEMR 5.0.2 Patch 4 and got the same results as above.

Is there any mechanism where by we can pay to have this issue focused on please?

You don’t need to pay Pete. I’ll see what I can do!

should be working if you were able to load rxnorm (had to fix master just now @sjpadgett)

please see


which leads to
http://www.open-emr.org/wiki/index.php/Administration_Globals#Rx_NLM_Drug-Drug

that’s for prescriptions, looks like there is a bug in Medications

@stephenwaite
Looks like we have the wrong code types. List has us using 109 for rxcui and rxnorm is importing as code type 110(Loinc)
umm, woops

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Is there a diff available for this so that I can make the alteration myself please?

We’re considering loading RxNorm, but not sure if it will work based on what we’re seeing here. Can someone please post a status update? (we run oemr v5.0.2(4) on Ubuntu 18.04)

first go to Administration->Lists and choose Code Types and set RXCUI active
then go to Administration->Other->Native Data Loads and follow the instructions there to grab the file and then upload and install it
should now be able to add a medication by rxcui

Success!

As per what Stephen says above, there is a completely different method now in OpenEMR 5.0.2 Patch 4 of installing RxNorm. Now we use Administration > Other > Native Data Loads and not Administration > Other > External Data Loads; although the latter is still present.

Also, the instructions within OpenEMR now say to use the “Current Prescribable Content Monthly Release” where previously we used “RxNorm Full Monthly Release”.

The OpenEMR 5.0.2 Patch 4 release documentation only said “RxNorm import fixes”. Also note that the “Import RxNorm and SNOMED Tables” page at https://www.open-emr.org/wiki/index.php/Import_RxNorm_and_SNOMED_Tables still says to “Copy the zipped RxNorm database file into the ‘contrib/rxnorm’ directory … note you’ll need to get an account and that only the Full Monthly Releases currently work … In OpenEMR, go to Administration->Other->RxNorm in order to then install/upgrade the RxNorm database.” None of that now appears to be true.

On first installation using Administration > Other > Native Data Loads, I received this issue:
“POST Content-Length of 70740105 [70 MB] bytes exceeds the limit of 31457280 [30 MB] bytes in Unknown on line 0, referer: …/interface/super/load_codes.php”

I fixed this by increasing php.ini’s “post_max_size” from 30M to 80M.

I then used Administration > Other > Native Data Loads to upload again and got this so-called confirmation of success:
“LOAD SUCCESSFUL. Codes inserted: 0, replaced: 0”
However RxNorm still wasn’t available.

Administration > Other > External Data Loads still lists the prior installation of RxNorm:
“Installed Release
Name: RXNORM
Revision: Standard
Release Date: 2020-07-06”

I removed the record of that old installation using the following:
DELETE FROM standardized_tables_track WHERE name=“RXNORM”;

I installed RxNorm again using Administration > Other > Native Data Loads and got this confirmation of success:
“LOAD SUCCESSFUL. Codes inserted: 139890, replaced: 0”
Which looks more positive. And indeed RxNorm now appears to work fine.

Thank you

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Thank you Pete for your excellent post on how to make this happen!
We’re going to take a shot at it today!

the native data load has been there for some time thanks to the nice work by Rod, @sunsetsystems

some day there may be a grand unification of the external and internal :slight_smile:

Ahh OK, excuse my naivete then, it’s just not an installation option that wasn’t in the OpenEMR RxNorm instructions.

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https://www.open-emr.org/wiki/index.php/Code_Types#RXCUI

Sorry, I don’t think I’ve ever seen that. Thanks for pointing it out. I’ve been going by https://www.open-emr.org/wiki/index.php/Import_RxNorm_and_SNOMED_Tables

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