RxNorm

OpenEMR Development
1

juggernautsei wrote on Friday, June 17, 2016:

Could anyone point me to clear documentation on this and SnoMed?

I have looked around the system and can’t find where or how it is used in anything.

I did notice that when I installed the RxNorm tables the native prescription page added drug interaction and formulary. However, can’t find where these actions are being done or can be done. The check boxes are arbitrary checked and perform no action other then to add a tick mark to the PQRS.

Thanks
Sherwin
www.openmedpractice.com

2

juggernautsei wrote on Tuesday, June 21, 2016:

Really??
There is no documentation on the RxNorm table purpose?

So if there is no documentation, can I have a brief as to why it exist?
Please?

3

tmccormi wrote on Tuesday, June 21, 2016:

RxNorm is required for some kinds of meaningful reporting (or will be), but mostly it is used internationally to map common drug names with their commercial names internationally. Peace Corps, for instance uses it heavily.

SnoMED is similar and is used/required in Meaningful use and will be used more in MU2 and MU3. It is also international coding of services and diagnosis. Also used by Peace Corps and most of the rest of the world.

4

bradymiller wrote on Wednesday, June 22, 2016:

Hi,

Regarding rxnorm, this can be a bit confusing. Note that there are 2 ways to bring in rxcui codes. See here for the 2 different ways:
http://www.open-emr.org/wiki/index.php/Import_Standard_Tables#Import.2FUpgrade_RxNorm

The first way brings in the entire rxnorm database, but has not been integrated into OpenEMR. There was a project in the past with the goal of doing this, but it stalled out a long time ago:
http://www.open-emr.org/wiki/index.php/Active_Projects#Integrate_RXNorm

The second way brings in the rxcui codes in a more straightforward fashion and has been integrated into OpenEMR; you can choose these codes when add a medication.

-brady
OpenEMR

5

mdsupport wrote on Wednesday, June 22, 2016:

NIH has probably changed file name to RxNorm_full_**prescribe_**06062016.zip. Built-in loader used to be thrown off by the highlighted node.

This is a good candidate for reducing load on mySQL - large and stable structures that can be reduced significantly. In one installation a denormalized load to couchbase worked well and saved daily database backup size. Would the project want to consider that approach?

6

juggernautsei wrote on Thursday, June 23, 2016:

Thank you all. Tony you were dead on the money.
I have loaded the RxNorm’s for a while now but on this last load, it slowed down the server tremendusly. Now I’m stuck trying to figure out how to speed it back up.

7

bradymiller wrote on Thursday, June 23, 2016:

Hi,

Note the first method discussed above (External Data Load) uses the RxNorm_full_06062016.zip package.
(note the Note in that instrucion screen states: “NOTE: Only the full monthly RxNorm release is currently supported”)

And the second method discussed above (Native Data Load) uses the smaller RxNorm_full_prescribe_06062016.zip package.

-brady
OpenEMR

8

bradymiller wrote on Thursday, June 23, 2016:

The slowdown of the large rxnorm package import is likely related to the fact that mysql is using InnoDB rather than using MyISAM when bringing in the large RxNorm package in the more recent mysql versions(RxNorm uses the default mysql engine which is InnODB in more modern mysql versions). OpenEMR 4.2.2 will be faster when import this since some optimization was done.

Note that I would recommend against importing the full rxnorm database anyways since it is not yet integrated into OpenEMR and instead bring in the rxcui codes via the Administration->Other->Native Data Loads

-brady
OpenEMR