Medication-Use technology national drug codes and drug knowledge bases

Clinicians need an accurate list of their patients’ medications to avoid prescribing errors and provide optimal care. Over time, a patient’s medications will be pre­ scribed by many different providers and dispensed by many different pharmacists, and medication records tend to be scattered. Consequently, clinicians today must gather a medi­ cation history, including both active and inactive medications, directly from their patients. Hospitals must do the same as part of the medication reconciliation process required by the Joint Commission. These processes are both time intensive and error prone and beg to be automated. Almost all inpatient and out­ patient pharmacies use computers to process and fill prescriptions or drug orders. In theory, health care Purpose. The utility of National Drug Codes (NDCs) and drug knowledge bases (DKBs) in the organization of prescription records from multiple sources was studied. Methods. The master files of most pharma­ cy systems include NDCs and local codes to identify the products they dispense. We obtained a large sample of prescription records from seven different sources. These records carried a national product code or a local code that could be translated into a national product code via their formulary master. We obtained mapping tables from five DKBs. We measured the degree to which the DKB mapping tables covered the national product codes carried in or associated with the sample of prescription records. Results. Considering the total prescription volume, DKBs covered 93.0–99.8% of the product codes from three outpatient sourc­ es and 77.4–97.0% of the product codes from four inpatient sources. Among the in­ patient sources, invented codes explained 36–94% of the noncoverage. Outpatient pharmacy sources rarely invented codes, which comprised only 0.11–0.21% of their total prescription volume, compared with inpatient pharmacy sources for which in­ vented codes comprised 1.7–7.4% of their prescription volume. The distribution of prescribed products was highly skewed, with 1.4–4.4% of codes accounting for 50% of the message volume and 10.7–34.5% ac­ counting for 90% of the message volume. Conclusion. DKBs cover the product codes used by outpatient sources sufficiently well to permit automatic mapping. Changes in policies and standards could increase cov­ erage of product codes used by inpatient sources.