| Version 31 (modified by , 11 years ago) ( diff ) |
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RxNorm Files for Vista/RPMS
Welcome to the homepage for the RxNorm VISTA/RPMS Support. I am Sam Habiel, and I am the developer for these packages. I can be reached at sam dot habiel at gmail dot com.
NB: Documentation for the older version of RxNorm can be found at RxNormForVista0.02.
What is RxNorm?
RxNorm is a standardized vocabulary set for Drugs in the United States. The goal of RxNorm is drug nomenclature standardization and systems interoperability. More information on RxNorm can be found at http://www.nlm.nih.gov/research/umls/rxnorm/.
Why do I want this?
RxNorm is necessary for interoperability with other systems. If you use VISTA alone without having to talk to any other system, then you don't need RxNorm. However, if you perform external drug interactions, send CCDA documents, or archive patient records for CCR, you are going to need RxNorm. For Meaningful Use, you are required to have RxNorm for various purposes.
What does this release contain?
This release contains Fileman files corresponding to most of public domain RxNorm (archived data is not loaded into VISTA). It also contains utilities for querying RxNorm for specific information and a utility to add drugs to the drug files automatically based on an RxNorm number.
It's important to note that the public domain RxNorm files here differ from the NLM prescribable subset of RxNorm. While both are public domain, the prescribable subset does not contain the VA datasets that enable translation between VISTA and RxNorm. These are available in the full RxNorm package from the NLM. Public domain corresponds to UMLS Restriction Level 0. Read further below to see how to get proprietary codes into your data file like First Databank GCNs and SNOMED codes.
How much does this cost?
This release is licensed under AGPL v3.0 and is free as in free beer. Commercial use for commercial entities running VISTA can be obtained for $2000 per VISTA instance; commercial license can be found here: RxNormForVista/CommercialLicense. Support costs for monthly updates are $100/month per VISTA instance both for AGPL and commercial users.
How can I install RxNorm on VISTA/RPMS?
Before you install
YOU MUST READ THIS BEFORE INSTALLING
The RxNorm globals file is about 2.5 GB, and when loaded it takes up about 2.5GB. You therefore need to have at least 10 GB on your drive.
It is very highly recommended that you load and maintain RxNorm in the ^C0CRXN global in an UNJOURNALED portion of your Mumps Database. The data is reproducible and does not need to be journaled; and journaling it is very expensive in terms of journal size. In addition, once loaded, it will not change until the next load. Maintaining back-ups of your database will be easier this way.
RxNorm contains very long text values. You must ensure that your Mumps database can do at least 16,000 characters in a single global node.
TODO: GT.M Example
Installation
As of version 0.02 (currently the version 2.2), this version changes how you would do installation. You now install the dictionary file (which you need to only install once unless it changes) and then install the data file, which changes month to month. The data installation now takes 30 minutes to 60 minutes since it is transported as globals.
Installation Order:
- DD and routines: source:ccr/trunk/rxnorm/tags/2.2/RXNORM_FOR_VISTA_2P2.KID
- Public Domain Data (unzip with 7z first): source:ccr/trunk/rxnorm/tags/2.2/RXNORM_FOR_VISTA_PD_DATA_11P2013.GKID.7z
Installation is a normal KIDS file installation. There is nothing special about it.
Contents of the KIDS file
Files
| Name | Number | Global | RxNorm NLM File | Approx # of entries at the end of 2013 |
| RXNORM CONCEPT NAMES AND SOURCES | 176.001 | ^C0CRXN(176.001) | RXNCONSO.RRF | 1,000,000 |
| RXNORM SIMPLE CONCEPT AND ATOM ATTRIBUTES | 176.002 | ^C0CRXN(176.002) | RXNSAT.RRF | 7,000,000 |
| RXNORM SOURCE INFORMATION | 176.003 | ^C0CRXN(176.003) | RXNSAB.RRF | 13 |
| RXNORM SEMANTIC TYPES | 176.004 | ^C0CRXN(176.004) | RXNSTY.RRF | 400,000 |
| RXNORM RELATED CONCEPTS | 176.005 | ^C0CRXN(176.005) | RXNREL.RRF | 5,000,000 |
| RXNORM DOCUMENTATION FOR ABBREVIATED VALUES | 176.006 | ^C0CRXN(176.006) | RXNDOC.RRF | 3,000 |
Pharmacy Files Computed Fields
| File Name | File number | Field Name | Field Number | Description |
| DRUG | 50 | RXNCUI | 176.001 | Pointer to the Semantic Clinical Drug in 176.001 that corresponds to this drug. |
| DRUG | 50 | RXN SCD NAME | 176.002 | Canonical Clinical Drug name according to RxNorm. |
| VA PRODUCT | 50.68 | COMPUTED GCNSEQNO | 176.001 | Multiple of GCNs corresponding to a VA PRODUCT |
Routines
| Routine | Description | Special Remarks |
| C0CRXNnn | Complied cross reference routines (12 routines on Fileman 22.2) | Routines compiled dynamically; not shipped in KIDS build. |
| C0CRXNRD | Import RxNorm data from NLM files | See below for API |
| C0CRXNLK | RxNorm mapping APIs for VISTA | See below for APIs |
| C0CRXNAD | Add a drug to drug file based on RxNorm code | See below for API |
What can I do with RxNorm
User Mode Interactions
All files are shipped with no file access code security for reading, and as such they can be read by all users if they are granted access to Fileman and don't have Kernel Part III security turned on. If Kernel Part III security is turned on, you will need to grant users access to files 176.001 through 176.006. If you don't know what Part III security is, then you don't have it.
Concepts
Users can query the Concepts file by typing the concept name (usually a drug generic name or brand name) or a drug code (such as a VUID). Here are a couple of examples:
Search for all entries that have the word PROZAC in them:
Select RXNORM CONCEPT NAMES AND SOURCES RXCUI: PROZAC
1 PROZAC 58827 MSH PEN D005473 Prozac
2 PROZAC 58827 RXNORM TMSY 58827 PROzac
3 PROZAC 58827 RXNORM BN 58827 Prozac
4 PROZAC 10 MG (FLUOXETINE HYDRO 205535 RXNORM SY 205535
Prozac 10 MG (fluoxetine hydrochloride 11.2 MG) Oral Capsule
5 PROZAC 10 MG (FLUOXETINE HYDRO 205535 RXNORM TMSY 205535
PROzac 10 MG (FLUoxetine hydrochloride 11.2 MG) Oral Capsule
Search for the VUID for Prozac after we obtain it from the NDF:
OUTPUT FROM WHAT FILE: RXNORM CONCEPT NAMES AND SOURCES// 50.68 VA PRODUCT
(23779 entries)
Select VA PRODUCT NAME: FLUOXETINE
1 FLUOXETINE HCL 10MG CAP
2 FLUOXETINE HCL 10MG CAP,UD
3 FLUOXETINE HCL 10MG TAB
4 FLUOXETINE HCL 20MG CAP
5 FLUOXETINE HCL 20MG CAP,UD
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5: 4 FLUOXETINE HCL 20MG CAP
ANOTHER ONE:
STANDARD CAPTIONED OUTPUT? Yes// (Yes)
Include COMPUTED fields: (N/Y/R/B): NO// - No record number (IEN), no Computed
Fields
DISPLAY AUDIT TRAIL? No// NO
NAME: FLUOXETINE HCL 20MG CAP VA GENERIC NAME: FLUOXETINE
DOSAGE FORM: CAP,ORAL STRENGTH: 20
UNITS: MG
NATIONAL FORMULARY NAME: FLUOXETINE CAP,ORAL
VA PRINT NAME: FLUOXETINE HCL 20MG CAP
VA PRODUCT IDENTIFIER: F0049 TRANSMIT TO CMOP: YES
VA DISPENSE UNIT: CAP
ACTIVE INGREDIENTS: FLUOXETINE HYDROCHLORIDE
STRENGTH: 20 UNITS: MG
PRIMARY VA DRUG CLASS: CN609 NATIONAL FORMULARY INDICATOR: YES
CS FEDERAL SCHEDULE: Unscheduled SINGLE/MULTI SOURCE PRODUCT: Multisource
DSS NUMBER: 1 OVERRIDE DF DOSE CHK EXCLUSION: NO
CREATE DEFAULT POSSIBLE DOSAGE: YES
FDA MED GUIDE: Fluoxetine_Cap_(Generic)_(2009).pdf
SERVICE CODE: 608147
EFFECTIVE DATE/TIME: MAR 10, 2005 STATUS: ACTIVE
VUID: 4008621 MASTER ENTRY FOR VUID: YES
Select VA PRODUCT NAME:
Select OPTION: INQUIRE TO FILE ENTRIES
OUTPUT FROM WHAT FILE: VA PRODUCT// 176.001 RXNORM CONCEPT NAMES AND SOURCES
(687143 entries)
Select RXNORM CONCEPT NAMES AND SOURCES RXCUI: 4008621
1 4008621 310385 VANDF CD 4008621 FLUOXETINE HCL 20MG CA
P
2 4008621 310385 VANDF AB 4008621 FLUOXETINE HCL 20MG CA
P
CHOOSE 1-2: 1 310385 VANDF CD 4008621 FLUOXETINE HCL 20MG CAP
ANOTHER ONE:
STANDARD CAPTIONED OUTPUT? Yes// (Yes)
Include COMPUTED fields: (N/Y/R/B): NO// - No record number (IEN), no Computed
Fields
RXCUI: 310385 LAT: ENG
RXAUI: 1424227 SAB: VANDF
TTY: CD CODE: 4008621
STR: FLUOXETINE HCL 20MG CAP SUPPRESS: N
Atoms
To search the Atoms file, chose file 176.002. You can search by the type of Atom or the Atom itself. The most useful thing to search here are NDC numbers. Here's a search for a Prozac NDC.
Select RXNORM SIMPLE CONCEPT AND ATOM ATTRIBUTES ATN: 00777310502 NDC RXNOR M 00777310502 ANOTHER ONE: STANDARD CAPTIONED OUTPUT? Yes// (Yes) Include COMPUTED fields: (N/Y/R/B): NO// - No record number (IEN), no Computed Fields ATN: NDC RXAUI: 787787 STYPE: AUI CODE: 104849 RXCUI: 104849 SAB: RXNORM ATV: 00777310502 SUPPRESS: N CVF: 4096
You can also enter an RxNorm concept code to get all available atoms about a drug. Using the RXCUI we just obtained above, we can get an exhaustive list of everything about it:
OUTPUT FROM WHAT FILE: RXNORM SIMPLE CONCEPT AND ATOM ATTRIBUTES//
Select RXNORM SIMPLE CONCEPT AND ATOM ATTRIBUTES ATN: 104849
1 104849 NST MTHFDA 20 MG
2 104849 NDC MTHFDA 054868-0511-*1
3 104849 NDC MTHFDA 053002-1016-*0
4 104849 DRT MTHFDA ORAL
5 104849 NDC RXNORM 00777310502
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-5:
6 104849 NDC MTHFDA 016590-*843-90
7 104849 DDF MTHFDA CAPSULE
8 104849 NDC MTHFDA 000002-3105-14
9 104849 NDC MTHFDA 051655-*390-25
10 104849 NDC MTHFDA 054868-0511-*5
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-10:
11 104849 DDF MTHFDA CAPSULE, GELATIN COATED
12 104849 MARKETING_STATUS MTHSPL active
13 104849 DST MTHFDA 20 MG
14 104849 DDF MTHFDA CAPSULE
15 104849 NDC MTHFDA 054868-0511-*2
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-15:
16 104849 NDC RXNORM 58864091730
17 104849 TRN MTHFDA PROZAC FLUOXETINE CAPSULES USP
18 104849 DDF MTHFDA CAPSULE, GELATIN COATED
19 104849 DRT MTHFDA ORAL
20 104849 DST MTHFDA 20 MG
Press <RETURN> to see more, '^' to exit this list, OR
CHOOSE 1-20:
21 104849 DRT MTHFDA ORAL
22 104849 DRT MTHFDA ORAL
23 104849 DST MTHFDA 20 MG
24 104849 DDF MTHFDA CAPSULE, GELATIN COATED
25 104849 NDC MTHFDA 000077-3105-07
Sources
File 176.004 is the Sources file. It isn't that useful except to check the proprietariness of a source or to check when it was last updated for your database. Here's an example:
OUTPUT FROM WHAT FILE: RXNORM SIMPLE CONCEPT AND ATOM ATTRIBUTES// 176.003 RXNO
RM SOURCE INFORMATION (13 entries)
Select RXNORM SOURCE INFORMATION RSAB: ?
Answer with RXNORM SOURCE INFORMATION RSAB
Do you want the entire 13-Entry RXNORM SOURCE INFORMATION List? y (Yes)
Choose from:
ATC Anatomical Therapeutic Chemical Classification System 3
GS Gold Standard Drug Database 3
MDDB Master Drug Data Base 3
MMSL Multum MediSource Lexicon 1
MMX Micromedex RED BOOK 3
MSH Medical Subject Headings, 2013_2013_01_21 0
MTHFDA Metathesaurus FDA National Drug Code Directory 0
MTHSPL Metathesaurus FDA Structured Product Labels 0
NDDF FDB MedKnowledge (formerly NDDF Plus) 3
NDFRT National Drug File 0
RXNORM RxNorm Vocabulary 0
SNOMEDCT_US US Edition of SNOMED CT 9
VANDF Veterans Health Administration National Drug File 0
Select RXNORM SOURCE INFORMATION RSAB: VANDF Veterans Health Administratio
n National Drug File 0
ANOTHER ONE:
STANDARD CAPTIONED OUTPUT? Yes// (Yes)
Include COMPUTED fields: (N/Y/R/B): NO// - No record number (IEN), no Computed
Fields
RSAB: VANDF RCUI: C1140288
VSAB: VANDF_2013_09_27 VCUI: C3530306
SON: Veterans Health Administration National Drug File
SF: VANDF SVER: 2013_09_27
IMETA: 2013AA
SLC: Michael Lincoln, M.D.;;U.S. Department of Veterans Affairs, Veterans Heal
th Administration;;;Washington;DC;United States;;;;michael.lincoln@med.va.gov;ht
tp://www.pbm.va.gov/default.aspx
SCC: Michael Lincoln, M.D.;;;;;;;;;;;michael.lincoln@med.va.gov;http://www.pbm
.va.gov/default.aspx SRL: 0
TTYL: IN,CD,AB,PT,MTH_RXN_CD
ATNL: VAC,DRUG_CLASS_TYPE,VA_CLASS_NAME,DDF,NFI,DCSA,PARENT_CLASS,VMO,SNGL_OR_
MULT_SRC_PRD,EXCLUDE_DI_CHECK,NDF_TRANSMIT_TO_CMOP,NF_INACTIVATE,VA_DISPENSE_UNI
T,VA_GENERIC_NAME,NF_NAME,NDC LAT: ENG
CENC: UTF-8 CURVER: Y
SABIN: Y SSN: National Drug File
SCIT: ;;;;Veterans Health Administration National Drug File;;;September 27, 20
13;Washington, DC;U.S. Department of Veterans Affairs;;;;;;;;
According to this, RxNorm was last updated with VA sources on September 27th 2013. An SRL of 0 means that the source is public domain.
Relationships
RxNorm relationships are not easy to query in this version due to Fileman not behaving well with compound B indexes. But they are doable if you know what you are searching for.
Let's find out the generic drug concept that correspond to the RxNorm code we obtained via the NDC for Prozac 20mg:
Select RXNORM RELATED CONCEPTS RXCUI1: 104849
RELA: has_tradename
RXCUI2:
1 104849
2 1048498
3 1048499
CHOOSE 1-3: 1 RXNORM
Select Another RXNORM RELATED CONCEPTS RXCUI1:
RELA:
RXCUI2:
STANDARD CAPTIONED OUTPUT? Yes// (Yes)
Include COMPUTED fields: (N/Y/R/B): NO// - No record number (IEN), no Computed
Fields
SAB: RXNORM STYPE1: CUI
REL: RB RXCUI2: 310385
STYPE2: CUI RELA: has_tradename
RUI: 4086805 RXCUI1: 104849
SUPPRESS: N CVF: 4096
To confirm that we indeed got the generic, we jump over to 176.001:
OUTPUT FROM WHAT FILE: RXNORM RELATED CONCEPTS// 176.001 RXNORM CONCEPT NAMES A
ND SOURCES (687143 entries)
Select RXNORM CONCEPT NAMES AND SOURCES RXCUI: 310385
1 310385 RXNORM SCD 310385 Fluoxetine 20 MG Oral Capsul
e
2 310385 VANDF CD 4008621 FLUOXETINE HCL 20MG CAP
3 310385 VANDF CD 4013939 FLUOXETINE HCL 20MG CAP,UD
4 310385 MTHFDA CD 272755 FLUOXETINE / FLUOXETINE HYDRO
CHLORIDE ORAL CAPSULE
5 310385 MTHFDA CD 235824 FLUOXETINE 20 MG ORAL CAPSULE
The Semantic Clinical Drug entry (SCD) for RxNorm means that we hit the jackpot: That is indeed the canonical generic entry for the branded Prozac 20mg capsule.
Technical Details
- Package File Entry Name is C0CR
Attachments (1)
- RxNormForVista.png (127.8 KB ) - added by 11 years ago.
Download all attachments as: .zip
