Short Version
Lots of the medications in our system have synonyms that have been made obsolete over the years either because they are no longer manufactured in their branded form, or for reformulation issues, or some other reasons. Pharmacists with IT will be going in and updating these over the next few weeks. This will save physicians and other providers hundreds of errors over the next few months.
Long Version
In an effort to allow computer systems used for patient care to communicate to each other and to the Health Information Exchange (HIE) system, the NIH U.S. National Library of Medicine has developed a Unified Medical Language System (UMLS). Medications will use a vocabulary termed RxNorm to communicate. Medications in Cerner must be matched to a medication in the RxNorm vocabulary. Many brand names that are no longer manufactured are not listed in the RxNorm vocabulary, for example, Phenergan™. One must use promethazine when ordering this medication.
Use and Standards has approved a massive clean-up of prescriptions that are not matched to something in the RxNorm vocabulary to begin immediately. Initial clean-up is being done to limit the impact on end-users. The first step is to allow a pharmacist to modify current prescriptions that are not matched to something that is matched to RxNorm. For example, a prescription for Phenergan 12.5mg PO q6h PRN nausea would be changed to a new prescription for promethazine 12.5 mg PO q6h PRN nausea. All other aspects of the prescription will be retained. If a prescription must be modified beyond what is allowed by law, the pharmacist will contact the provider for approval. Providers WILL NOT receive an alert in their message center. The medication list will appear as follows once the prescription has been “fixed”:
The discontinued order will retain the history of “Obsolete Synonym” as the reason for discontinuation:
