New routes (and de-standardization of old SNOMED routes)

[zhuk (Oleg Zhuk)]

@benskov

One interesting route-related challenges is vancomycin: in our data, vancomycin has been given via six different routes: intravenous, via nasogastric tube, inside the bladder, intraperitoneal, local (through a absces drain) and intrathecal. The nasogastric route is used only for clostridium difficile colitis because you want the drug to work in the intestinal lumen and, thus, do not want it to be absorbed.

Hey @benskov

In the proposal at least two routes are missing, which are inside the bladder, intraperitoneal, therefore I doubt it fits your use case perfectly. If we add these two routes, why not add more? And one day we will end up in SNOMED - exactly where we are now.

Besides, for local route, you need to use some proxy route Local, which is a hierarchical ancestor of topical, intrathecal, etc. Currently, all the routes you are looking for are available in SNOMED in a high-resolution with the correct hierarchy and no assumptions / data loss / data gain. Even the nice Surgical drain for Abscess management.

Makes sense?

Also could you please describe your experience (read wrestle) with weight-based medications here? This discussion takes its route in 2018, but to this day there is still no standard way how to do it (or am I missing something)?