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Prescribed and Dispensed Drugs in the DRUG_EXPOSURE table

(Christian Reich) #41

Those types were old, tired, broken and corrupt. They had to go! :slight_smile:

Ok, what are you suggesting?

  • 32838 “EHR prescription”
  • New “Prescription”

32833 “EHR order” is for within the Visit. Not for another (e.g. Pharmacy) Visit. 32839 “EHR prescription issue record” I think is an artifact. No idea how it snuck in. We could kill it.

(Sebastiaan Van Sandijk) #42

Thanks for clearing up this ‘prescription issue record’, @Christian_Reich. Couldn’t figure what that was supposed to mean…
As to the EHR prescription versus other types of prescriptions, we now have a number of new CDMs that include both hospital data (including EHR prescription records, possbily with corresponding EHR administration records) and primary care data. The latter may or may not come from the same system, but has definitely been recorded in a different setting. Would it be possible to make a distiction between the two types? Strictly speaking the term EHR is applicable to GP record systems as well, but usually it refers to hospital information systems. Perhaps ‘EHR outpatient note’ > EHR outpatient prescription would work, or, if we look for a type concept similar to ‘Pharmacy claim’, something like GP prescription.

(Melanie Philofsky) #43

Please explain this more. I don’t understand the difference. If a Person receives an order for a drug during a Visit, we use 32833, EHR order? When do we use 32838, EHR prescription?

The drug_exposure.visit_occurrence_id is the FK to the Visit table which will distinguish an inpatient and outpatient visit. Assuming the “hospital data” = inpatient Visit and primary_care = outpatient Visit. Does that work, @Sebastiaan_van_Sandi?

(Sebastiaan Van Sandijk) #44

That could work, Melanie, were it not that the outpatient care in this case (also) refers to hospital care provided in an ambulatory setting. I did not look at visit_concepts for this, but as it appears there is no way to specifically represent GP visits there either. It may be possible to work with care_site and/or provider location information, but that would be a roundabout way - especially compared to the hospital setting and/or provenance which it is supposed to distinguish from.