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Why can't RxNom precise ingredients be standard concepts?

I know this has been discussed before but I did not follow the argument why not: Why can’t RxNom precise ingredients be standard concepts?

They could, @mgurley. And there is talk to switch over. But that is a big open abdominal surgery on RxNorm and another one on RxNorm Extension, requiring resources.

Just in broad strokes, what are the steps that need to be completed for the abdominal surgery?

  1. De-standardize ingredients and standardize precise ingredients, except for those where there is only an ingredient and no precise ingredient.
  2. Rewire all relationships, unless they exist, from ingredient to precise ingredient.
  3. Deal with the screaming of the OHDSI population who have cohort definitions of now defunct concepts, and helping them to upgrade.
  4. Rewire all mappings from drug source vocabularies (all international drug vocabs, HCPCS, CPT4) from ingredient to precise ingredient, and resolution of ambiguities. Potentially de-standardizing RxNorm Extension ingredients, which really where precise ingredients.
  5. Rewire all drug classes (ATC, VA Class. Indications) to the precise ingredients.
  6. Rebuild the RxNorm Extension builder (the “boiler”) to create precise ingredients, rather than ingredients, for non-US data.
  7. Rebuild the RxNorm update scripts to do all of the above at each refresh.
  8. Rebuild the classification update scripts.
  9. Pray that it all works out and have a team on call for doing rapid hot fix releases when a bug reveals itself.

I probably forgot something.