|A Reader's E-Prescribing Question||| Print ||
We received the following question from a reader about e-prescribing:
"What I have noticed about e-prescriptions coming into our pharmacy from our very own clinics (and a host of others in the community) is that all of the electronic data is nothing more than a text string. Oh, it's in a certain format of patient name, physician, etc., in terms of order. And this way every pharmacy system vendor can take the parsed data and 'throw' it up on the screen and make some educated matches to the pharmacy databases. Here's the part I don't get. Why are these vendors not taking advantage of the drug's generic code number? All drugs have one and it is the same for that drug strength, no matter what manufacturer, brand or generic. The code is consistent as it comes from First DataBank. To be clear, for instance, there is one generic code for Neurontin 300mg or Gabapentin 300mg. It is 21414. Makes no difference if the manufacturer is Pfizer, Greenstone, Apotex, etc. Again, the code is specific to the drug's generic makeup and strength. Even drug wholesalers use it to ensure generic substitutes. So, why doesn't the e-prescribing software send this little gem so that the pharmacy software can read it and make a 'dead on' match of the drug prescribed?"
Thank you for your time,
Lee Easterday, C.Ph.T. Texas Tech University Health Sciences Center
We passed Lee's question along to Ken Whittemore, senior VP of regulatory affairs at Surescripts, and got the following response:
"The notion of having one generic coding system for use in e-prescribing has existed for some time. However, there currently isn't such a coding system used by all drug database companies that provide drug lists to e-prescribing and electronic health record (EHR) companies. The generic code number, or GCN, that Lee is referring to is proprietary to First DataBank. First DataBank is but one of about a half dozen drug database companies that provide services in the health information technology (HIT) industry, so the GCN cannot be considered an industry standard. Thus, the GCN would not work for e-prescribing except in those instances in which both the prescriber and pharmacy HIT systems in question used First DataBank, and that would not be a significant enough fraction of all e-prescribing that takes place to make using the GCN worthwhile. These things said, the National Library of Medicine's RxNorm clinical terminology system has been established and has been piloted successfully. We are optimistic that eventually RxNorm codes will be able to be used for e-prescribing in the way that Lee describes, in turn resolving one of the major interoperability issues that the industry currently faces."
Hope this helps,
Ken Whittemore, R.Ph., M.B.A.
Senior VP, Regulatory Affairs
We also recevied further comment from Micro Merchant Systems' Ketan Mehta:
"I agree with Ken's statement... Even though FDB is a major vendor, it is not the only one... Unless some standards are not set that are constant, it would be very difficult for them to send that information across...