Medication List

MU Requirements

Meaningful Use Measures:

At least 80% of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient is not currently prescribed any medication) recorded as structured data.

Certification Criteria for EHR:

Enable a user to electronically record, modify, and retrieve a patient’s active medication list as well as medication history for longitudinal care (i.e., over multiple office visits) in accordance with the applicable standard specified in Table 2A row 1: Any code set by an RxNorm drug data source provider that is identified by the United States National Library of Medicine as being a complete data set integrated within RxNorm.

Proposed Solution

Medication List can be found in Issues section of each patient's Medical Record.

It will be easier to access in the new GUI developed by Tony. See Rx.

The proposed solution is as follows:

1. Add a "problem_list_status" field to "patient_data" table. The default for this field is "". This status is displayed under Medical Problems (new GUI).

2. Create a new field in Encounter form to allow the provider to choose "None" if there is no problem.
O Add Problem O None
O Add Allergy O None
O Add Medication O None

3. Create a new table since there are over 52,000 drug records from Lexi-comp medication database.

4. Rename "Prescriptions" to "Medication List" as it can include prescription, medication, and supplements. Note that Rx is for prescription/e-prescribing.

Effected Code, Tables, etc

CREATE TABLE IF NOT EXISTS `medication_list` (

 `drug_id` bigint(20) NOT NULL AUTO_INCREMENT,
 `drug_name` varchar(255) DEFAULT NULL,
 `date_obsolete` date DEFAULT NULL,
 `is_obsolete` tinyint(1) NOT NULL DEFAULT '0',
 PRIMARY KEY (`drug_id`)

) ENGINE=MyISAM DEFAULT AUTO_INCREMENT=1 ;

-- -- Table structure for table `patient_data` --

DROP TABLE IF EXISTS `patient_data`; CREATE TABLE `patient_data` (

 `id` bigint(20) NOT NULL auto_increment,
 `title` varchar(255) NOT NULL default ,
 `language` varchar(255) NOT NULL default ,
 `financial` varchar(255) NOT NULL default ,
 `fname` varchar(255) NOT NULL default ,
 `lname` varchar(255) NOT NULL default ,
 `mname` varchar(255) NOT NULL default ,
 `DOB` date default NULL,
 `street` varchar(255) NOT NULL default ,
 `postal_code` varchar(255) NOT NULL default ,
 `city` varchar(255) NOT NULL default ,
 `state` varchar(255) NOT NULL default ,
 `country_code` varchar(255) NOT NULL default ,
 `drivers_license` varchar(255) NOT NULL default ,
 `ss` varchar(255) NOT NULL default ,
 `occupation` longtext,
 `phone_home` varchar(255) NOT NULL default ,
 `phone_biz` varchar(255) NOT NULL default ,
 `phone_contact` varchar(255) NOT NULL default ,
 `phone_cell` varchar(255) NOT NULL default ,
 `pharmacy_id` int(11) NOT NULL default '0',
 `status` varchar(255) NOT NULL default ,
 `contact_relationship` varchar(255) NOT NULL default ,
 `date` datetime default NULL,
 `sex` varchar(255) NOT NULL default ,
 `referrer` varchar(255) NOT NULL default ,
 `referrerID` varchar(255) NOT NULL default ,
 `providerID` int(11) default NULL,
 `email` varchar(255) NOT NULL default ,
 `ethnoracial` varchar(255) NOT NULL default ,
 `interpretter` varchar(255) NOT NULL default ,
 `migrantseasonal` varchar(255) NOT NULL default ,
 `family_size` varchar(255) NOT NULL default ,
 `monthly_income` varchar(255) NOT NULL default ,
 `homeless` varchar(255) NOT NULL default ,
 `financial_review` datetime default NULL,
 `pubpid` varchar(255) NOT NULL default ,
 `pid` bigint(20) NOT NULL default '0',
 `genericname1` varchar(255) NOT NULL default ,
 `genericval1` varchar(255) NOT NULL default ,
 `genericname2` varchar(255) NOT NULL default ,
 `genericval2` varchar(255) NOT NULL default ,
 `hipaa_mail` varchar(3) NOT NULL default ,
 `hipaa_voice` varchar(3) NOT NULL default ,
 `hipaa_notice` varchar(3) NOT NULL default ,
 `hipaa_message` varchar(20) NOT NULL default ,
 `hipaa_allowsms` VARCHAR( 3 ) NOT NULL DEFAULT 'NO',
 `hipaa_allowemail` VARCHAR( 3 ) NOT NULL DEFAULT 'NO',
 `squad` varchar(32) NOT NULL default ,
 `fitness` int(11) NOT NULL default '0',
 `referral_source` varchar(30) NOT NULL default ,
 `usertext1` varchar(255) NOT NULL DEFAULT ,
 `usertext2` varchar(255) NOT NULL DEFAULT ,
 `usertext3` varchar(255) NOT NULL DEFAULT ,
 `usertext4` varchar(255) NOT NULL DEFAULT ,
 `usertext5` varchar(255) NOT NULL DEFAULT ,
 `usertext6` varchar(255) NOT NULL DEFAULT ,
 `usertext7` varchar(255) NOT NULL DEFAULT ,
 `usertext8` varchar(255) NOT NULL DEFAULT ,
 `userlist1` varchar(255) NOT NULL DEFAULT ,
 `userlist2` varchar(255) NOT NULL DEFAULT ,
 `userlist3` varchar(255) NOT NULL DEFAULT ,
 `userlist4` varchar(255) NOT NULL DEFAULT ,
 `userlist5` varchar(255) NOT NULL DEFAULT ,
 `userlist6` varchar(255) NOT NULL DEFAULT ,
 `userlist7` varchar(255) NOT NULL DEFAULT ,
 `pricelevel` varchar(255) NOT NULL default 'standard',
 `regdate`     date DEFAULT NULL COMMENT 'Registration Date',
 `contrastart` date DEFAULT NULL COMMENT 'Date contraceptives initially used',
 UNIQUE KEY `pid` (`pid`),
 KEY `id` (`id`)

) ENGINE=MyISAM AUTO_INCREMENT=1 ;

-- -- Table structure for table `lists` --

DROP TABLE IF EXISTS `lists`; CREATE TABLE `lists` (

 `id` bigint(20) NOT NULL auto_increment,
 `date` datetime default NULL,
 `type` varchar(255) default NULL,
 `title` varchar(255) default NULL,
 `begdate` date default NULL,
 `enddate` date default NULL,
 `returndate` date default NULL,
 `occurrence` int(11) default '0',
 `classification` int(11) default '0',
 `referredby` varchar(255) default NULL,
 `extrainfo` varchar(255) default NULL,
 `diagnosis` varchar(255) default NULL,
 `activity` tinyint(4) default NULL,
 `comments` longtext,
 `pid` bigint(20) default NULL,
 `user` varchar(255) default NULL,
 `groupname` varchar(255) default NULL,
 `outcome` int(11) NOT NULL default '0',
 `destination` varchar(255) default NULL,
 PRIMARY KEY  (`id`)

) ENGINE=MyISAM AUTO_INCREMENT=1 ;

The affected file is "\htdocs\openemr\interface\patient_file\summary\add_edit_issue.php".

Owner and Status

Design - Thomas Wong (Intesync) and Tony McCormick (MI2)

Coding - TBA

Links

• CCHIT_MU_2011_Project
• Associated with sourceforge forum: http://sourceforge.net/projects/openemr/forums/forum/202506/topic/3529451