Data Element

Additional Information

Medications

Applicable Vocabulary Standard(s)

Applicable Standards
  • RxNorm Full Monthly Release, June 7, 2021 

Comment

Three medication lists

Within this data class, I suggest specification of three medication lists: 1. The Pre-Admission Medication List (PAML) including all prescription medications, supplements, OTC meds that the individual takes.  Importantly, this represents the medications that the individual will have access to after discharge. 2. The Discharge Medication List including all medications that the individual is to continue after discharge. 3. The "Delta Report", which is a list of all of the differences between the PAML and Discharge Medication List with an explanation for each change.  Adding this list provides several important safety benefits'      a.  it is an opportunity for the discharging clinician to replace changes made to the medication list for formulary reasons with the comparable pre-admission medication.  This help individuals avoid inadvertently taking differently named, but similarly acting, medications from both medication lists.      b.  by providing an explanation for the change, the list provides the receiving clinician with information to determine the importance of maintaining the change.     c.  by explicitly identifying medications that have been stopped and the reasons for which they were stopped, it informs the receiving clinician that the medication wasn't inadvertently omitted but rather omitted for a specific reason The "Delta Report" does not replace medication reconciliation, rather it provides another opportunity to correctly reestablish discharge medications and reduce risks of injury.

NCPDP Comment

  • NCPDP Transactions utilize Rx Norm or Representative NDC on NewRx transactions in the NCPDP SCRIPT Standard Version 2017071. Transactions originating from the pharmacy (Change, RenewalRequest, RxFill) contain the specific NDC of the product dispensed. RxCancel must contain the specific NDC of the product dispensed.
    • NCPDP recommends: NDC be added to acceptable values for Draft Version 2.

FDA Comment

Consider adding NDC to USCDI v2. 

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