Home Forums Discussions Problems A prescription mapping hazard

I think this is a hazard in mapping meds to the new Lexi database. Perhaps I am wrong, but I am interested in opinions.
This is another one of those things it is hard to describe in words, but is obvious when you sit down to map.

This issue: sometimes the original prescription to be mapped is rather vague with regard to dosing. If you map it to the wrong dose of the medication, your prior record of prescribing will not accurately reflect what you wrote for.

I can come up with better examples now that I am looking for them, but here is a benign one that illustrates the issue. Some of my patients take garlic tablets. In the old, Lexi database, "Garlic oral capsule" or "garlic oral tablet" shows up. When I go to map it, there are multiple doses for garlic capsules and tablets, but all list a specific dose. If I pick the wrong one, it will appear that any patient that had "Garlic capsule" previously actually got that dose. If I want to renew it, I will write for the wrong dose. I know that is a weak example (it's garlic :-) ) but the same thing can easily happen with a medication with more significant implications of recording the wrong dose, perhaps with dangerous results.

This also has implications for how long it takes one to map. For example, Folbee is a multivitamin with B12. When I map "Folbee oral tablet" which was in Lexi on the left, about 30 options come up in the right hand screen. I can find one listing that has the medication dosage. But before I match it, I must scroll through all 40 possible other choices - (which are NOT in alphabetical order - another annoyance) to be sure there is only one dosing form. Because if there is more than one, I might be mapping my "Folbee oral tablet" to a specific dose I have not used. It will look like I prescribed something that I did not.


(By the way... we are now about halfway through the 3200 meds we need to migrate).

If I don't find a specific match in the first 20 seconds, I do the free text option.
Like you, I prefer that over introducing a possible error.
ACZ

When you simply wrote Garlic oral tablet in the past, what strength did the patient get?

I kinda know the answer to this but....I wouldn't mind this mapping thing if you could demap. When I write for Augmentin (one that is used a lot), it brings up every brand name Augmentin, but it leaves out on of the most important ones, "Augmentin 875 mg" If I write for amoxicillin-clavulanate, it goes to the 1000 mg Augmentin. I would love to change the mapping of amoxicillin-clavulante to Augmentin 875 mg es[ecoa;;u since I can write for the 1000 mg using the Brand name.

It's frustrating because all of the meds are in the databases. You are just screwed if you map one to a wrong one.

Using free text for things like vitamins and supplements.

Bert, I am not sure "all of the meds are in the database". I have not been able to find a couple of things. Augmentin 875mg being one of them. That is not a mapping issue, it is a name bran vs generic issue.

The idea of being able to change is a good because as I see it, you are definitely out of luck if you map to the wrong thing.

One of the things I am finding very annoying is that the program is putting in medications twice. You see this in the inactivated area a lot. The problem is when you go to reactivate, trying to pick the right one is a hassle.

Just reactivated Bentyl for a pt, it is mapped, 2 instances of it in the inactive med list, tired one version get a message inactive NDC, tried the other version and got the same message, so dicyclomine it is, would be nice to be able to at least use the codify and change as it would be faster than writing it over.

You really need a way to "demap." Plus I have no way to write for "Augmentin," the brand name. THAT is aggravating because I write for that 90% of the time. On another note, which I believe has been brought up before and was happening prior to this mapping thing, a LOT of my active meds get moved to inactive randomly.

I see two choices for Augmentin suspension and one for the pills.
Some dosing options are not included.

I would think this is an issue with an incomplete database rather than a mapping issue.

Agreed, I think this is database, because there are other medications I can not find.

Glucophage XR 500mg is an example, it is an out dated NDC, did not change with mapping and can not codify it. Frustrating.