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Medication Class in Chart

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MEL, SQL, Oracle

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ronmoses

(@ronmoses)

Posts: 158

Estimable Member

Topic starter

In the CPS chart's Medication section, there is a column called Class. It features entries such as "Analgesics and Anesthetics", "Respiratory Agents", "Anti-infective Agents", etc. I'm having difficulty determining where in the database this field lives. I've done a brute-force search of the database for a couple of these terms and it's come up empty. I don't find them in the GEMedispan database either.

What I need to do is identify all antibiotic meds, but manually sifting through a list of thousands of GPI codes doesn't seem like a realistic way to accomplish this. If CPS is displaying this information, there must be some way for a report to grab it as well. They can't possibly have the entire GPI database hard-coded into the application for this purpose.

Posted : July 19, 2017 1:24 am

Lee

(@lee-cooper)

Posts: 348

Reputable Member

Review the table named 'MS_TCRF'. I think you will like what you find. 😉

Posted : July 19, 2017 7:36 am

DavidShower

(@davidshower)

Posts: 1255

Noble Member

Also in mldefs.txt - Object _ThereputicClass (yes, spelled that way)

Posted : July 19, 2017 9:33 am

ronmoses

(@ronmoses)

Posts: 158

Estimable Member

Topic starter

I've reviewed MS_TCRF, and have seen the report based on it, but its descriptions don't match up to what's displayed in the chart.

Posted : July 19, 2017 10:34 pm

Lee

(@lee-cooper)

Posts: 348

Reputable Member

All or some?

If some, you might want to verify that the medication is not a combination medication or being used 'off label'. Both of these conditions can return different information from 'use'.

If all, then you might need to check with GE Support to see if something is broken or 'changed'.

MS_TCRF is the table that stores the Group, Class, Sub-Class information.

Posted : July 20, 2017 3:39 am

ronmoses

(@ronmoses)

Posts: 158

Estimable Member

Topic starter

For example, I'm looking at a patient with three meds. The classes displayed in the chart's medication section read "Central Nervous System Drugs" (Ativan), "Topical Products" (Triamcinolone Acetonide), and "Respiratory Agents" (Albuterol Sulfate). None of those descriptions exist in MS_TCRF. Added to which, all classes displayed in that grid are proper case, while everything in MS_TCRF is uppercase. So it seems pretty clear that's not where they're coming from.

Posted : July 20, 2017 3:56 am

Lee

(@lee-cooper)

Posts: 348

Reputable Member

I see where your disconnect may be. Understanding the table is key. The table is set to certain 'depths' of the GPI code referenced by the TC_TYPE field.

TC_TYPE 1 will match on the first two digits of the GPI to produce the Group Name

TC_TYPE 2 will match on the first four digits of the GPI to produce the Class Name

TC_TYPE 3 will match on the first six digits of the GPI to produce the Sub-Class Name

TC_Type 4 will match on the first 10 digits of the GPI to produce the Medication Name plus extension (i.e. med name + HCL)

At one time, there was a Type 5, which produced the full medication name dose form and strength, but I believe that has been dropped from the table now.

The Group, Class, Sub-Class, and Med-Extension names are all found in the TC_NAME field. The example you show demonstrates the Group name (type 1) is being displayed. I think you just needed to dig a bit deeper?

Posted : July 20, 2017 4:58 am

ronmoses

(@ronmoses)

Posts: 158

Estimable Member

Topic starter

I've done a SELECT against that table WHERE TC_NAME = each of those values. The query comes up empty. Those values do not appear in the table.

Posted : July 20, 2017 5:01 am

Lee

(@lee-cooper)

Posts: 348

Reputable Member

Interesting. What EMR version? In the MLDEFS.TXT file for that version, what table is the _TheraputicClass definition referencing?

Posted : July 20, 2017 5:07 am

ronmoses

(@ronmoses)

Posts: 158

Estimable Member

Topic starter

CPS12, and mldefs is referencing that file.

Posted : July 20, 2017 5:10 am

Lee

(@lee-cooper)

Posts: 348

Reputable Member

Instead of searching, have you tried to return all values in the table? Does it contain anything?

Posted : July 20, 2017 5:12 am

ronmoses

(@ronmoses)

Posts: 158

Estimable Member

Topic starter

Yes, I've done a SELECT *, and there's plenty in the table. All the names are in all caps, and none of them correspond to what's displayed in the chart module.

Posted : July 20, 2017 5:16 am

Lee

(@lee-cooper)

Posts: 348

Reputable Member

Quite odd. What exactly are you looking to achieve?

Posted : July 20, 2017 5:26 am

ronmoses

(@ronmoses)

Posts: 158

Estimable Member

Topic starter

I was hoping to leverage those descriptions to find all antibiotics as one big class. Since the application lumps them all together as "Anti-Infective Agents", no reason I shouldn't be able to do the same. But in the absence of that option, we had to sift through MS_TCRF after all, try to identify every class that would represent an antibiotic (an arduous task), and use that list as our filter. It works, I'm just hoping we didn't miss any.

Posted : July 20, 2017 5:30 am

Lee

(@lee-cooper)

Posts: 348

Reputable Member

I compiled a list nearly a decade ago that I use as my cheat sheet. Maybe it will be of some help?

GPI Classification System

Understand that the accuracy of the list is not complete due to off label uses of medications (where the original class is retained) and combination medications (where the primary component's classification determines the overall class).

With all of the possibilities, you can be assured that you have missed a few, at minimum, just be sure to code things so that you can include more digits in the GPI mask for matching and add them on the fly as they are identified. It is about the best you can hope for given the fluid nature of pharmaceuticals.

Good Luck!

Posted : July 20, 2017 5:48 am

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