MedicationRequest.medicationCodeableConcept odd terminology

[Feng Niu]

Hi,

We are using the R4 API, and found that most of the medication codes (MedicationRequest.medicationCodeableConcept) have the coding system "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/synonym" rather than RxNorm. See examples below. What terminology is that? Is it something we need to deal with on production systems? If so, how do we map them to standard terminologies?

{"coding": [{"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/synonym", "code": "274145179", "display": "R-Tannic-S A/D (phenylephrine 5 MG / pyrilamine 30 MG) per 5 ML Oral Suspension", "userSelected": true}], "text": "template non-formulary (medication) (R-Tannic-S A/D (phenylephrine 5 MG / pyrilamine 30 MG) per 5 ML Oral Suspension)"}

{"coding": [{"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/synonym", "code": "274145179", "display": "AA_Medication", "userSelected": true}], "text": "template non-formulary (medication) (AA_Medication)"}

{"coding": [{"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/synonym", "code": "274145179", "display": "Charmander", "userSelected": true}], "text": "template non-formulary (medication) (Charmander)"}

{"coding": [{"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/synonym", "code": "274145179", "display": "template non-formulary (medication) (traMADol-acetaminophen)", "userSelected": true}], "text": "template non-formulary (medication) (template non-formulary (medication) (traMADol-acetaminophen))"}

Feng

[Fenil Desani (Cerner)]

Hello,

https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/synonym is the Cerner's Proprietary System binding [1]

Yes, you would see that in PROD. If the RxNorm is not associated with that Med, it would not come back in the FHIR response.

[1] http://fhir.cerner.com/millennium/r4/proprietary-codes-and-systems/#medications-1

Thanks,

Fenil

[Feng]

Thanks, Fenil. Are the "code" values meaningful? For example, it's "274145179" for all of them in my examples.

Are there ways to obtain metadata for such proprietary codes besides the "code" and "display" values in the FHIR resources?

Feng

[Francesca Ricci-Tam]

I am also interested in the question -- are the proprietary Cerner 'code' values meaningful? Is there a way to translate between those codes and RxNorm if RxNorm is not present?