Medication and indication linkage: A practical therapy for the problem list?
BACKGROUND
Establishing a relationship between medications and diagnoses within a functioning electronic medical record system (EMR) has many valuable applications,such as improving the quality and utility of the problem list to support better decisions.


METHODS
We evaluated over 1.6 million de-identified patient records from the Regenstrief Medical Record System (RMRS) with over 90 million diagnoses and 20 million medications. Using RxNorm, the VA National Drug File Reference Terminology, and SNOMED-CT (SCT)standard terminologies and mappings we evaluated the linkage for local concept terms for medications and problems (diagnoses & complaints).


RESULTS
We were able to map 24,398 candidates as medication and indication pairs. The overall sensitivity and specificity for term pairs was 67.5% and 86% respectively and 39.5% and 97.4 when adjusted for term pair occurrence within single patient records.


CONCLUSIONS
Medications can be mapped by machine to a disease/ disorder using established terminology standards.This mapping may inform many knowledge management and decision support features in an EMR.
Burton
Matthew M
MM
Regenstrief Institute,Indiana University School of Medicine; and Indiana University Schoolof Informatics, USA.
Simonaitis
Linas
L
Schadow
Gunther
G
D020000:Decision Support Systems, Clinical; D004358:Drug Therapy; D017723:Drug Utilization Review / Q000379:methods*; D016347:Medical Records Systems, Computerized; D008510:Medication Systems, Hospital; D009323:Natural Language Processing; D014481:United States; D018875:Vocabulary, Controlled