title: A prototype knowledge base and SMART app to facilitate organization of patient medications by clinical problems.
abstract: Increasing use of electronic health records requires comprehensive patient-centered views of clinical data. We describe a prototype knowledge base and SMART app that facilitates organization of patient medications by clinical problems, comprising a preliminary step in building such patient-centered views. The knowledge base includes 7,164,444 distinct problem-medication links, generated from RxNorm, SNOMED CT, and NDF-RT within the UMLS Metathesaurus. In an evaluation of the knowledge base applied to 5000 de-identified patient records, 22.4% of medications linked to an entry in the patient's active problem list, compared to 32.6% of medications manually linked by providers; 46.5% of total links were unique to the knowledge base, not added by providers. Expert review of a random patient subset estimated a sensitivity of 37.1% and specificity of 98.9%. The SMART API successfully utilized the knowledge base to generate problem-medication links for test patients. Future work is necessary to improve knowledge base sensitivity and efficiency.
authors.affiliation: School of Biomedical Informatics, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
authors.forename: Allison B
authors.initials: AB
authors.lastname: McCoy
authors.forename: Adam
authors.initials: A
authors.lastname: Wright
authors.forename: Archana
authors.initials: A
authors.lastname: Laxmisan
authors.forename: Hardeep
authors.initials: H
authors.lastname: Singh
authors.forename: Dean F
authors.initials: DF
authors.lastname: Sittig
mesh_terms: D004360:Drug Therapy, Computer-Assisted; D057286:Electronic Health Records; D006801:Humans; D051188:Knowledge Bases; D008501:Medical Records, Problem-Oriented; D004364:Pharmaceutical Preparations; D017432:Unified Medical Language System; D018875:Vocabulary, Controlled
chemical_list: D004364:Pharmaceutical Preparations