Standardized Placement of Cannabinoids on the Medication List (of the electronic medical record)

[ptkocis]

Issue Name: A few years ago, CMS accepted my language to include the placement of cannabinoids (e.g., OTC, Rx, CBD, x:y (CBD/THC), medical cannabis) on the electronic medical record - medication LIST. This is associated with CMS' 'Documentation of Current Medications in the Medical Record' as per the following link: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS68v13.html
This in order to develop the framework for standardized drug-drug interaction screening with other medications.

Recognizing that OHDSI's focus is largely based on the inclusion of already captured observational data, this project idea allows OHDSI a unique opportunity to offer opinion, suggestions, in advance of the data elements/class being approved by HealthIT.gov - this for the standardized placement of cannabinoids and their respective routes of administration (ROA) onto the electronic medical record - medication LIST.

I have been emphasizing medication LIST since cannabinoid use if often placed in the notes, outpatient letter, by the health care provider. More recently, these text sections are being captured by way of natural language processing algorithms to locate these cannabinoids. This idea is NOT an cannabinoid advocacy project, but more related to a patient safety initiative, to reduce potential drug-drug interactions, and thus improve patient care, safety and outcomes.

Issue Type: I have already created a list of standardized cannabinoids and ROA for placement on the electronic medical record where I have received comment from cannabis dispensing pharmacists. I have also discussed this idea with the NLM RxNorm dept, and more recently HelathIT.gov. I was informed by HealthIT.gov to submit this idea for consideration to the United States Core Data for Interoperability (USCDI) for new data elements and classes (v5) due September 20th, 2023 @ 11:59PM.

Description: Some of the ROA are related to smoking/inhalation and some of the medical cannabis formulation are different (e.g., shatter) than the more commonly recorded 'tablet, capsule'. Since OHDSI represents a large diverse community, OHDSI support for this project would be incredibly helpful for the v5 submission.

This idea can also be linked to the to the Joint Commission (NPSG.03.06.01) / Medication Reconciliation patient safety initiative - https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2023/npsg_chapter_ahc_jul2023.pdf

Related forum post: I can provide the standardized list and the ROAs - and would welcome your critiques, expert opinions - and path forward. If at all possible, I would like to include any of OHDSI comments by Sept 18th @12noon, so I can include before the v5 USCDI submission deadline of September 20th, 2023 @ 11:59PM.

Also, knowledge of cannabinoid use can be helpful in the perioperative setting where alcohol and tobacco abuse is often treated post surgical procedure while hospitalized.

Thank you in advance for considering. I look forward to continuing this discussion.

Reported By: Paul T. Kocis, PharmD, MPH (Penn State Hershey Medical Center)