Use of RxNorm to Exchange Codified Drug Allergy Information between Department of Veterans Affairs (VA) and Department of Defense (DoD)

Under a congressional mandate, VA and DoD have built a framework to exchange standardized, codified patient drug allergy information through a mediation terminology. Initially, the Unified Medical Language System (UMLS) was deemed to be the most appropriate translator. After both agency files were mapped to UMLS, DoD could understand 45 percent of VA's mapped terms and VA could understand 26 percent of DoD's mapped terms. A significant portion of the non-mediated information was brand names in DoD with generic counterparts in VA. Recently, a Consolidated Health Informatics (CHI) group designated RxNorm as the standard for trade name allergies. An analysis was conducted to estimate mediation improvement using RxNorm. Both agency files were re-mapped to RxNorm. By utilizing the RxNorm defined relationships between brand names and generics and between variants of therapeutic moieties , DoD will understand 74 percent of VA terms and VA will understand 58 percent of DoD terms.