Custom Lists & Organization Formulary

In modern clinical practice, relying solely on standardized international medication databases can be limiting. Clinics frequently stock localized brand names, specialized compounded solutions, herbal formulations, or prefer prescribers to prioritize in-stock dispensary inventory.

Medaius provides a dedicated Custom Lists & Formulary Engine that empowers Clinic Administrators and Medical Directors to curate an internal drug catalog, map custom items to standardized medical terminologies, and control clinical prescribing search behavior across the practice.

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1. Configuring Search Scope & Code Lists

Practice Administrators can determine where prescribers source medication information under Admin → Configuration → Custom Lists (/admin?section=config&tab=custom_lists):

Drug Search Sources:

1. RxNorm (system):
   • Prescribers search exclusively against the international standardized RxNorm database.
   • Useful for practices that do not dispense internal inventory and rely on external commercial pharmacies.
2. Your list (org):
   • Prescribers only see medications that have been explicitly approved, cataloged, and enabled in your clinic's drug list.
   • Ideal for specialized clinics, dispensaries, or health posts operating with a strict, closed formulary.

   [!NOTE] To prevent prescribers from encountering blank search results, the Your list option is automatically disabled if your clinic formulary contains zero enabled medications.

3. Both (both) (Recommended):
   • Provides a blended search experience. When a doctor types a medication name, matching drugs from your clinic formulary appear first, followed by broader results from RxNorm.
   • Ensures clinic inventory is prioritized while retaining immediate access to global pharmaceutical references.

Real-Time Catalog Overview:

• The configuration card displays the active count of enabled medications (e.g., 3 drugs in your list) along with flagged counts for items requiring review.
• A direct Manage drug list → link provides quick access to the formulary catalog (/custom-lists/drugs).

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2. Organization Drug Catalog Directory

Navigate to Custom Lists → Drugs (/custom-lists/drugs) to manage your clinic's medication master list:

Directory Highlights & Filtering:

• Interactive Status Filters:
  • All: View all cataloged items across the organization.
  • Needs review: Highlights drugs imported without standardized code bindings that require clinical verification.
  • Linked: Medications successfully mapped to standardized RxNorm concepts.
  • No code: Uncoded medications explicitly marked as custom formulations or herbal remedies.
  • Disabled: Temporarily deactivated medications hidden from prescriber searches.
• Detailed Formulary Columns:
  • Drug: Medication display name and associated generic active ingredient.
  • Strengths · Forms: Configured dosage strengths and delivery forms (e.g., 250 mg Cap, 500 mg Tab · Oral Pill).
  • RxNorm: Status badge indicating the linked RxNorm CUI concept ID (RxNorm 104416), No code, or Needs review.
  • Local code: National regulatory code or FDA registration numbers.
• Instant Search: Real-time debounced filtering by medication name, generic ingredient, or category.

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3. Adding & Editing Medications

To catalog a new medication, click Add drug (/custom-lists/drugs?drugId=new), or click any existing row in the directory to modify its details:

Key Configuration Sections:

A. Standardized RxNorm Mapping

• Search RxNorm: Type the generic or international nonproprietary name (e.g., amlodipine, metformin, paracetamol). Selecting an RxNorm concept automatically imports its generic name, therapeutic category, ATC classification, and standard dosage forms.
• Change or Unlink: Re-map an existing medication at any time with a single click.
• "No RxNorm code" Toggle: For traditional herbal remedies (e.g., Herbal Cough Syrup), specialized hospital compounds, or local preparations that do not have an international equivalent, check No RxNorm code to bypass standard mapping cleanly.

B. Clinical Details & Categorization

• Name (Required): The localized or commercial brand name recognized by your clinic staff and prescribers.
• Generic Name: Active pharmacological compound.
• Category: Therapeutic class (e.g., Antihypertensive, Analgesic / Antipyretic, Respiratory).

C. Strengths, Forms, and Routes (Quick-Pick Chips)

Tag chips configured here directly power the one-click dosage selectors available to prescribers during consultations:

• Strengths: Enter numeric potencies (e.g., 5 mg, 10 mg, 500 mg).
• Forms: Physical preparation (e.g., Tablet, Capsule, Oral Liquid, Injection).
• Routes: Administration pathway (e.g., Oral, Intravenous, Topical).

D. Regulatory Tracking & Operational Status

• ATC Code: Anatomical Therapeutic Chemical code for epidemiological reporting.
• Local Code & System: Food and Drug Administration (FDA) registration number or internal pharmacy stock keeping unit (SKU).
• Enabled / Disabled: Deactivate a medication when temporarily out of stock without deleting historical patient prescribing records.

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4. Bulk Importing via Google Sheets & CSV

Practices migrating existing pharmacy spreadsheets or hospital inventory systems can import hundreds of medications in seconds by clicking Import:

Import Methods:

1. Google Sheets Integration:
   • Paste the link to a public Google Sheet (https://docs.google.com/spreadsheets/d/...).
   • Medaius reads published sheets directly, allowing team collaboration on spreadsheets before instant synchronization into the clinic EMR.
2. CSV Upload:
   • Upload a comma-separated .csv file directly from your computer.

Supported Spreadsheet Columns:

[!TIP] Automatic Code Binding: If you supply an rxnorm_cui in your spreadsheet, Medaius automatically validates and links the concept during import. If omitted, the row is added and marked with a Needs review status so medical staff can link it manually with one click.

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5. Prescriber Workflow & Clinical Ordering

When clinicians order medications in patient charts (via the Medications ledger or inside the Encounter Consultation Workbench), the custom lists configuration enhances the prescribing experience:

Clinical Prescribing Features:

• Search Context Banner: Clarifies the active search scope directly under the input bar (e.g., “Searching your list, then RxNorm” or “Searching your list”).
• Formulary Badging: When searching in Both mode, items from your clinic formulary display a prominent Your list badge to help doctors choose in-house medications first.
• One-Click Quick-Pick Chips: Selecting a clinic medication displays pre-configured Dosage/Strength chips (e.g., 250 mg Cap, 500 mg Cap, 500 mg Tab). Prescribers click once to populate the exact dose rather than typing manually.
• Automatic RxNorm Continuity: When a prescription is saved, the associated RxNorm code is stored with the patient's record, ensuring safety checks, allergy interaction monitoring, and standardized referral summaries remain fully compliant.