Out of band discussion on projects using Medications List
- Brett Esler
- Danielle Bancroft
- Dusica Bojicic
- Richard Townley-O'Neill
- Grahame Grieve
Agenda
- Discuss plans for common advice on medications list types and implementation
- Project scope of Interest
- FRED IT projects and scope of completed work
- Agency lists in documents (Shared Health, Discharge Summary, Event Summary)
- Oridashi current medications list; prescription history list
- Types to discuss of list and attributes of those lists
- Current medications (GP)
- Current medications (Discharge)
- Ceased medication (Discharge)
- Relevant medications (Event Summary)
- Prescribing history (GP/Dispense?)
- Reconciled (Review?)
- Appropriate List.mode and List.status usage
- Change records
- List.entry used for change record
- Change type vocabulary - agency work
- Proposed List.entry.extension - change-description - detailed change text statement
- Preadopt use of PractitionerRole as STU3 extension
- Suggest invariant - make sure entry.flag matches MedicationStatement.status
Discussion
FRED
- FRED MedsList/MedsReconcillation all transactions
- Prescription exchange ERX/Medisecure
- Opt-out MedView (Austin Health/Peninsula)
- Prescriber/Dispenser can manage this list
- Include OTC list
- Source of the information
- Community pharmacy
- Point in time record of reconciled list
- Single instance of each medication
- MyHR Discharge Summary is accessible
- Storing
- List, MedicationStatement (contained Medication)
- List of MedicationRequest
- List of MedicationDispense
- Reconciled as the Current Medications List
- Hospital - admission/discharge review
- Community - medications check, home medicine review
- Declaration of context - info on the reconcilation; reasons; risks - QuestionnaireResponse ; extension on List resource
- Withheld date range
- Clinical Intervention (change record) - QuestionnaireResponse
Agency
- Proposed use in documents
- Base AU common proposal
- Change vocabulary common exchange proposal
List Types
- Types of list can affect the allowed content in the list
- Provenance used for the source detail
- Medication List Types
Type 1- Process Medication Reconciliation -Hospital: Admission/Discharge; Pharmacist/Nurse: RMMR / MMR (regular/diabetes) / Pharmacist: HMR
- List of MedicationStatement (complete)
- Active and Ceased meds
- No restriction on MedicationStatement
- Includes change detail
Type 2
- GP comprehensive meds summary / Record Transfer
- List of MedicationStatement (complete)
- No restriction on MedicationStatement
- Active and Ceased meds
- no change detail
Type 3
- SHS current meds
- List of MedicationStatement (complete)
- Active meds
- no change detail
Type 4
- Event Summary Meds / Discharge Summary (as one list)
- List of MedicationStatement (pertinent)
- Includes change detail
- Active and Ceased meds
- Work to do: How to handle draft record - discussion point on how to address this
- Work to do: Representation of Declaration of Context in detail (common reconciliation content)
- Work to do: Use of Provenance with medication lists
- Work to do: Withheld date range
- BE: summarise list types discussion
- BE: AU Base Medication List general purpose
- BE: add the text change extension as agency proposed
- BE: publish draft of change status vocabulary (look at definitions - simplify) - Packing Patient Medication Profile (PMP) definitions (source also)
- Who to involve: FRED, Oridashi, Agency, Webster, Cerner and others