HL7AU - FHIR WG : MedicationRequest

Approval Number

this is a PBS coding?

Example

<MedicationRequest>
    ...
    <extension url="http://hl7.org.au/fhir/StructureDefinition/pbs-approval-number">
      <valueCoding/>
    </extension>
   ...

</MedicationRequest>

Authority Numbers

Example

<MedicationRequest>
    ...
    <extension url="http://hl7.org.au/fhir/StructureDefinition/pbs-authority">
      <valueIdentifier/>
    </extension>
   ...

</MedicationRequest>

FRED IT: ?? identifier http://erx.com.au/id/DVAAuthority

TGA Schedule

https://www.tga.gov.au/scheduling-basic
coding system?

Example

<MedicationRequest>
    ...
    <extension url="http://hl7.org.au/fhir/StructureDefinition/tga-schedule">
      <valueCode/>
    </extension>
   ...

</MedicationRequest>

Concession Benefit Entitlement

Need input from the MyHealthRecord mobility implementation; is there are definiton already?

http://meteor.aihw.gov.au/content/index.phtml/itemId/603679

value set definition includes: PBS Status, Close the Gap
PBS Status: PBS, RPBS, private, CTG
ExplanationOfBenefit
Do we need extension outward reference?
DCM: MedicationInstruction.concessionBenefit

Terminology

NCTIS: Admin Codes - Medical Benefit Category Type

displayName	code	codeSystemName	codeSystem
PBS	1	NCTIS Medical Benefit Category Type Values	1.2.36.1.2001.1001.101.104.16095
RPBS	2	NCTIS Medical Benefit Category Type Values	1.2.36.1.2001.1001.101.104.16095
CTG	3	NCTIS Medical Benefit Category Type Values	1.2.36.1.2001.1001.101.104.16095
No Benefit	9	NCTIS Medical Benefit Category Type Values	1.2.36.1.2001.1001.101.104.10159

Example

<MedicationRequest>

    ...
        <id value="(eobId)"/>
    ...
    <extension url="http://hl7.org.au/fhir/StructureDefinition/concession-benefit">
        <valueReference reference="ExplanationOfBenefit/(eobId)"/>
    </extension>
    ...
</MedicationRequest>

<ExplanationOfBenefit>

    ...
        <id value="(eobId)"/>
    ...

        <prescription reference="MedicationRequest/(medicationId)"/>
    ...

</ExplanationOfBenefit>

Grounds for Concurrent Supply

Value-set: regulation 24, hardship conditions
DCM: MedicationInstruction.dispensing.groundsForConcurrentSupply

Terminology

NCTIS: Admin Codes - Concurrent Supply Grounds

displayName	code	codeSystemName	codeSystem
Pursuant to Regulation 24	1	NCTIS Concurrent Supply Grounds Values	1.2.36.1.2001.1001.101.104.16085
Hardship Conditions Apply	2	NCTIS Concurrent Supply Grounds Values	1.2.36.1.2001.1001.101.104.16085
No Grounds	9	NCTIS Concurrent Supply Grounds Values	1.2.36.1.2001.1001.101.104.16085

Example

<MedicationRequest>
    ...
    <extension url="http://hl7.org.au/fhir/StructureDefinition/grounds-for-concurrent-supply">
      <valueCoding/>
    </extension>
   ...

</MedicationRequest>

Minimum Dispensing Interval

aka: minimum interval between repeats
always unit day?
DCM: MedicationInstruction.dispensing.minimumIntervalBetweenRepeats

<MedicationRequest>
    ...
    <extension url="http://hl7.org.au/fhir/StructureDefinition/minimum-dispensing-interval">
      <valueDuration>
        <value/>
        <system value="http://unitsofmeasure.org"/>
        <code value="d"/>
    </extension>
   ...

</MedicationRequest>

eRx SCID

FRED IT: MedicationRequest.Identifier http://erx.com.au/id/eRxSCID

EAN/GTIN

Barcode -> Package+Product Identifier Type

Not in the basic GTIN is another set of product Information: lot number/batch number extra bar codes

Change Type

Definition: The way in which this instruction differs from the previous instruction

Data type: Text

Value domain: SNOMED CT-AU Concept Id: 15071000036100 |Change type reference set|

displayName code codeSystemName codeSystem

Unchanged 01 NCTIS Change Type Values 1.2.36.1.2001.1001.101.104.16592

Changed 02 NCTIS Change Type Values 1.2.36.1.2001.1001.101.104.16592

Cancelled 03 NCTIS Change Type Values 1.2.36.1.2001.1001.101.104.16592

Prescribed 04 NCTIS Change Type Values 1.2.36.1.2001.1001.101.104.16592

Ceased 05 NCTIS Change Type Values 1.2.36.1.2001.1001.101.104.16592

Suspended 06 NCTIS Change Type Values 1.2.36.1.2001.1001.101.104.16592

All codes from system http://hl7.org/fhir/medication-request-status

Code	Display	Definition
active	Active	The prescription is 'actionable', but not all actions that are implied by it have occurred yet.
on-hold	On Hold	Actions implied by the prescription are to be temporarily halted, but are expected to continue later. May also be called "suspended".
cancelled	Cancelled	The prescription has been withdrawn.
completed	Completed	All actions that are implied by the prescription have occurred.
entered-in-error	Entered In Error	The prescription was entered in error.
stopped	Stopped	Actions implied by the prescription are to be permanently halted, before all of them occurred.
draft	Draft	The prescription is not yet 'actionable', i.e. it is a work in progress, requires sign-off or verification, and needs to be run through decision support process.
unknown	Unknown	The authoring system does not know which of the status values currently applies for this request

All codes from system http://hl7.org/fhir/medication-request-intent

Code	Display	Definition
proposal	Proposal	The request is a suggestion made by someone/something that doesn't have an intention to ensure it occurs and without providing an authorization to act
plan	Plan	The request represents an intension to ensure something occurs without providing an authorization for others to act
order	Order	The request represents a request/demand and authorization for action
instance-order	Instance Order	The request represents an instance for the particular order, for example a medication administration record.

MedicationRequest.intent = order for all.

Unchanged -> MedicationRequest.status = active

Changed -> MedicationRequest.status = active

Cancelled -> MedicationRequest.status = cancelled

Prescribed -> MedicationRequest.status = active

Ceased -> MedicationRequest.status = stopped

Suspended -> MedicationRequest.status = on-hold

extension - 'Active Status': new / changed / unchanged

Change Status

Definition: Identifies whether the change has already been made or is a recommendation that has not been made.

Data type: Text

Value domain: SNOMED CT-AU Concept Id: 669181000168104 |Change status reference set|

displayName code codeSystemName codeSystem

A recommendation to make the change. 01 NCTIS Recommendation or Change Values 1.2.36.1.2001.1001.101.104.16594

The change has been made. 02 NCTIS Recommendation or Change Values 1.2.36.1.2001.1001.101.104.16594

Recommendation - MedicationRequest.intent = proposal

Change Made - MedicationRequest.intent = order

Change Description

Definition: Description of the change in the subject's medication item information.

Data type: Text

Just MedicationRequest.note ?

Status implies whether a change.

Change or Recommendation Reason

Definition: The justification for the stated change in medication.

Data type: Text

Just MedicationRequest.reasonReference / reasonCode ?

Status implies whether a change or recommendation reason.