FHIR Chat · Algorithm output is medication · implementers

Stream: implementers

Topic: Algorithm output is medication

Krishna Moorthi (Jul 21 2021 at 10:27):

Hi all,

We have an application algorithm which recommends a “family” of medications. I am looking for an approach on how to document the output of the data. The recommendation would be a medication, I guess I would use a "MedicationRequest". For example, a algorithm analyzes various vitals and generates medication recommendation.

Is this assumption correct? Any suggestions to represent such information as FHIR resources is much appreciated.

Thanks!

Rik Smithies (Jul 21 2021 at 13:08):

if this is a single "instance" of a decision to be communicated and actioned then perhaps this is DetectedIssue http://hl7.org/fhir/detectedissue.html
Or if this is a bit of general knowledge that is created and then referred back to then over time for many cases, then it may be an new indication, and that could be ClinicalUseDefintion, from R5 (recently renamed from ClinicalUseIssue) http://build.fhir.org/clinicalusedefinition.html
I don't think you would go direct to a MedicationRequest without some other step in the loop, unless it really is a prescription generating system, not just an advising system.

Lloyd McKenzie (Jul 21 2021 at 14:57):

MedicationRequest (with intent=proposal) if you're passing back a decision support recommendation and want to actually provide a 'draft' prescription with appropriate dose and other information filled in. We actually have a number of decision support engines that create Request resources in that manner.

Krishna Moorthi (Jul 21 2021 at 15:21):

Thanks Rik & Lloyd.
the process of this recommendation is below.

1. Practitioners will input some current vitals and along with history of vital data
2. Application algorithm will assess the data and provide the medication family (ex.,Biguanides)
3. Algorithm can return one medication family or multiple.
4. practitioner may prescribe a medication in any one of the family
5. so the output data only contains medications families data.

Rik Smithies (Jul 21 2021 at 15:47):

CDS Hooks may cover this https://cds-hooks.org/ but I don't know if/how it represents the actual medication choice. DetectedIssue has the right concept of "things found by decision support" but doesn't seem to cover a medication suggestion. Maybe an almost empty MedicationRequest in proposal mode.

Lloyd McKenzie (Jul 21 2021 at 16:22):

For something like this where you're just providing a high level medication code, I would look at GuidanceResponse.

Krishna Moorthi (Jul 22 2021 at 09:21):

Thanks @Llyod & Rik. It is more of a use case where not only the output of medication family. it is also practitioner will prescribe medication after that. I have come to proposal based on your inputs from above.

Proposal for Algorithm output:

1. Create a MedicationRequest with draft status and codable concept with (family medication code) , supportingInformation element contains reference where all the data (like bg, HbA1c etc ) used in decision support system

Proposal for Practitioner prescription:

2. Create a MedicationRequest with active status and medicationReference for actual prescription of medication from the family. basedOn element will be referenced with output of family medication on above from step1.

Thanks

Last updated: Apr 12 2022 at 19:14 UTC