Stream: implementers
Topic: Change in medication
Dave Barnet (Jan 05 2018 at 15:08):
What's the best way to represent changes (and no change) to medication in FHIR to help in medication reconciliation? (assume a FHIR document with coded statements)
The use case is that a patient is admitted to hospital and their dose of Ramipril is changed from 5mg to 10mg. They are started on Warfarin and told to keep taking their current dose of Lisinopril. The hospital needs to let the General Practitioner know about the change.
Is it as simple as a series of MedicationStatements
1. a status of "stop" on Ramipril 5mg
2. a status of "active" on Ramipril 10mg
3. a status of "active" on Warfarin
4. a status of "active"on Lisinopril (with the original effective date) ?
OR should I use a Flag resource to Flag the 5mg Ramipril as being stopped, the 10mg Ramipril Warfarin as added & Lisinopril as continued?
Which option would make the reconciliation easier for the recipient?
Jose Costa Teixeira (Jan 05 2018 at 15:30):
Sorry, removed previous comment after reading the idea is to report back to the GP
Jose Costa Teixeira (Jan 05 2018 at 15:31):
(deleted)
Jose Costa Teixeira (Jan 05 2018 at 15:45):
If your question is whether to use Flag, i'd say no
Jose Costa Teixeira (Jan 05 2018 at 15:46):
a flag is to indicate emerging conditions or info.
Lloyd McKenzie (Jan 05 2018 at 15:46):
The List resource allows you to document what changes have been made
Jose Costa Teixeira (Jan 05 2018 at 15:46):
in this case, a flag could make sense is more like "be aware that this patient's medication is increased / stopped".
Jose Costa Teixeira (Jan 05 2018 at 15:47):
if you want to later reconcile, use the statements.
Lloyd McKenzie (Jan 05 2018 at 15:48):
Flag is generally for ongoing situations that needs to be seen immediately before interacting with the patient. Things like "latex allergy", "hard of hearing", etc.
Jose Costa Teixeira (Jan 05 2018 at 15:48):
yep, bring the statements under a list
your specific list is "list of things that happened to this patient's medication upon admission"
Brian Postlethwaite (Feb 22 2018 at 00:27):
Is there an operation that returns the current list of active meds?
I thought I remembered one called $current, but I can't find it, was it this one:
http://build.fhir.org/list-operation-find.html (with current-medications as name can't see it)
Melva Peters (Feb 22 2018 at 01:12):
In the US Meds Implementation Guide, there are some searches for Medication Lists that include MedRequests and MedStatements. http://build.fhir.org/ig/Healthedata1/FHIR-ONC-Meds/guidance.html#uc-1
Last updated: Apr 12 2022 at 19:14 UTC
