Stream: implementers
Topic: Dates in Medication order
Shanta Sankaran (May 06 2016 at 00:40):
Hi! Can anyone shed some light on why the medication order (http://hl7.org/fhir/medicationorder.html) has a dateEnded (which is clearly about the medication as indicated by reasonEnded), but does not have a dateStarted?
We have HL7 V2 data that includes the start and end date times, and we are not able to map the start date while the end date can be mapped. Thanks!
Josh Mandel (May 06 2016 at 01:11):
In your V0.0.0.2 model, do "start date" and "end date" indicate the clinician-prescribed times to start and stop, or the (presumably patient-reported) actual dates on which these events occurred?
Shanta Sankaran (May 06 2016 at 01:55):
The start and end date-time fields are by definition the scheduled times to start and stop and that is how we interpret them even in past data.
They are not patient-reported actual dates.
Josh Mandel (May 06 2016 at 02:30):
Then you want to populate those values in MedicationOrder.dosageInstruction[].timing.repeat.boundsPeriod (start and end).
Josh Mandel (May 06 2016 at 02:31):
See discussion at https://chat.fhir.org/#narrow/stream/implementers/topic/prescription.20with.20.22stop.20date.22
Lloyd McKenzie (May 06 2016 at 17:19):
So the dosage instructions say "when *should* the patient start?". An actual date started would be "when did they really start taking the med?" (just as date ended says "when did they actually stop taking the med?" - independent of what may have been initially requested. I'm not familiar with many/any systems that capture the former, though it could certainly be done with an extension. If you feel it really is a common thing, then you could submit a change proposal.
Shanta Sankaran (May 08 2016 at 20:47):
Thank you very much.
Josh Mandel (May 08 2016 at 20:48):
The correct usage is to report when a patient, in fact, stopped taking the drug.
Josh Mandel (May 08 2016 at 20:48):
(In practice I don't know how often this is recorded well.)
Shanta Sankaran (May 08 2016 at 23:17):
Thanks a lot. This has been very helpful for implementation.
Last updated: Apr 12 2022 at 19:14 UTC
