Stream: implementers
Topic: How can summary data be represented in FHIR?
Keerthi M (Mar 24 2021 at 11:39):
We are using the MedicationAdministration resource to capture each Insulin administration recorded by a pump device at different times of the day. We also need to capture a summary/total of the Insulin administered per day. We are unable to capture this in MedicationAdministration again because it will lead to data duplication. Is there any way to handle this in the MedicationAdministration resource? Or can we use a different resource like MedicationStatement to capture the summary? Since this data is coming from a device I am not sure MedicationStatement is ideal. Any inputs are highly appreciated.
Thanks!
Lloyd McKenzie (Mar 24 2021 at 13:09):
Two options:
- you could have two MedicationAdministration instances, with the detailed ones having a 'partOf' relationship to the overall. That would mean you'd need to define your 'overall' before you define your details, and then update it at the end of the day to reflect the totals (or perhaps update it as you go). You wouldn't have a duplication issue because the partOf relationships would differentiate the 'detail' records from the 'summary' record
- you could use MedicationStatement as your summary and would need to use an extension to indicate the source as a Device (feel free to submit a change request to add Device as an allowed informationSource in future versions). That's probably more granular than what most systems would expect MedicationStatement to be used for, but it could work.
Jose Costa Teixeira (Mar 24 2021 at 16:41):
+1 for option 1 above, this is what was defined in IHE Pharmacy MMA profile for this very topic.
Jose Costa Teixeira (Mar 24 2021 at 16:43):
The "overall" medAdmin should be created from the moment you know that you have a "overall" and a detail.
So you can actually start with the details, but the moment that you change anything (flow rate, change the bag of drug or the bag of solvent, etc) at that moment you create a "overall"
Lin Zhang (Mar 24 2021 at 16:44):
An Observation for the summary/total derived from those MedicationAdministrations everyday?
Lloyd McKenzie (Mar 24 2021 at 16:52):
Observation is also viable - but it's sort of sliding down the "everything's an Observation" slope.
Jose Costa Teixeira (Mar 24 2021 at 17:09):
Lin Zhang (Mar 24 2021 at 23:43):
Ha-ha， EHR would be at the bottom:big_smile:
Keerthi M (Mar 30 2021 at 10:24):
Many thanks for all the inputs!
Last updated: Apr 12 2022 at 19:14 UTC
