FHIR Chat · Ingredient - sufficient quantity

Stream: implementers

Topic: Ingredient - sufficient quantity

Arianne van de Wetering (Oct 17 2018 at 16:28):

How can I express a 'sufficient quantity' for a medication ingredient in FHIR?

in v3 I would say:

                           <otherIngredient>
                              <!--fill up to 100 ml  -->
                              <quantity>
                                 <numerator xsi:type="PQ" nullFlavor="QS"/>
                                 <denominator xsi:type="PQ" value="100" unit="ml"/>
                              </quantity>
                              <ingredientMaterialKind>
                                 <code code="261173" codeSystem="2.16.840.1.113883.2.4.4.7" displayName="BOORZUUR-BENZALKONIUMOPLOSSING FNA MR">
                                    <translation code="24155" codeSystem="2.16.840.1.113883.2.4.4.1" displayName="GRONDSTOF VLOEIBAAR"/>
                                 </code>
                              </ingredientMaterialKind>
                           </otherIngredient>

Grahame Grieve (Oct 17 2018 at 18:58):

looks to me like no arrangements have been made in the resource, so you'd fall back the nullFlavor using http://hl7.org/fhir/StructureDefinition/iso21090-nullFlavor for the numerator

Michael Riley (Oct 17 2018 at 19:31):

An extension would be the appropriate way to add a "sufficient quanitity" field to the resource, but then you have to get people to use your extension.

Grahame Grieve (Oct 17 2018 at 19:36):

yes it's distinctly less than ideal. I think @Arianne van de Wetering should make a task for pharmacy to take this up

Arianne van de Wetering (Oct 18 2018 at 09:59):

yes it's distinctly less than ideal. I think @Arianne van de Wetering should make a task for pharmacy to take this up

https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=19439

Robert Gooch (Mar 14 2022 at 11:20):

Michael Riley said:

An extension would be the appropriate way to add a "sufficient quanitity" field to the resource, but then you have to get people to use your extension.

@Rik Smithies

The interop medicines (NHS X/D) have identified this is a problem for infusion use cases. An example has been drafted at https://simplifier.net/EPMAImplementationGuidanceforR4/calcium-gluconate-infusion-request2/~json. Implementers on the Interop Medicines Working Group have stated that whilst using a dm+d VMP for the diluent could work, there are various reasons they would not want to use a dm+d VMP for the diluent. Therefore we keep coming back for the need for an ingredient quantity extension.

If there is a way to handle this natively within FHIR please let me know. If an extension is needed, I can take that to the UKCore mgmt team. Thanks.

Rik Smithies (Mar 14 2022 at 12:24):

see https://jira.hl7.org/browse/FHIR-30879 and the code system in the build has this now http://build.fhir.org/valueset-quantity-comparator.html. That works for Medication.ingredient.strength, in R5 onwards

Robert Gooch (Mar 14 2022 at 12:52):

@Rik Smithies Not sure if the above addresses our use case. Could this model BOTH a strength (e.g. 0.9%) and a quantity (e.g. 100ml) for an ingredient? I'd need to see our infusion example modelled in R5 with this new code system, then take that to our working group to verify if it will meet the implementation need. Who could convert my example (linked above) into R5 to show this?

Rik Smithies (Mar 14 2022 at 13:41):

Ingredients only have strength, so by quantity do you total quantity of substance, as in dose? What is the use case - sufficient quantity for ingredient of a medication or of a dose of a request?

Rik Smithies (Mar 14 2022 at 13:42):

that json doesn't seem to validate

Rik Smithies (Mar 15 2022 at 12:11):

@Robert Gooch I have sent a fixed version in R5 format

Last updated: Apr 12 2022 at 19:14 UTC

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FHIR Chat · Ingredient - sufficient quantity · implementers