Stream: implementers
Topic: MedicationOrder scope
Richard Townley-O'Neill (Sep 21 2016 at 03:33):
In Australia prescriptions are sometimes for non-medication therapeutic goods (such as bandages), for supplements to medications (such as asthma puffer spacers), for hybrids (such as medicated bandages) and the normal medications, vitamins, supplements, lotions and ointments. In the Electronic Transfer of Prescriptions Australian Technical Specification a prescription is for a Therapeutic Good, which “includes medications and medical devices. It includes drugs, appliances, dressings and reagents.”
MedicationOrder (http://hl7-fhir.github.io/medicationorder.html) suggests that some of this is in scope :
“It also includes orders for over-the-counter medications (e.g. Aspirin), total parenteral nutrition and diet/ vitamin supplements. It may be used to support the order of medication-related devices. It is not intended for use in prescribing particular diets, or for ordering non-medication-related items (eye-glasses, supplies, etc.).”
but does not give any further information or examples.
Does MedicationOrder include bandages? crutches? pregnancy tests?
If not, which resource should be used for orders for such non-medication therapeutic goods?
Grahame Grieve (Sep 21 2016 at 10:17):
SupplyRequest.
Richard Townley-O'Neill (Sep 21 2016 at 10:25):
Thanks Grahame
Though this text makes me think that it should be SupplyRequest - which is draft:
"The SupplyRequest resource is used for inventory management. When requesting medication, substances and devices when there is a patient focus or instructions regarding their use, DeviceUseRequest or MedicationOrder should be used instead "
Michelle (Moseman) Miller (Sep 21 2016 at 11:47):
When I asked a similar question around the boundaries between Device vs Medication (for medical supplies) in GF#8944, the resolution was adding the following text to Device boundaries "However, the specific boundary between medications and devices is defined at the implementation level and this standard does not enforce a boundary with the exception of devices that are implanted in a patient. The Medication resource should not be used to represent implanted devices."
Lloyd McKenzie (Sep 21 2016 at 12:38):
My understanding is that SupplyRequest is evolving towards being general inventory, non-patient-specific. DeviceUseRequest will be the resource for ordering device/supply-type items for patients. In those cases where a system can't differentiate, MedicationOrder would be used (as in general, missing out on the fact that a patient received a device is less important than missing out on the fact a patient received a drug
Eric Haas (Sep 26 2016 at 01:25):
What Lloyd said is correct and the Supply Request resource has been updated see boundaries "The SupplyRequest resource is used for inventory management. When requesting medication, substances and devices when there is a patient focus or instructions regarding their use, DeviceUseRequest or MedicationOrder should be used instead" If this is unclear then please submit a tracker to with clarifying wording. I think the DeviceUseRequest needs a similar counterpoint statement in its boundaries to clarify.
Last updated: Apr 12 2022 at 19:14 UTC
