Stream: implementers
Topic: MedicationRequest Disallow refills
Jeffy Mathew Jose (Sep 12 2017 at 08:16):
How can I code explicit refusal of refills.
I see that medicationRequest dispenseRequest has numberOfRepeatsAllowed as positiveInt. Means I can't say 0 refills. Is there any consensus on how to approach this?
Jose Costa Teixeira (Sep 12 2017 at 08:28):
Hi. in the Request pattern, we should add a doNotPerform attribute to say explicitly "this is a request NOT to do this bit". (gforge #13468)
Since the medicationRequest has a request for clinical action and dispense, it makes sense that medicationRequest has medicationRequest.doNotPerform AND medicationRequest.dispenseRequest.doNotPerform. It's up to the pharmacy folks, but "do not dispense" seems quite relevant. Would this meet your needs?
Jose Costa Teixeira (Sep 12 2017 at 08:30):
for the actions to be taken: @Lloyd McKenzie should #13468 be applied? Applying the changes is straightforward but I'd look for help to write concise guidance.
Jose Costa Teixeira (Sep 12 2017 at 08:31):
@Melva Peters @John Hatem @Scott Robertson for discussion - should "doNotPerform" be applied to both medicationRequest and medicationRequest.dispenseRequest?
Jeffy Mathew Jose (Sep 12 2017 at 09:53):
Actually I was referring to the concept of refill. The dispense request is valid and should be allowed.
But a refill(or a repeat) should not be allowed.
Lloyd McKenzie (Sep 12 2017 at 14:33):
numberOfRepeatsAllowed is optional. If no repeats are permitted, exclude the element. If you think it needs to be explicit in the instance, you could submit a change request for that element to allow "0" in the future.
Lloyd McKenzie (Sep 12 2017 at 14:34):
@Jose Costa Teixeira Yes, this would be good, but I'd expect it to be used to capture orders like "do not give morphine" rather than "do not dispense" as you can handle that by simply setting the dispense authorization to 0.
Jose Costa Teixeira (Sep 12 2017 at 14:44):
@J Mathew Jose : numberOfRepeatsAllowed=0 means "only dispense first time, no furhter repetitions / refills". Leaving it empty also, I believe. If it is only the refill, that should meet your needs?
Jose Costa Teixeira (Sep 12 2017 at 14:47):
@Lloyd McKenzie indeed, that is the common case. I was thinking of "patient must take this, but he still has it at home so no drugs for you". In that case, clinical part is active, but not dispense.
if by "dispense Authorization to 0" you mean setting dispenseRequest.quantity to 0, that would work too.
Jeffy Mathew Jose (Sep 12 2017 at 14:52):
@Lloyd McKenzie, @Jose Costa Teixeira Excluding numberOfRepeatsAllowed should be fine.
Thanks
Jose Costa Teixeira (Sep 12 2017 at 14:52):
thanks, and apologies for overloading the question with other pending matters. Have fun!
Melva Peters (Sep 12 2017 at 21:20):
Pharmacy changed the datatype for the "numberOfRepeatsAllowed" to unsignedInt to allow the inclusion of "0" to explicitly say no refills permitted.
Last updated: Apr 12 2022 at 19:14 UTC
