Stream: implementers
Topic: MedicationStatement & prescription and dispense date
Grahame Grieve (Jun 22 2017 at 04:10):
I'm doing a FHIR Mapping for an implementer. In their database, they have a list of medication statements (very definitely a list of medication statements, not other kind of resources). They have 2 fields which don't obviously map to existing fields:
- date of prescription
- date of dispense
Grahame Grieve (Jun 22 2017 at 04:11):
I think that the first might belong in MedicationStatement, where as the second seems... idiosyncratic. Thoughts? (@Melva Peters , @John Hatem , @Scott Robertson )
Richard Townley-O'Neill (Jun 22 2017 at 04:11):
I think that it can also go in medication statement, maybe as 0..*, probably as an extension.
" A medication statement is not a part of the prescribe->dispense->administer sequence, but is a report that such a sequence (or at least a part of it) did take place, resulting in a belief that the patient has received a particular medication."
Grahame Grieve (Jun 22 2017 at 04:42):
well, they'll be extensions now, unless I've misunderstood here. I'm checking I understand correctly, and wondering whether one of them is a candidate for core in the future
John Hatem (Jun 22 2017 at 04:48):
both dates are only available in referenced resources ("based on" reference to the Medication Request.authoredOn for the date of prescription; "part Of" reference to the Medication Dispense.datePrepared for date of dispense)
Richard Townley-O'Neill (Jun 22 2017 at 04:50):
If the information is from the patient it is not clearly based on a medicationRequest or a medicationDispense.
Grahame Grieve (Jun 22 2017 at 06:24):
but also not clearly not based on...
Lloyd McKenzie (Jun 22 2017 at 14:48):
A MedicationStatement is a summary that will often span prescriptions. Do they want every prescription? The most recent prescription?
Michelle (Moseman) Miller (Jun 22 2017 at 17:20):
The information in the MedicationStatement isn't always from the Patient. In our system, a MedicationStatement can also be "derived from" a given prescription (order/request) or dispense, which means we can use the MedicationStatement.derivedFrom to point to the full MedicationRequest and/or MedicationDispense resource.
Michelle (Moseman) Miller (Jun 22 2017 at 17:27):
When the information is truly from the patient, then we would try to get the start date (effective dates) of the medication, but not the date(s) the corresponding prescription(s) were written.
Vadim Peretokin (Jul 21 2017 at 06:41):
@Grahame Grieve date of prescription could be https://simplifier.net/NictizDSTU2/mp9-authoredOn, it's a Dutch extension and we've reused it for Norway in https://simplifier.net/HelseVestdosagemappi/kule-prescribing
Richard Townley-O'Neill (Jul 24 2017 at 04:53):
MP9 Authored On is "The date/time when the Medication Dispense or Statement was authored." But the date the statement is authored is not the same as the date that the prescription is authored.
Richard Townley-O'Neill (Jul 24 2017 at 04:55):
It is a similar, but different, concept. 
Vadim Peretokin (Jul 24 2017 at 07:03):
That is true!
Jose Costa Teixeira (Jul 24 2017 at 21:15):
i see those as attributes of the prescription and of a dispense that are behind the statement - so can they use "derivedFrom" for those details? i.e. if they want the details from a request of a prescription or a dispense, they could embed those resources.
Jose Costa Teixeira (Jul 24 2017 at 21:21):
a statement is a summary, possibly linked to the "sources" of that summary. if some details may need to emerge from the sources, they should be universal - and i am not sure "date of prescription" is universal. Could be, but I am not sure...
date of dispensing seems to lack something. so i'd think of those as not core.
Grahame Grieve (Jul 25 2017 at 07:51):
it's difficult because you have no other information about the request or dispense - not even status ...
Jose Costa Teixeira (Jul 25 2017 at 18:25):
Yes, so i'd be inclined to leave those attributes out of core. Date of start of treatment is relatively clear and is already supported, but date of prescription i'm not sure.
Jose Costa Teixeira (Jul 25 2017 at 18:26):
but i defer to the other pharmacy folks.
Melva Peters (Jul 26 2017 at 14:29):
I will add a tracker item related to this topic for Pharmacy WG to consider
Last updated: Apr 12 2022 at 19:14 UTC
