Stream: implementers
Topic: mapping for brand in medication resource
ravindra kondiparthi (Nov 14 2019 at 23:12):
Hi,
Can anyone point me to the right field to use in R4 for isBrand field in R3?
It looks like isBrand field from R3 medication is deleted in R4 medication.
Thanks
Ravi
Lloyd McKenzie (Nov 14 2019 at 23:19):
@Melva Peters @Jean Duteau
Jean Duteau (Nov 15 2019 at 00:32):
You'd have to use an extension if you needed that field or use MedicationKnowledge. Within the actual scope of Medication - used to identify a product that has been ordered/dispensed/administered - we had no use case for the isBrand and isOverTheCounter flags.
Jose Costa Teixeira (Nov 15 2019 at 14:33):
I'm happy we don't have "isBrand" and "isOTC" as flags, but should we have a "medicationConceptType" - to show whether this is a Generic, a substance, a product, a PHP, a package...?
Peter Muir (Nov 15 2019 at 15:58):
Whether clinician orders brand or generic is of interest to payers. They are also interested in how pharmacy filled as brand or generic. At some point I would expect this will be a required or desired feature. Clinicians might order generic but think by brand name. Trying to consider end user use case.
Jose Costa Teixeira (Nov 15 2019 at 16:07):
concept "isBrand" is not interoperable. It means different things in different places. hence my point
Jose Costa Teixeira (Nov 15 2019 at 16:08):
yes, it may be relevant, as a characteristic of a drug, but not as a boolean. In practice we have more than one option, so IMO that is a code.
Jean Duteau (Nov 15 2019 at 17:09):
Doesn't the medication.code tell you whether it is a brand or generic? It did in all of the drug code systems that the committee looked at. So it was just a redundant piece of data.
Lloyd McKenzie (Nov 15 2019 at 17:27):
More specifically, when systems care about whether something is a generic or brand, they typically care based on their own definition rather than the declaration from some other source.
Melva Peters (Nov 15 2019 at 17:55):
On MedicationKnowledge there is a productType attribute “
Category of the medication or product (e.g. branded product, therapeutic moeity, generic product, innovator product, etc.).”
Peter Muir (Nov 15 2019 at 18:26):
In US, if chart information is being pulled from EHR with FHIR used for chart data transmission to payer, there may be interest in EHR's generic/brand flag being transmitted for local/regional requirements without going to MedicationKnowledge. Generic prescription ratio has been used by payers as a provider performance measure. They may compare to pharmacy fill ratio. Use case? Not quite redundant. Just trying to cover use cases.
Jose Costa Teixeira (Nov 15 2019 at 19:38):
there may be interest in EHR's generic/brand flag being transmitted for local/regional requirements without going to MedicationKnowledge.
I would not challenge the need. You _could_ still do it with a contained medKnowledge. Just don't make it a flag, but a code.
Peter Jordan (Nov 15 2019 at 20:55):
More specifically, when systems care about whether something is a generic or brand, they typically care based on their own definition rather than the declaration from some other source.
That's definitely not true in NZ or Australia - where the respective national medicines terminologies make a clear distinction between generic and brand medications, and there is an increasing body of regulations and instructions with regard to which of these categories should be prescribed in explicit use cases. For example...
https://aushealthit.blogspot.com/2019/11/what-are-regulations-for-new-electronic.html
Last updated: Apr 12 2022 at 19:14 UTC
