Stream: canada
Topic: MedicationRequest.reasonCode
David evans (Jul 16 2017 at 12:31):
How can I use the Terminology Gateway to identify the appropriate reasonCodes to use on a MedicationRequest?
Following the FHIR specs leads here -> https://www.hl7.org/fhir/valueset-condition-code.html. But I can't seem to search by the OID 2.16.840.1.113883.4.642.3.152 and also not sure if there is Canada specific OID.
Lloyd McKenzie (Jul 16 2017 at 14:39):
Where are you getting that OID from?
Lloyd McKenzie (Jul 16 2017 at 14:39):
In general, we try to avoid the use of OIDs with FHIR.
Lloyd McKenzie (Jul 16 2017 at 14:40):
The value set pointed to by the spec is an "example" binding - meaning there's no expectation that systems will necessarily use that value set - it's just to give an idea of the types of codes that could be used. In this case, the example binding is to a set of codes from SNOMED CT
Lloyd McKenzie (Jul 16 2017 at 14:41):
Where are you implementing in Canada? Who are you looking to interoperate with?
David evans (Jul 17 2017 at 12:49):
Thanks @Lloyd McKenzie - I got the OID from the FHIR link I included so good to know that is just an example. I'm doing some work in the medication management space interoperating with prescribers and dispensers.
Can you suggest the best value set to use for MedicationRequest.reasonCode?
Lloyd McKenzie (Jul 17 2017 at 14:44):
To the best of my knowledge, the Infoway terminology gateway is not yet hosting FHIR-defined terminology - and I'm not even sure if it's intending to. FHIR support for the gateway is still pending. Hopefully it will support searching by canonical URL rather than OID as OIDs won't even necessarily exist for all value sets and code systems used by FHIR. Are you trying to look up the content in the gateway for a particular reason? Are you trying to implement in alignment with a particular jurisdiction's project or are you pursuing FHIR support independently of any particular jurisdiction's efforts?
David evans (Jul 17 2017 at 15:06):
I want to be aligned with whatever Canada Health Info recommends for coding systems in Ontario for now.
Lloyd McKenzie (Jul 17 2017 at 15:32):
I don't think Infoway is planning to recommend code systems yet (or maybe ever). Rather, they're hosting value sets used by various projects. And I'm not familiar with any Ontario projects that are leveraging the Condition resource yet, though it's always hard to keep tabs on everything that's going on. I think you're probably safe with the example value set as it's most likely that Canadian implementations would use SNOMED for condition codes.
Lloyd McKenzie (Jul 17 2017 at 15:32):
But you won't see the value set on the Gateway until a project asks for it.
Igor Sirkovich (Jul 17 2017 at 16:20):
As far as I know Health Canada and Infoway have been looking at the terminology for Prescription Indication for Use (an equivalent of MedicationRequest.reasonCode) for their Canadian Clinical Drug Data Set & PrescribeIT projects, but I don't believe they have anything ready yet. @David Evans , you can raise your questions at the Canadian Medication Management forum at https://infocentral.infoway-inforoute.ca/en/forum/344 and/or join one of their weekly meetings on Tuesdays - the next meeting is tomorrow, July 18 at 11 am.
David evans (Jul 17 2017 at 18:53):
Thanks @Igor Sirkovich . I was able to find the following using the gateway.
{
"id": "2.16.840.1.113883.2.20.3.401",
"name": "PrescriptionIndicationForUse",
"effectiveDate": "20170626",
"description": "The clinical reason for which a medication is being ordered.",
"status": "active",
"category": "SNOMED CT",
...
I won't be able to make tomorrow's meeting but would like to in the future...thanks for pointer!
Igor Sirkovich (Jul 17 2017 at 19:42):
Right, this is the one for ePrescribe domain (PrescribeIT solution), though I suspect this might still be work in progress.
Grahame Grieve (Jul 22 2017 at 07:16):
...just to point out that while Lloyd is correct that OIDs may not exist for all code systems and value sets used by FHIR, FHIR does provide OIDs for the codesystems and value sets it defines itself
Grahame Grieve (Jul 22 2017 at 07:17):
however there are already a number of code systems in new functional areas covered by FHIR but not v3/CDA that have URIs and have not been assigned OIDs
Andy Stechishin (Oct 17 2017 at 17:02):
(deleted)
Last updated: Apr 12 2022 at 19:14 UTC
