FHIR Chat · Controlled Substance Schedule

Stream: Medication

Topic: Controlled Substance Schedule

Vishak OS (Oct 06 2020 at 03:00):

When a patient's medication list is provided as a Medication Dispense Resource -
how can we represent the

Schedule type (eg; I, II, III..) https://www.hl7.org/fhir/v2/0477/index.html
Drug class (eg; Insulin, Diabetic supplies, Opioid)

Should it be done with an extension to the Medication Dispense Resource or the Medication Resource?

Thank you.

Lloyd McKenzie (Oct 06 2020 at 03:24):

I would expect both of these would go in the MedicationDispense.category. @Melva Peters ?

Vishak OS (Oct 06 2020 at 11:54):

@Lloyd McKenzie : Thanks for the suggestion and tagging @Melva Peters on this thread.

btw, If both goes to the MedicationDispense.category, does it mean that the Cardinality of MD.category should be changed from 0..1 to 0..* ?
Thank you.

Melva Peters (Oct 06 2020 at 12:35):

The cardinality for MedicationDispense.category has been changed to 0..* in the Current Build. @Vishak OS

Jose Costa Teixeira (Oct 06 2020 at 13:14):

There was a previous discussion and while I understand this is the current approach, I'd suggest to (also?) add a classification to the medication resource.
ATC and Schedule are about the medication, not about the dispense act. And the use of classification in a medication ( in clinical use ) is rather common. If we acknowledge it is common, we should do it in the right place.

Vishak OS (Oct 06 2020 at 14:22):

@Melva Peters : Thanks for the info, so if i need to support this in the STU3 profile - what should the approach to get this in? An extension to the medication resource?

Lloyd McKenzie (Oct 06 2020 at 14:38):

You would need to use an extension. @Grahame Grieve Can we use the 'standard' extension mechanism to pre-adopt an element that repeats in a future version of FHIR but already exists as non-repeating in the current version of FHIR?

Grahame Grieve (Oct 07 2020 at 09:54):

I don't think so?

Grahame Grieve (Oct 07 2020 at 09:54):

though the validator probably won't complain about that

Lloyd McKenzie (Oct 07 2020 at 13:04):

Should we enable that capability? It seems like something we'd want to support being standardized...

Vishak OS (Oct 08 2020 at 11:11):

@Lloyd McKenzie : Thanks for this info and tagging @Grahame Grieve on this thread.

Vishak OS (Oct 08 2020 at 11:25):

@Jose Costa Teixeira : Thanks for the info. I can agree that ACT and Schedule are about the medication.

So my inference is: for STU3 profile- i should be adding a classification extension to the Medication Resource with card 0..* with type as codeableConcept.
The same can go with other profiles as well.