Stream: Medication
Topic: Kits
Patricia Almeyda Polanco (Mar 30 2020 at 20:00):
We have some medications that are kits, for example a box that inside contains packets of a powder and pills. We are wondering how we can represent those products with medication knowledge. In these case what will be the correct value for amount, dosage and packaging. Attached is a picture with an example
Lloyd McKenzie (Mar 30 2020 at 20:31):
@Melva Peters @Jean Duteau
Jean Duteau (Mar 30 2020 at 20:45):
You would use the packaging BackboneElement to specify the various packages:
1) packaging: type = box, quantity = # of packets in the box
2a) packaging: type = packet, quantity = amount of powder in the packet
2b) packaging: type = packet, quantity = amount of pills in the packet
(I wasn't sure if the box had the pills in it loosely or if they were in a separate packet from the powder.
Jean Duteau (Mar 30 2020 at 20:45):
2a and 2b are children of packaging 1
Patricia Almeyda Polanco (Mar 30 2020 at 21:00):
In R4 we are only allow to set one packaging for medicationKnowledge, but in build you can set a packaging refereces https://build.fhir.org/medicationknowledge.html#MedicationKnowledge, so we will need to use these model
Jean Duteau (Mar 30 2020 at 21:06):
ah yes. the packaging capability wasn't in the first iteration of the MedKnowledge resource.
James Bock (Apr 09 2020 at 02:34):
If you are limited to one packaging element, could you use the relatedMedicationKnowledge element, which has 0..* cardinality, and create separate MedicationKnowledge resources for the packets inside the box to which you could reference?
I'm a bit unclear as to what the type element of the relatedMedKnowledge is describing. Could you use a SNOMED CT like 419888008 (Packet - unit of product usage) and the underlying MedicationKnowledge resources could use 1681000175101 (Package - unit of product usage)? Or is ValueSet/medicationknowledge-package-type appropriate here?
Jean Duteau (Apr 09 2020 at 03:17):
No, that wouldn't work. You really have to use an extension to handle the extra packaging. The relatedMedicationKnowledge is intended for traversing drug hierarchies - Product X is a manufactured product and it is related to Generic Formulation Product Y and also related to a Therapeutic Moiety Product Z.
James Bock (Apr 09 2020 at 03:30):
@Jean Duteau
Thanks for the correction, Jean, good to know. I wouldn't have gathered that was the propose of the resource based on the documentation on hl7.org. Is there a place that has a more in-depth discussion on the use-cases of resources? I'm still learning the specification and its implementation.
Jean Duteau (Apr 09 2020 at 06:01):
MedKnowledge is very draft. It was just introduced into FHIR so Pharmacy is still working on the documentation around it.
Melva Peters (Apr 09 2020 at 12:45):
@James Bock if you have suggestions for wording that would help clarify it for you, please consider adding a change request. As Jean said the MedicationKnowledge is still new and we would appreciate your feedback. Thanks
Last updated: Apr 12 2022 at 19:14 UTC
