Stream: Medication
Topic: MedicationDispense image
John Moehrke (Aug 03 2018 at 15:46):
I have a use-case where a picture of the medication that was dispensed is desired. Such as when a Patient is using a portal, and wants to see an image of the pill so that they don't confuse drugs that they have. This would be an image of exactly what was dispensed, so it can't really be at the level of code, right? Or can it? Would an extension on MedicationDispense be helpful, it could point at Binary?
Melva Peters (Aug 03 2018 at 16:10):
MedicationKnowledge includes the ability to include an image. This isn't information that would be included in the dispense, but is part of drug information.
John Moehrke (Aug 03 2018 at 16:54):
thanks. Is that specific to the actual drug that was dispensed? I am not an expert, but sometimes they look different... right?
John Moehrke (Aug 03 2018 at 16:58):
I don't see a place in MedicationKnowledge for an image
Melva Peters (Aug 03 2018 at 17:01):
The attribute is drugCharacteristic.value. This resource is draft so it's possible it isn't clear or we don't have the specific data type right.
Melva Peters (Aug 03 2018 at 17:02):
It is expected that you would query MedicationKnowledge using the exact identifier for the instance of the medication dispensed to get additional drug information such as image or monographs, etc.
John Moehrke (Aug 03 2018 at 17:59):
okay, so MedicationKnowledge.drugCharacteristic.. seems the .type needs a valueset, where one of the codes in there would be something like 'image of drug'? I would then expect .value[x] to have a Resource(Binary|Media).
John Moehrke (Aug 03 2018 at 18:01):
what element in MedicationDispense is the link to MedicationKnowledge?
Jose Costa Teixeira (Aug 04 2018 at 10:46):
MedicationDispense links to medication which has a medicationKnowledge (the definition) associated with it
Richard Townley-O'Neill (Aug 06 2018 at 04:25):
I expect that the image in MedicationKnowledge would be a standard image. Could the following happen? The medication is dispensed in a bottle with a custom label, and looks nothing like the standard image. If so, an image in MedicationDispense seems best.
Jose Costa Teixeira (Aug 06 2018 at 05:39):
right, the use case makes sense. But this is an image of the medication, not of the dispense.
Jose Costa Teixeira (Aug 06 2018 at 05:40):
i think there was an idea that medication and medicationKnowledge would be somewhat closer (as in: one being a profile of the other) and use cases like this could argue for that
Melva Peters (Aug 06 2018 at 14:50):
Agree, the image is of the medication and not the dispensed product in my experience.
John Moehrke (Aug 10 2018 at 15:44):
In my case (VHA) I think they want the image of what was dispensed. Not what should have been. Would this not be a change in the MedicationDispense to point at a different MedicationKnowledge?
Jose Costa Teixeira (Aug 11 2018 at 04:46):
MedicationDispense will point to a medication.
Jose Costa Teixeira (Aug 11 2018 at 04:48):
so the example would be:
Prescription1 > medication1 >MedicationKnowledge1 with its image
but
Dispense1 > medication2 (dispensed something that is not what was prescribed) > medicationKnowledge2 with its image.
John Moehrke (Aug 12 2018 at 20:32):
Is it reasonable that a Patient would have access to all the information in MedicationKnowledge? Might there be a different resource for Patient vs Clinician?
John Moehrke (Aug 12 2018 at 20:35):
yes, I can understand an app that has more rights than the Patient (user), where this app is trusted to only expose a subset... I am just wondering if we could examine Resource sizing to better fit expected access control needs. It is far more clean to differentiate access levels at Resource boundaries, than within a Resource.
Jose Costa Teixeira (Aug 13 2018 at 08:54):
In practice, it is not about access control, app vs person, or patient vs clinician,...
rather "defining a product vs mentioning a few characteristics of product" . This discussion is known and also emerging on Devices. hence my suggestion to look at boundaries between xxxDefinition and xxx resources, where xxx is medication, device...
for this example, i am thinking that the boundary between medicationKnowledge and Medication may best be a bit more fluid, but that hasn't been discussed.
John Moehrke (Aug 13 2018 at 12:27):
Yes, and Resources should also be designed to hold similarly sensitive information. RESTful access control models are at the Resource level. We should not make a bad design decision this early.
Last updated: Apr 12 2022 at 19:14 UTC
