Stream: Covid-19 Response
Topic: Remdesivir
Nathan Bunker (Oct 12 2020 at 17:47):
Is there anyone who is currently working on projects where Remdesivir is being reported to public health authorities? We have a state that is asking submitters to send Remdesivir administration information to the immunization registry. We want to advise them on the right format/method for this type of information and wanted to know if anyone else has seen Remdesivir or similar type products reported to state health departments?
Jose Costa Teixeira (Oct 12 2020 at 17:49):
hmmm... Remdesivir in the immunization registry?
Jose Costa Teixeira (Oct 12 2020 at 17:51):
Can Remdesivir be considered a therapeutic immunzation?
Nathan Bunker (Oct 12 2020 at 17:59):
Definitely not. I'm not sure why they decided the registry was the spot to send it. But that was a state decision. What I need to advise them on is if they are required to report this to the state (wherever it might go) what format would be sensible? Because the state asked the registry to do this they registry as specified an immunization format with codes for Remdesivir. This is not the right solution.
Jose Costa Teixeira (Oct 12 2020 at 20:11):
then your immunization registry is also a treatment registry, i don't see a way for the immunization registry (looking at the resource) to contain an administration
Nathan Bunker (Oct 12 2020 at 20:18):
@Jose Costa Teixeira You are right, it's not really the right way to hold the data. In this case I can't recommend to them to select a different system, but I can advise them on the format that the data should be in. Where they put that data is their own policy decision.
Jose Costa Teixeira (Oct 12 2020 at 20:18):
I mean:
- you could consider remdesivir treatment to be a kind of immunization and use the Immunization resource. That would be weird / wrong.
- you could consider adding an extension to Immunization to contain the administration of a drug, but then your entire Immunization would just be a shell to contain a drug administration. I don't see why you'd do that
- you can just let your immunization registry to receive MedicationAdministrations besides Immunizations. That would be OK, because today remdesivir, tomorrow another drug or treatment...
Jose Costa Teixeira (Oct 12 2020 at 20:20):
if remdesivir administration is not an therapeutic administration, then the format is MedicationAdministration (if you record the actual administration).
if it's a bit more vague like "this patient has had vitamin D intake regularly" then you'd use a medicationStatement - but I guess that is not what you want.
Jose Costa Teixeira (Oct 12 2020 at 20:20):
so my impression is that you are expanding the immunization registry with therapy information, starting with medicationadministration. and that is OK - you have the resource to use there
Vassil Peytchev (Oct 12 2020 at 20:45):
[...] but I can advise them on the format that the data should be in.
Since in most cases immunization registries are using HL7 V2.x, you could use an RAS^O17 message. It uses the RXA and RXR segments already in use in the VXU messages received by immunizations registries...
Nathan Bunker (Oct 12 2020 at 20:52):
@Vassil Peytchev Thanks for the lead. For this situation we are probably looking at something in HL7 v2.x. But really it's more about having the receiving system using something that is already being created rather than doing something non-standard
Nathan Bunker (Oct 12 2020 at 20:54):
@Jose Costa Teixeira Yes, for this particular situation they are expanding their system. But I don't have much insight into this. Some states in the US can be like their own countries, and this is particularly true of this one. Their leadership says that the immunization system is going to collect this information, so it is. It's not a US federal initiative, but completely a decision on their part. My only role is to advise on how that information could be properly messaged.
Jose Costa Teixeira (Oct 12 2020 at 21:23):
I did not consider the fact that if they have a V2 infrastructure, you're better off with a v2 RAS. I guess you'd need a small part of the RAS message, since you probably don't want to capture complex administrations, nor the ordering process, just the administration
Last updated: Apr 12 2022 at 19:14 UTC
