Minutes - Medication WG 2020-12-08

Attendees

• José Costa Teixeira
• Robin Bosman
• Jan Lenie
• Bruno Casneuf
• Jens Penny
• Annemieke Vergauwe
• Elhassan Baazizi
• Nils Devos
• Jeroen De Wilde
• Karlien Erauw
• Tom De Backer
• Hanne Vuegen

Excused

• Richard Francken
• Lieven Peeters

Agenda

• Review examples & prepare publication
• New action items for this WG

Minutes

• Jens is showing his work on the examples

• we have to agree that this is a valid minimal dispense
• is name of performer mandatory ? we don't think so
• is name of patient mandatory ? we don't think so
• what about the quantity ? it is not mandatory ; is the default then 1 ? for clarity we should make it mandatory with a severity warning, not a severity error, ; we should start with the documentation, eventually maybe an invariant

• José will add this item to the backlog

• if this is a minimal profile, we should remove everything that is not mandatory

• one tablet a day example

• some assumptions were made

• dose and rate: which codesystem are we going to use ? ucum codes are used, Jan used kmehr admin units in other examples, we need to decide what we are going to use as a base
• only admin units kmehr are available at pharmacies, which are hard to map one a 1-2-1 basis

• there are different value sets f.e. CD rout, CD administration unit ; there are no constraints but we need to raise that we need value sets
• is there a naming system for administration units ? we should have one

• add a code system empty for kmehr administration unit
• have a dummy value set is a good idea
• what about the instructions to the patient, where to put them ? Jens uses additionalInstruction, Jan uses patientInstruction, all under dosageInstruction

• additionalInstruction is a codeable concept ; the other is not, is a string
• kmehr is patient oriented
• putting it in patientInstruction makes sense

• 2 tablets a day example

• timing is specific here, specifying ACM and ACV

• 3rd example

• 2 dosageInstruction blocks here
• check with Jan's example where morning and evening is in 2 blocks: "when": ["ACM"], "frequency": 2,"timeOfDay": ["20:00:00"] ; having it in 2 blocks is also confusing ; there is rule: If there's a timeOfDay, there cannot be a when, or vice versa it can't be compiled ; we don't want to bypass this rule so we will use 2 dosageInstruction blocks ; what about the sequence of the blocks ? For same sequencenumber, you have to take them the same day. For different sequencenumbers, you have to take them on different days
• José to create backlogitem "multiple dosageInstructions in the same sequence", reference FHIR: "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential."

• daynumber is available in kmehr but not in FHIR

Next steps / action items:

• add some examples
• work on backlog items
• Prepare vaccination profile that is under development under HL7, check where the vaccin's serial number can be included
• receive FAGG mapping on kmehr and SAMv2 through RIZIV: Karlien to ask Jeroen about the status
• Final review of the profiles