Difference between revisions of "Minutes - Medication WG 2020-12-08"

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===== '''Agenda''' =====
 
===== '''Agenda''' =====
 +
* Update on IHE International work
 
* Review examples & prepare publication
 
* Review examples & prepare publication
 
* New action items for this WG
 
* New action items for this WG
  
 
===== '''Minutes''' =====
 
===== '''Minutes''' =====
−
* Jens is showing his work on the [http://build.fhir.org/ig/hl7-be/hl7-be-fhir-medication/MedicationDispense-example-minimal-dispense.json.html examples]
+
* José gives updates on the work that is ongoing at IHE International, see more deatils on the [https://wiki.ihe.net/index.php/Pharmacy_Technical_Committee IHE International wiki]
−
::* we have to agree that this is a valid minimal dispense
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::* Medication scheme is one of the top 3 problems in Healthcare everywhere
−
::* is name of performer mandatory ? we don't think so
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::* there are taskforce son Medication List, Vaccination topic
−
::* is name of patient mandatory ?  we don't think so
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::* IHE Int’l Technical Committees are open for IHE Belgium members
−
::* 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
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::* IHE int'l is moving into the same direction as Belgium
−
::::* José will add this item to the backlog
+
::* IHE int'l will work towards a system with all prescriptions, all dispenses, adverse events, lot numbers, history of reconciliations by doctors etc. ; every medication record will have medication treatment lines with start date & end date (similar to kmehr but might need to remove & add some thgs)
−
::* if this is a minimal profile, we should remove everything that is not mandatory
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::::* the medication records will have content, source data, process (incl privacy)
−
* one tablet a day [http://build.fhir.org/ig/hl7-be/hl7-be-fhir-medication/MedicationDispense-posology-1-tablet-a-day.json.html 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
 
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::::* 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
 
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::::* 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 [http://build.fhir.org/ig/hl7-be/hl7-be-fhir-medication/MedicationDispense-posology-2-tablets-breakfast-dinner.json.html example]
+
* update on examples
−
::* timing is specific here, specifying ACM and ACV
+
::* no progress has been made the last 2 weeks
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* 3rd [http://build.fhir.org/ig/hl7-be/hl7-be-fhir-medication/MedicationDispense-posology-3-tablets-beforebreakfast-20PM.json.html example]
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::* Jan will continue "translation" from kmehr into FHIR
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::* 2 dosageInstruction blocks here
 
−
::* check with Jan's [https://drive.google.com/drive/folders/1mW-p-cIPkYnysUJ_T7Fke5l9y5a1jc6w 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 [http://hl7.org/fhir/R4/datatypes.html#Timing 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
 
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::* 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."
 
  
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* daynumber is available in kmehr but not in FHIR
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* Jens is sharing
 +
::* how NHS is doing dosage instructions: [https://developer.nhs.uk/apis/dose-syntax-implementation-1-3-1-alpha/dosage-examples-standard.html#metformin-500mg-tablets-initially-500-mg-once-daily-for-1-week-dose-to-be-taken-with-breakfast-then-500-mg-twice-daily-for-week-dose-to-be-taken-with-breakfast-and-evening-meal-then-500-mg-3-times-a-day-dose-to-be-taken-with-breakfast-lunch-and-evening-meal-maximum-2-g-per-day see here]
 +
::* [https://www.hl7.org/fhir/medicationexample0317.json.html www.hl7.org/fhir/medicationexample0317.json.html]
 +
::* [https://www.hl7.org/fhir/medication-examples.html www.hl7.org/fhir/medication-examples]
 +
 
 +
* FHIR has 3 examples for magistral medication: [http://build.fhir.org/medication-examples.html see here] 
 +
* Jens will give an online workshop on sushi on Jan 8 at 1PM - 2.30PM. Notify [http://mailto:karlien.erauw@agoria.be Karlien] if you want to attend
  
 
'''Next steps / action items:'''
 
'''Next steps / action items:'''
−
* add some examples
+
* José to check in the FHIR community how to deal with
−
* work on backlog items
+
::* alternate dosages of drugs
 +
::* why offset is only in minutes (could a day offset help?)
 +
* Next meeting on Dec 22 at 11AM
 
* Prepare vaccination profile that is under development under HL7, check where the vaccin's serial number can be included
 
* 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
+
* receive FAGG mapping on kmehr and SAMv2 through RIZIV: Karlien will provide update in the upcoming days
−
* Final review of the profiles
+
* need more work on examples for final sign-off of profiles

Latest revision as of 11:04, 8 December 2020

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
  • Update on IHE International work
  • Review examples & prepare publication
  • New action items for this WG
Minutes
  • José gives updates on the work that is ongoing at IHE International, see more deatils on the IHE International wiki
  • Medication scheme is one of the top 3 problems in Healthcare everywhere
  • there are taskforce son Medication List, Vaccination topic
  • IHE Int’l Technical Committees are open for IHE Belgium members
  • IHE int'l is moving into the same direction as Belgium
  • IHE int'l will work towards a system with all prescriptions, all dispenses, adverse events, lot numbers, history of reconciliations by doctors etc. ; every medication record will have medication treatment lines with start date & end date (similar to kmehr but might need to remove & add some thgs)
  • the medication records will have content, source data, process (incl privacy)
  • update on examples
  • no progress has been made the last 2 weeks
  • Jan will continue "translation" from kmehr into FHIR
  • Jens is sharing
  • FHIR has 3 examples for magistral medication: see here
  • Jens will give an online workshop on sushi on Jan 8 at 1PM - 2.30PM. Notify Karlien if you want to attend

Next steps / action items:

  • José to check in the FHIR community how to deal with
  • alternate dosages of drugs
  • why offset is only in minutes (could a day offset help?)
  • Next meeting on Dec 22 at 11AM
  • 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 will provide update in the upcoming days
  • need more work on examples for final sign-off of profiles
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