Difference between revisions of "Minutes - Medication WG 2021-02-16"

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* Lars Vanreppelen, Corilus
 
* Lars Vanreppelen, Corilus
 
* Pablo Christiaens, Corilus
 
* Pablo Christiaens, Corilus
−
* Richard Franken
+
* Richard Francken
 
* Robin Bosman  
 
* Robin Bosman  
 
* Tom De Backer  
 
* Tom De Backer  
−
* Tom Henkens  
+
* Tom Henkens
  
 
===== '''Excused/Nor present''' =====
 
===== '''Excused/Nor present''' =====
Line 31: Line 31:
 
===== '''Minutes''' =====
 
===== '''Minutes''' =====
 
* '''Magistral preparations''': no work on examples was done due to time constraints
 
* '''Magistral preparations''': no work on examples was done due to time constraints
−
::* update from HL7 int'l: sufficient quantity: there will be a change in FHIR R5 adding a new concept on quantity : up to a quantity
+
::* update from HL7 int'l on sufficient quantity: there will be a change in FHIR R5 adding a new concept on quantity: up to a quantity
  
−
* Profiling for medication dispense: has not been requested in the FHIR validation meeting
+
* '''Profiling for medication dispense''': has not been requested in the FHIR validation meeting
 
::* new federal standards will be published in March (home care plan, allergy, vaccination, ...), dispense will not be included. It is ok to be included later in 2021. It can meanwhile be published at HL7 Belgium level
 
::* new federal standards will be published in March (home care plan, allergy, vaccination, ...), dispense will not be included. It is ok to be included later in 2021. It can meanwhile be published at HL7 Belgium level
  
−
* Vaccinations (part of RIZIV project) & international impact
+
* '''Vaccinations''' (part of RIZIV project) & international impact
 
::* José is showing the logical model : http://build.fhir.org/ig/hl7-be/riziv-inami/StructureDefinition-be-model-vaccination.html  
 
::* José is showing the logical model : http://build.fhir.org/ig/hl7-be/riziv-inami/StructureDefinition-be-model-vaccination.html  
−
http://build.fhir.org/ig/hl7-be/riziv-inami/StructureDefinition-be-model-vaccination.html
 
 
::* once the logical model was composed, profiling has been done : http://build.fhir.org/ig/hl7-be/riziv-inami/StructureDefinition-be-vaccination.html
 
::* once the logical model was composed, profiling has been done : http://build.fhir.org/ig/hl7-be/riziv-inami/StructureDefinition-be-vaccination.html
 
::* plenty of FHIR resources were immature and plenty of extensions were needed to profile this in Belgium
 
::* plenty of FHIR resources were immature and plenty of extensions were needed to profile this in Belgium
 
::* there are everywhere initiatives on COVID vaccinations, there were discussions with IHE and HL7 - there will be a broad global profile that will be based on the Belgian one - IHE profile will come up soon, which will influence EC and WHO looks at the work
 
::* there are everywhere initiatives on COVID vaccinations, there were discussions with IHE and HL7 - there will be a broad global profile that will be based on the Belgian one - IHE profile will come up soon, which will influence EC and WHO looks at the work
 
::* is recorder extension necessary? can provenance resource be used? could have been a solution
 
::* is recorder extension necessary? can provenance resource be used? could have been a solution
−
::* lot number and expiration date
+
::* lot number and expiration date: one possible change
−
 
+
::* vaccineCode:
−
* HL7 FHIR (international): offset is in minutes, so it could be resolved by changing the start date
+
::* there are many examples (nonCOVID and a couple of COVID ones): http://build.fhir.org/ig/hl7-be/riziv-inami/StructureDefinition-be-vaccination-examples.html
−
::* can we put together an example on this ? So that we can point out the need for an extension for it
 
−
::* Belgium can also make his own extension for it
 
  
 
* '''Draft model for the medication record''' (we are not going to use the medication scheme as this is a reserved word in Belgium)
 
* '''Draft model for the medication record''' (we are not going to use the medication scheme as this is a reserved word in Belgium)
 
::* from architectural update
 
::* from architectural update
−
::* José is using the use cases for the medication record - for which there were some challenges...
+
::* medication record could have the medication summary + details/facts (source data f.e. prescriptions, dispenses, vaccination records, adverse events, maybe allergy intolerances...)
−
::::* Context: you can have very simple summaries vs complex summaries
+
::::* all dispenses, even when not prescribed, should be part of the medication record
−
::::* medication scheme can be updated by GP, pharmacists, nurse, ... and updates are pushed to vaults
 
−
::::* what if dispenses are sent to the vault ? is the vault handling the update ? at the vault, the update is put next to the current scheme and GP or pharmacist have to determine which is the right one
 
−
::::* a compiled summary step might be needed = the need for a process of automated reconciliation will have to be confirmed and if so, defined
 
−
::::* would/could it be better to work from medication dispenses ?
 
−
::::* medication record could have the medication summary + details/facts (source data f.e. prescriptions, dispenses, vaccination records, ...)
 
−
::::::* not all the details would be relevant to the summary
 
−
::::::* all dispenses, even when not prescribed, should be part of the medication record
 
−
::::* Will it be feasible to code all these "facts" ? Only medication related.
 
−
::::* could it be a solution for a "solid pot" = personal wallet with all information
 
 
::::* goal is not to implement this right now, but to foresee the possibilities, to make our architecture ready for the future
 
::::* goal is not to implement this right now, but to foresee the possibilities, to make our architecture ready for the future
 
::::* see [http://build.fhir.org/ig/hl7-be/hl7-be-fhir-medication/branches/master/StructureDefinition-be-model-medication-record.html draft proposal here]
 
::::* see [http://build.fhir.org/ig/hl7-be/hl7-be-fhir-medication/branches/master/StructureDefinition-be-model-medication-record.html draft proposal here]
 +
::* feedback:
 +
::::* medication dispenses are one source for the medication record, there are other sources
 +
::::* what exactly is the treatment line: f.e. hypertension includes several prescribed medications - will be different treatment line
 +
::::* aspirine can be taken on a regular basis (f.e. for blood thinning) and for ache (headache): treatment line gives the possiblity to have this in several treatment lines
 +
::::* it will depend by region whether there will be several treatment lines
 +
::::* if the treatment is exactly the same for several indications, no additional treatment line is needed
 +
::::* maybe indication has to be 1-many
 +
::::* this has a major impact on the medication scheme and the prescribing sources
 +
::::* business rules will have to be defined
 +
 +
::::* medication record has the equivalent value of a care plan f.e. in Suisse
 +
::* how does the medication scheme have to made up based on this: work item for next meeting
 +
::::* bring your own proposal
 +
::* relations with current way of working
 +
  
 
'''Next meeting March 2'''
 
'''Next meeting March 2'''
 +
* examples of magistral preparations
 +
* feedback on vaccination FHIR profiling
 +
* feedback on medication record

Latest revision as of 16:57, 22 February 2021

Attendees
  • Annemieke Vergauwe
  • Bruno Casneuf
  • Dieter Sauvillers, Corilus
  • Elhassan Baazizi
  • Hanne Vuegen
  • Jan Lenie
  • Jean-Louis Maggetto
  • Jens Penny
  • José Costa Teixeira
  • Karlien Erauw
  • Lars Vanreppelen, Corilus
  • Pablo Christiaens, Corilus
  • Richard Francken
  • Robin Bosman
  • Tom De Backer
  • Tom Henkens
Excused/Nor present
  • Anne Nerenhausen
  • Jeroen De Wilde
  • Marc Buckens
  • Nils Devos
  • Will Van Norel
Agenda
  • examples of magistral preparations of ingredients/products with codes to distinguish the different types (incl offset)
  • vaccination: logical model and Belgian FHIR profiling
  • feedback on first draft of logical model for the medication record
Minutes
  • Magistral preparations: no work on examples was done due to time constraints
  • update from HL7 int'l on sufficient quantity: there will be a change in FHIR R5 adding a new concept on quantity: up to a quantity
  • Profiling for medication dispense: has not been requested in the FHIR validation meeting
  • new federal standards will be published in March (home care plan, allergy, vaccination, ...), dispense will not be included. It is ok to be included later in 2021. It can meanwhile be published at HL7 Belgium level
  • Vaccinations (part of RIZIV project) & international impact
  • Draft model for the medication record (we are not going to use the medication scheme as this is a reserved word in Belgium)
  • from architectural update
  • medication record could have the medication summary + details/facts (source data f.e. prescriptions, dispenses, vaccination records, adverse events, maybe allergy intolerances...)
  • all dispenses, even when not prescribed, should be part of the medication record
  • goal is not to implement this right now, but to foresee the possibilities, to make our architecture ready for the future
  • see draft proposal here
  • feedback:
  • medication dispenses are one source for the medication record, there are other sources
  • what exactly is the treatment line: f.e. hypertension includes several prescribed medications - will be different treatment line
  • aspirine can be taken on a regular basis (f.e. for blood thinning) and for ache (headache): treatment line gives the possiblity to have this in several treatment lines
  • it will depend by region whether there will be several treatment lines
  • if the treatment is exactly the same for several indications, no additional treatment line is needed
  • maybe indication has to be 1-many
  • this has a major impact on the medication scheme and the prescribing sources
  • business rules will have to be defined
  • medication record has the equivalent value of a care plan f.e. in Suisse
  • how does the medication scheme have to made up based on this: work item for next meeting
  • bring your own proposal
  • relations with current way of working


Next meeting March 2

  • examples of magistral preparations
  • feedback on vaccination FHIR profiling
  • feedback on medication record
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