Minutes - Medication WG 2021-02-16

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 Franken
• 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: 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

• José is showing the logical model : 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
• 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
• is recorder extension necessary? can provenance resource be used? could have been a solution
• lot number and expiration date: one possible change
• 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

• 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
• José is using the use cases for the medication record - for which there were some challenges...

• Context: you can have very simple summaries vs complex summaries
• 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
• see draft proposal here

Next meeting March 2