Minutes - Medication WG 2021-03-02

Attendees

• Anne Nerenhausen
• Annemieke Vergauwe
• Bruno Casneuf
• Dieter Sauvillers
• Elhassan Baazizi o
• Hanne Vuegen o
• Jan Lenie o
• Jean-Louis Maggetto o
• Jens Penny o
• José Costa Teixeira
• Karlien Erauw
• Lars Vanreppelen o
• Pablo Christiaens
• Richard Francken o
• Robin Bosman
• Tom De Backer
• Tom Henkens o
• Will van Norel

Excused/Nor present

• Jeroen De Wilde
• Marc Buckens
• Nils Devos

Agenda

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

• 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

• 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
• vaccineCode:
• 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
• 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