Minutes - Medication WG 2021-02-16

Attendees

• Anne Nerenhausen
• Annemieke Vergauwe
• Bruno Casneuf
• Elhassan Baazizi
• Hanne Vuegen
• Jan Lenie
• Jean-Louis Maggetto
• Jens Penny
• José Costa Teixeira
• Karlien Erauw
• Marc Buckens
• Richard Franken
• Tom De Backer
• Tom Henkens
• Will Van Norel

Excused

• Jeroen De Wilde
• Robin Bosman
• Nils Devos

Agenda

• examples of magistral preparations of ingredients/products with codes to distinguish the different types (incl offset)
• feedback on first draft of logical model for the medication record

Minutes

• Magistral preparations: Jan has not been able to work on it due to some internal deadlines. Tom Henkens prepared some things on the magistral preparations. See the summary here. Recip-e can prescribe 3 things:

• pre-packed product
• INN
• Compounded drugs/magistral preparation: text as well as structure is permitted

• structure by defining one or more compounds

• substances
• formulary reference
• pre-packed product (as compound)

• structure: defined by formulary reference only

• How to translate this in a model ?
• How indicate that it is a magistral preparation: as a flag or derive it from one of the used codes, f.e. naming system = BE magistral preparation
• 1 CNK can point to multiple GTIN, 1 GTIN can never link to multiple CNK's
• discussion on quantum satis : there seems no need to add this in our FHIR profile
• do we have to encode this in such a detail ?

• HL7 FHIR (international): offset is in minutes, so it could be resolved by changing the start date

• 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)

• 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