Minutes - Medication WG 2020-03-31

Attendees

• Jan Lenie
• Annemieke Vergauwe
• Will Van Norel
• Tom Henkens
• Jens Penny
• José Costa Teixeira
• Karlien Erauw

Agenda

• Review previous meeting minutes
• Updates on action items

• Way of Working (FHIR-based content, other standards)
• Work planning
  • Existing information
  • Medication WG Backlog

Way of working

• Discussion on FHIR vs other standards (e.g. CDA, HL7 v2):
  • We will focus on FHIR

Input from other parties:

• We should be aware what is out there: at federal regulations level, at regional level etc
  • We should start to collect this information in a repository and maintain this

• Outcome of this group and Publication materials:
• The output of the WG will be technical artifacts
  • We have the FHIR Implementation Guide as a way to manage and publish our documentation
  • Jose shows: http://build.fhir.org/ig/hl7-be/be-core/branches/master/index.html

• Functional Description has Use cases & Logical data models
  • Logical Models are not a FHIR resource, it is the logical abstraction
  • Example of a logical data model (for Communication): http://build.fhir.org/ig/hl7-be/be-core/branches/master/StructureDefinition-model-communication.html
    • Actual model is in the "Snapshot" tab

• Profiles are what we will deliver as technical guidance
  • Jose shows a profile http://build.fhir.org/ig/hl7-be/be-core/branches/master/StructureDefinition-be-patient.html

• Dispense Record information:
• Jose mentions it is relatively stable, so he doesn’t expect a lot of discussion
• Medication dispense: is this a quick win ? We have input from BE & HL7

• We have to discuss what fields we want in the dispense record
• 2 steps: analysis + implementation

• Archiving of prescriptions happens manually so there would be a direct advantage

• Delivery of prescriptions is also stored at pharmacies, in farmaflux, DPD – hospitals do not use the farmaflux system

• Jens has question on https://simplifier.net/eHealthPlatformFederalProfiles/~introduction
  • All the source is on simplifier, content is the same
    • See: http://build.fhir.org/ig/hl7-be/be-core/branches/master/standardsstatus.html
  • Will asks about the platform where dispenses are documented
  • Does the WG focus on ambulatory use cases (pharmacies) or hospital dispense use case ?
    • Ambulatory prescriptions in hospital
    • The hospital dispense use case is completely different
  • Only extern pharmacists have access to farmaflux
  • Archive the proof that you delivered the medicine
    • Tom: amongst pharmacists share what has been delivered to patient and is available to all pharmacists if patient has given his consent ; has nothing to do with the prescription, there is no link with the prescription
    • Pharmacist has to keep 10 years what he has delivered – farmaflux takes care of this, only archive = different use case
  • Medication dispense (Cerner will not implement this in EHR), prefers to have clear standard on medication statement
  • A dispense record does not mean that the patient is taking this, it only states what has been delivered to patient
  • Medication profile – links with dispense records (and assume patient is taking the medicine since the prescription)
  • Medication record/scheme : VIDIS is looking into this, do we want them aboard? Ask PM for presentation & Q&A session
  • Jens & Will: medication scheme is a holy grail for both of them, is acomplex project with many stakeholders so we will run in a ditch very soon
  • Jan wants to develop in FHIR , is part of VIDIS project, info for patient (list of medication list)
  • Medication dispense- chance of getting this implemented is slim
    • If you model this, this is a good starting point for the medication scheme, we should have an overarching model
    • Dispense can be re-used in the medication scheme, it will be fed into the medication scheme ; do we want to focus
  • Medication scheme is a very hot topic – we can start working on this, will be a lot of work, but we should start preparation

• Collecting info & analyzing information & model for dispense record & how it will be in FHIR
  • Collect info – who can do this ?
  • Farmaflux: demo ?
    • Tom : can give demo of current system, what info is shared amongst pharmacists, 10 minutes demo about farmaflux, about elements that are shared, is proprietary standards, open std, kmehr, propagate info to patients & other stakeholders – can also share model
    • Info that we have today –-> build model in FHIR
    • Jens: medication statements hospital intra muros
    • Will: Everyone probably found this, but this is the MedicationDispense Resource: http://hl7.org/fhir/medicationdispense.html