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Difference between revisions of "RegulatedMedicinalProduct FHIR Resource Proposal"

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=RegulatedMedicinalProduct=
 
=RegulatedMedicinalProduct=
  
 +
Draft resource in build:
 +
[[Image:RegulatedMedicialProduct_June2019.png|center||Relationship to other resources]]
 
<!-- Resource names should meet the following characteristics:
 
<!-- Resource names should meet the following characteristics:
 
* Lower camel case
 
* Lower camel case
Line 33: Line 35:
  
 
==Committee Approval Date:==
 
==Committee Approval Date:==
6th May 2019 (earlier approval with different, as "MedicinalProduct" 13th September 2017)
+
6th May 2019 (earlier approval as "MedicinalProduct" 13th September 2017)
  
 
==Contributing or Reviewing Work Groups==
 
==Contributing or Reviewing Work Groups==
Line 39: Line 41:
 
<!-- Additional work groups that may have an interest in contributing to, or reviewing  the content of the resource (optional) -->
 
<!-- Additional work groups that may have an interest in contributing to, or reviewing  the content of the resource (optional) -->
 
* Pharmacy
 
* Pharmacy
* O&O
+
* Orders and Observations
 +
* Clinical Decision Support
  
 
==FHIR Resource Development Project Insight ID==
 
==FHIR Resource Development Project Insight ID==
Line 49: Line 52:
 
==Scope of coverage==
 
==Scope of coverage==
  
To support the content of the ISO 11615 IDMP Medicinal Product standard and its ISO/TS 20443 Technical Specification, and other domain areas with similar requirements. 11615 covers detailed definition of products, their submissions to regulators, authorization activities, ingredients, packaging, accompanying devices, clinical particulars etc). Not all of those are expected to be covered in this single resource.
+
To support the content of the ISO 11615 IDMP Medicinal Product standard and other domain areas with similar requirements. 11615 covers detailed definition of products, their submissions to regulators, authorization activities, ingredients, packaging, accompanying devices, clinical particulars etc. Not all of those are expected to be covered in this single resource.
  
 
==RIM scope==
 
==RIM scope==
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==Resource appropriateness==
 
==Resource appropriateness==
  
There is an outstanding requirement to support the standardised exchange of detailed Product data, as covered by the ISO 11615 specification.  
+
There is an outstanding requirement to support the standardised exchange of detailed "Product" data, for regulatory and other use cases.  
  
This resource does not intend to clash with the existing Medication FHIR resource, but complements with an extra level of detail. It is seen as a sibling rather than a parent or a superclass to be profiled. This resource has been designed in close consultation with Pharmacy, and in conjunction with the MedicationKnowledge resource
+
This resource does not intend to clash with the existing Medication resource, but complements it with an extra level of detail. It is seen as a sibling rather than a parent or a "superclass" to be profiled.  
  
It is intended to add an extra level of product specification detail, such as is typically used by regulators, and only indirectly used during normal medication related work flows (e.g. for lookups of unfamiliar products).
+
(The superclass option has widely discussed and rejected, since this would mean the Medication resource - much more commonly used - would become more complicated, being a very small profile of a very large model. We don't want to introduce such confusing complexity in that space - which is largely separate.)
  
Manufacturers submit this data to regulators, when products are registered or altered, or marketing situations change.
+
This resource has been designed in close consultation with Pharmacy WG, and in conjunction with the MedicationKnowledge resource
  
Use cases include:
+
RegulatedMedicinalProduct is intended to add an extra level of product specification detail, such as is typically used by regulators, and only indirectly used during normal medication related work flows (e.g. for look-ups of unfamiliar products).
Submission of products from drug companies and NCAs (National Competent Authorities - the national regulators) to regional regulators. This is already implemented in Europe (by EMA and EU-wide stakeholders) with an earlier non-HL7 format (XEVPRM/XEVMPD).
 
  
Drug Manufacturing Quality information (aka PQ/CMC, Pharmaceutical Quality), as used by the FDA in the US.
+
Drug manufacturers currently submit this data electronically to regulators, when products are registered or altered, or marketing situations change.
  
 
==Expected implementations==
 
==Expected implementations==
  
EMA and European drug manufacturers, who have a requirement to submit to EMA (and already do so in a proprietary format. They are required to move to IDMP, and this is a good opportunity to use a standards-based FHIR solution.
+
EMA and European drug manufacturers, who have a requirement to submit to EMA (and already do so in a proprietary format). They are required to move to IDMP, and this is a good opportunity to use a standards-based FHIR solution.
FDA (currently using SPL, which is not likely to change in the near term, but have expressed an interest in researching what can be done with FHIR).
+
 
 +
FDA for drug submission (currently using SPL, which is not likely to change in the near term, but have expressed an interest in FHIR).
 +
 
 +
FDA for Pharmaceutical Quality (HL7 PSS approved, based on this resource, June 2019),
  
 
==Content sources==
 
==Content sources==
  
The basis for the resource is the information in ISO 11615 Substances standard. A large amount of actual data exists in the EMA XEVMPD data base and XEVPRM XML messages. Example FHIR data of several full product data sheets exists based on prototyped resources.
+
The core basis for the resource is the information in ISO 11615 Medicinal Products standard, which is in turn partly based on the existing implementations in the EU and US. A large amount of actual data exists in the EMA EU XEVMPD data base (and XEVPRM XML messages). Example FHIR data for several full product data sheets exists based on draft resources.  
  
Draft resources covering some of IDMP are here: [[MedicinalProduct]]
+
Also, information gained from early stage implementation of these resources at EMA (2018, 2019), and from FDA requirements (for PQ/CMC) and other workgroup review (BR&R, Pharmacy) and their comments.
  
 
==Example Scenarios==
 
==Example Scenarios==
  
Pharma companies submit details of new products to regulators. Updates are made when necessary e.g. Clinical particulars change (a new contra-indication), a new marketing authorization exists etc.
+
Pharma companies submit details of new products to regulators. Updates are made when necessary e.g. clinical particulars change (a new contra-indication), a new marketing authorization exists etc.
  
 
Pharmacies and prescribers can view and download this information for reference and integration with their systems.
 
Pharmacies and prescribers can view and download this information for reference and integration with their systems.
 +
 +
Specific use cases include:
 +
 +
Submission of products from drug companies and NCAs (National Competent Authorities - the national regulators) to regional regulators. This is already implemented in Europe (by EMA and EU-wide stakeholders) with an earlier non-HL7 format (XEVPRM/XEVMPD). That scenarion is currently being re-implemented, using this resource, as part of the EU wide SPOR project.
 +
 +
Drug Manufacturing Quality information (aka PQ/CMC, Pharmaceutical Quality), as used by the FDA in the US. Specific plans to use this resource for that project.
  
 
==Resource Relationships==
 
==Resource Relationships==
  
See diagram below and also associated proposal: [[SubstanceSpecification_FHIR_Resource_Proposal]]
+
See diagram below. <!-- and also associated proposal: [[SubstanceSpecification_FHIR_Resource_Proposal]]-->
  
Reference to Organization, for the manufacturer, regulator and other establishments.
+
Some notable resource references:
 +
Reference to Organization, for the manufacturer, regulator and other establishments.  
 
Reference to DocumentReference, for the regulatory submission documentation.
 
Reference to DocumentReference, for the regulatory submission documentation.
Reference to (proposed) SubstanceSpecification to describe ingredients in detail.
+
Reference to directly supporting resources such as RegulatedPackagedProduct.
Reference to directly supporting (proposed) resources such as MedicinalProductAuthorization, MedicinalProductPackaged
+
Incoming reference from resource RegulatedAuthorization.
 +
Indirect reference to DeviceDefinition, via the other proposed resources (DeviceDefinition was created with O&O with input from this IDMP project and includes our all of our device requirements).
 +
Indirect reference to proposed SubstanceSpecification resource to describe ingredients in detail.
 +
 
 +
===RegulatedMedicinalProduct and Medication===
 +
 
 +
This resource is intended to complement the Medication resource, which is focused on what is commonly needed for medical/clinical use cases. RegulatedMedicinalProduct adds information needed for regulatory use cases, of which there is little overlap to day to day prescribing.
  
===MedicinalProduct and Medication===
+
Most aspects of RegulatedMedicinalProduct are not present in Medication at all, and are not current candidates for inclusion in the prescribe/dispense/administer workflow.
  
This resource is intended to complement the Medication resource, which is focused on what is commonly needed for medical/clinical use cases. MedicinalProduct adds information needed for regulatory use cases, of which there is little overlap, and also may be appropriate for drug database use.
+
===RegulatedMedicinalProduct and MedicationKnowledge ===
  
Most aspects of MedicinalProduct are not present in Medication at all, and are not current candidates for inclusion in the prescribe/dispense/administer workflow.
+
MedicationKnowledge resource is aimed at drug knowledge bases. There is partial overlap in scope between that resource and some aspects of regulatory use cases. To fulfil that, the common associated resources of RegulatedMedicinalProduct will be used (e.g. Ingredient, ClinicalUseIssue). MedicationKnowledge includes some local specifics such as pricing. The boundaries between all these resource have been carefully thought out and have had much discussion in workgroups (BR&R, Pharmacy, CDS) and with FMG representatives.  
  
Clinical particulars - indications, contra-indications etc
+
Also refer to the logical model which was used to clarify the resource relationships, at the request of FMG, in the preparation of this proposal (linked to the approved MedicationKnowledge proposal page): [[MedicationKnowledge_FHIR_Resource_Proposal]]
Authorisations and Marketing - key area for regulators, of little interest to prescribers. Dates, statuses, territories etc.
 
Product packaging - details of packages, including contents, sizes etc
 
Ingredients - Typically at a prescribing level these are inherent in the medication code. The Medication resource does allow specifying ingredients of a medicine but this is typical for extemporaneous mixtures, and not the manufacturing of products.
 
  
===MedicinalProduct and Device===
 
  
IDMP does include descriptions of devices that are included with medicinal products. These include physical properties and characteristics that apply at the model level rather than the "instance" or usage level, that the Device resource is primarily concerned with.
+
High level relationships of the main prescribing resources and the regulatory strata below:
 
[[Image:Resources_sketch.png|center||Relationship to other resources]]
 
[[Image:Resources_sketch.png|center||Relationship to other resources]]
  
 
==Timelines==
 
==Timelines==
  
Early draft by December 2017 comment-only ballot.
+
Draft content is modelled in the FHIR build (http://build.fhir.org/regulatedmedicinalproduct.html), with outline supporting documentation. Completion planned Q4 2019.
  
 
==gForge Users==
 
==gForge Users==
  
riksmithies (already has commit permission)
+
riksmithies
  
 
==When Resource Proposal Is Complete==
 
==When Resource Proposal Is Complete==

Revision as of 09:22, 14 June 2019



RegulatedMedicinalProduct

Draft resource in build:

Relationship to other resources

Owning work group name

BR&R

Committee Approval Date:

6th May 2019 (earlier approval as "MedicinalProduct" 13th September 2017)

Contributing or Reviewing Work Groups

  • Pharmacy
  • Orders and Observations
  • Clinical Decision Support

FHIR Resource Development Project Insight ID

1367


Scope of coverage

To support the content of the ISO 11615 IDMP Medicinal Product standard and other domain areas with similar requirements. 11615 covers detailed definition of products, their submissions to regulators, authorization activities, ingredients, packaging, accompanying devices, clinical particulars etc. Not all of those are expected to be covered in this single resource.

RIM scope

Similar in scope to the product parts of CPM. Entity: Material (EntityClass="MAT")

Resource appropriateness

There is an outstanding requirement to support the standardised exchange of detailed "Product" data, for regulatory and other use cases.

This resource does not intend to clash with the existing Medication resource, but complements it with an extra level of detail. It is seen as a sibling rather than a parent or a "superclass" to be profiled.

(The superclass option has widely discussed and rejected, since this would mean the Medication resource - much more commonly used - would become more complicated, being a very small profile of a very large model. We don't want to introduce such confusing complexity in that space - which is largely separate.)

This resource has been designed in close consultation with Pharmacy WG, and in conjunction with the MedicationKnowledge resource

RegulatedMedicinalProduct is intended to add an extra level of product specification detail, such as is typically used by regulators, and only indirectly used during normal medication related work flows (e.g. for look-ups of unfamiliar products).

Drug manufacturers currently submit this data electronically to regulators, when products are registered or altered, or marketing situations change.

Expected implementations

EMA and European drug manufacturers, who have a requirement to submit to EMA (and already do so in a proprietary format). They are required to move to IDMP, and this is a good opportunity to use a standards-based FHIR solution.

FDA for drug submission (currently using SPL, which is not likely to change in the near term, but have expressed an interest in FHIR).

FDA for Pharmaceutical Quality (HL7 PSS approved, based on this resource, June 2019),

Content sources

The core basis for the resource is the information in ISO 11615 Medicinal Products standard, which is in turn partly based on the existing implementations in the EU and US. A large amount of actual data exists in the EMA EU XEVMPD data base (and XEVPRM XML messages). Example FHIR data for several full product data sheets exists based on draft resources.

Also, information gained from early stage implementation of these resources at EMA (2018, 2019), and from FDA requirements (for PQ/CMC) and other workgroup review (BR&R, Pharmacy) and their comments.

Example Scenarios

Pharma companies submit details of new products to regulators. Updates are made when necessary e.g. clinical particulars change (a new contra-indication), a new marketing authorization exists etc.

Pharmacies and prescribers can view and download this information for reference and integration with their systems.

Specific use cases include:

Submission of products from drug companies and NCAs (National Competent Authorities - the national regulators) to regional regulators. This is already implemented in Europe (by EMA and EU-wide stakeholders) with an earlier non-HL7 format (XEVPRM/XEVMPD). That scenarion is currently being re-implemented, using this resource, as part of the EU wide SPOR project.

Drug Manufacturing Quality information (aka PQ/CMC, Pharmaceutical Quality), as used by the FDA in the US. Specific plans to use this resource for that project.

Resource Relationships

See diagram below.

Some notable resource references: Reference to Organization, for the manufacturer, regulator and other establishments. Reference to DocumentReference, for the regulatory submission documentation. Reference to directly supporting resources such as RegulatedPackagedProduct. Incoming reference from resource RegulatedAuthorization. Indirect reference to DeviceDefinition, via the other proposed resources (DeviceDefinition was created with O&O with input from this IDMP project and includes our all of our device requirements). Indirect reference to proposed SubstanceSpecification resource to describe ingredients in detail.

RegulatedMedicinalProduct and Medication

This resource is intended to complement the Medication resource, which is focused on what is commonly needed for medical/clinical use cases. RegulatedMedicinalProduct adds information needed for regulatory use cases, of which there is little overlap to day to day prescribing.

Most aspects of RegulatedMedicinalProduct are not present in Medication at all, and are not current candidates for inclusion in the prescribe/dispense/administer workflow.

RegulatedMedicinalProduct and MedicationKnowledge

MedicationKnowledge resource is aimed at drug knowledge bases. There is partial overlap in scope between that resource and some aspects of regulatory use cases. To fulfil that, the common associated resources of RegulatedMedicinalProduct will be used (e.g. Ingredient, ClinicalUseIssue). MedicationKnowledge includes some local specifics such as pricing. The boundaries between all these resource have been carefully thought out and have had much discussion in workgroups (BR&R, Pharmacy, CDS) and with FMG representatives.

Also refer to the logical model which was used to clarify the resource relationships, at the request of FMG, in the preparation of this proposal (linked to the approved MedicationKnowledge proposal page): MedicationKnowledge_FHIR_Resource_Proposal


High level relationships of the main prescribing resources and the regulatory strata below:

Relationship to other resources

Timelines

Draft content is modelled in the FHIR build (http://build.fhir.org/regulatedmedicinalproduct.html), with outline supporting documentation. Completion planned Q4 2019.

gForge Users

riksmithies

When Resource Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org

FMG Notes