2017-01-02 Rx Conf Call

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  • Melva Peters (Chair)
  • John Hatem
  • Jose Costa Texeira

WGM Agenda

  • Any other topics to consider?

ListServ Discussions


  • MedicationAdministration R2:R3
  • MedicationStatement
    • related to "do not do" - as in patient not to be given a certain medication
    • may come out of Negation project from Patient Care
    • a number of items included in this Zulip chat
      • patient not to be given medication
        • not likely a medicationStatement - is this a negative order?
        • has not come up for Cerner - may infer something like this from an allergy
      • doctor recommends that GP prescribes drug ABC
Action:  Melva to reach out to Philip to post tracker item

FHIR Tracker Items

TR#7830 2015May core #1152 - Add RXD

  • Scott has provided updated mappings
    • Scott suggests that we enter the current mapping (TQ1.6) and see if there is a means to comment about prior v2 versions. (There may be installations still using v2.3.1 … or prior!)
      • Also, v2.x supports the concept of days supply (Duration) in any pharmacy message with an ORC/TQ1 segment set. This includes the original order, the dispense, and the administration (and other messages which do not have FHIR counterparts).
      • See updated Tracker Item
  • Motion: that we include current V2 mapping as per Tracker Item at a minimum and if we can, include previous version mapping as comments - John/Jose - 2/0/0 - Carried


  • requests common search parameters across resources. One of the requests is for date across medication resources - but the medication resources do not have any common date related search parameters. I would suggest that there should be a 'date' on each of them.
    • MedicationRequest datewritten rename to date
    • MedicationAdministration effective-time - add date with same definition
    • MedicationDispense - whenhandedover rename to date
    • MedicationStatement - add date = MedicationStatement.dateAsserted
    • Some ideas:
      • 1 - I would have thought that when comparing MedicationStatements with MedicationAdministrations and other medication resources, the date of interest was the the 'date of medication use', not the 'date of assertion'. So MedicationStatement's search date should be based on effective.
      • 2 - This would be an opportunity to align the names of MedicationAdministration.effectiveTime[x] and MedicationStatement.effective[x].
      • 3 - The information that can be held by the combined data elements effectiveDateTime and effectivePeriod can also be held by two different data elements date and duration. That design would give a common date data element for searching without adding an extra data element just for searching.
      • Discussed 11/21 call, a common search parameters across resources.
 Action: John to ask Grahame (or someone on FMG) to join our call to discuss this with us

TR#12347 - Adjust Medication.package.container value set to SNOMED CT Physical object hierarchy


  • December 15 - IDMP - could look at using
    • Scott thinks NCPDP may have looked at using SNOMED-CT
    • could use a US centric value set if can't find anything else
Action:  Scott to look at what NCPDP used and if we can reference it
Action: Jose to look at IDMP and it's implementations
    • EDQM example - container list - Jose has found and will provide to the list if there is no copyright issue

TR#12440 Add PerformerType to MedicationRequest

  • this was discussed previously - would be handled by an extension for now
  • Jose will withdraw this request.

TR12439 - Add "intendedPerformer" to medicationRequest

Action: Jose is forwarding email to workflow for clarity

TR 12387 Harmonization of MedicationAdministration with event Workflow logical model

  • See updated spreadsheet and updates in FHIR tracker

TR#12362 Track current number of Dose Administrations

TR#12238 How to say exact timing is up to party executing the schedule?

TR#10389 Add guidance about whether to choose medication codeableConcept or reference to medication if need to include lot number or batch

TR 12486 - Make MedicationAdministration.reasonReference more like MedicationStatement.ReasonforUseReference

TR 12470 - MedicationStatement.status and notTaken

TR 12386 Harmonization of MedicationDispense with Workflow event logical model

TR 12479 Add Organization to EventHistory in Med Order and possible Med Admin

FHIR Workflow Meetings Status

FHIR Maturity - Deferred

  • Current Maturity status
    • spreadsheet has been submitted - MedicationOrder, MedicationStatement and Medication - MM2
    • review of MedicationStatement Maturity
    • no further need for the resources to get them to MM2
  • Update on MedicationDispense implementations

Order Service Catalogue PSS - Deferred

  • Update on project meetings


  • None

Next meeting

  • Monday, January 09, 2017 at 4pm Eastern