Medication Profile

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Medication Profile Under SVN

SVN Location is under http://gforge.hl7.org/svn/pharmacysig/pharmacysig/Documents/Whitepapers

Definition

• Existing Pharmacy materials – medication order, medication dispense, medication administration, medication statement may be used in a medication profile
• Medication Profiles are essentially queries for some combination of data from the above items that can be persisted for future queries or may be dynamically generated with each query
• May not always be persistent
• Prescriptions – all orders in any state – active, stopped, cancelled, held, etc
• Dispenses – picked up-returned to stock
• Administered
• Medication Statements
• “Current” vs “Active” vs “Past”
• We need definitions for a number of items
• Stephen Chu proposed the following items: medication list, medication profile, medication review, medication reconcilation, medication management plan
• Medication Reconcilation – may be a process – uses medicaation profiles to “review” and perform reconciliation
• Medication Review is different than Reconciliation – done prior to reconciliation
• It is clear that some people think of a Medication Profile from what content is displayed to a user in an application. This ‘display” may include all of the medication orders, dispenses, statements and events, BUT may also include information such as patient demographics, relevant lab observations, relevant observations (weight, height, BSA/BMI, allergy/intolerances, etc).
• “Treatment type” and other types of data as a means of organizing profile was discussed
• in the Canadian examples, organize into: continuous, short term, external information (i.e. medication statements)
• The focus of the Pharmacy Work Group is on Medication Orders, Medication Dispenses, Medication Statements and Medication Administrations.
• Systems that could query – EMR, Pharmacy, EHR
• Systems that could respond – Central respository (Rx, EHR, DIS, HIE) or local system (EHR, eRx, Pharmacy)

• Discussion of the definition of a medication profile
• The following table was developed using NL, CAN and IHE information:

Element	NL	Can (1 Jurisdiction)	IHE Pharmacy
=================	=================	=================	=================
Prescribed Meds	yes	yes	yes

Dispensed Meds Yes Yes Administered Med Yes No Medication Statements Yes Yes Yes (and dietary Use of alcohol and other drugs Yes – under consideration to remove No – although may be on local profile, but not DIS Labs Yes No – not part of DIS, but may be retrieved from other system Indications for use Yes Yes (but would be part of prescription record) Diagnosis Contraindications – conditions Yes No Contraindications – allergy/intolerances and reaction Yes Yes Reason for stop/start Yes Yes (but would be part of prescription record) Name of the prescriber Yes Yes (but would be part of prescription record) Original Prescriber Yes No Name of Pharmacist Yes Yes (but would be part of dispense) Patient – ID and demographics Yes Yes Yes

• It was determined that the committee can work on a set of queries to retrieve the information that is in our purview - Prescriptions, Dispenses, Administrations, Statements.
• John drafted the following statement that was agreed to by the attendees:
• The Pharmacy WG is responsible for defining the content e.g. Medication Queries that may populate a Medication Profile or Medication List. We acknowledge that one definition of a Medication Profile may include a broad range of data such as lab results, allergies and intolerance, height, weight, etc. However the Pharmacy WG will focus on queries for Medication Orders, Medication Dispenses, Medication Administrations and Medication Statements.
• Pharmacy WG also acknowledges there are several processes that are common when evaluating Medication information for a patient. We often see Medication Review and Medication Reconciliation steps called out as processes that clinicians will perform. In both cases, the clinician will need access to the type of content we provide via our Medication queries.
• Work was begun on a PSS for Patient Medication Queries but it was not completed and will be brought back at a later meeting.

Miscellaneous Material

File:2012-06-18 eMM-Concept-Definitions v02.pptx

File:2012-07-02 eMM-Landscape-and-Concepts.pptx