CSCR-089-Med-Add Orderable & Administerable Medication CMETs

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Submitted by: John Hatem	Revision date: 01/14/2009
Submitted date: 01/14/2009	Change request ID: CSCR-089

Issue

Documentation of what medication information was associated with a medication order or medication event needs to be allowed in the clinical statement model. This may be an ingredient, a medication or a packaged medicine.

Recommendation

Add the R_OrderableMedication universal CMET to the model, associating it with the SubstanceAdministration class in the model. The orderable medication would be associated with the SubstanceAdministration class via a consumable (CSM) participation.

Add the R_AdministerableMedication universal CMET to the model, associating it with the Supply class in the model. The administerable medication would be associated with the Supply class via a product (PRD) participation.

• Remove AgentChoice from the consumable (CSM) participation on the SubstanceAdministration class
  • Also removes MaterialKind, MaterialPart and MaterialPart2. Pharmacy WG believes all of these constructs are present in current CMET
• Add a consumable (CSM) participation from SubstanceAdministration to the R_OrderableMedication universal CMET
  • Remove contextControlCode from consumable (CSM) participation
• Remove ManufacturedProduct from the product (PRD) participation on the Supply class
  • Also removes Organization and DrugOrOtherMaterial. Pharmacy WG believes all of these constructs are present in current CMET
• Add a product (PRD) participation from Supply to the R_AdministrableMedication universal CMET
  • Remove contextControlCode from product (PRD) participation
  • Change cardinality on product to CMET from 1..* to 0..1

Resolution

15-Jan-09 - Motion to accept: John, Patrick

Only make following changes

• Relax product.contextControlCode participation to 0..1 optional
• Only replace R_Medication with R_OrderableMedication[universal], keep rest the same.
• Instead of replacing Manufactured Product, add choice of R_AdministerableMedication[universal] while keeping device participation to ManufacturedProduct

Against: 0; Abstain: 1; In Favor: 20

• Need to follow-up on the topic related to cardinality (temporarily removed from the motion):
  • Add a product (PRD) participation from Supply to the R_AdministrableMedication universal CMET

Remove contextControlCode from product (PRD) participation Change cardinality on product to CMET from 1..* to 0..1. Follow-up indicated that Rx prefers 0..*. To be discussed in follow-up.

20-Jan-09 - We need to get Rx to clarify the use case where the Supply does not have a product associated with it.