Finnish PHR Insulin Dosing Profile

Finnish PHR profile for FHIR® Medication Admistration to be used for the administered insulin doses of a patient.

A full list of the extensions, constraints and a structured definition of this profile can be found in Simplifier. There are also different views of the profile (details, mappings, table, XML, JSON).

Mandatory elements for Finnish PHR Insulin Dosing

Mandatory elements table for Finnish PHR Insulin Dosing profile
Content Name in structure Description / Type of information
Language language Language used in the medication administration stored in Kanta PHR.
Language SHALL be chosen from the FHIR languages ValueSet.
Narrative text A text summary of the observation.
SHALL include all content for a human to understand the essential clinical and business information of the medication administration.
Unique identifier identifier

At least one globally unique identifier has to be provided for the medication administration, in addition other identifiers may be given as well.

This identifier may be used to uniquely identify the medication administration if the application doesn't receive an id for the medication administration provided by Kanta PHR.

Status status The status of the medication administration.
Only completed medication administrations are stored in Kanta PHR, thus the status SHALL always be 'completed' (from FHIR Medication Administration Status ValueSet).
Medication that was administered medication
CodeableConcept		 The identifier/code and name of the medication.
- When the medication can be uniquely identified, the VNR code of the medication and the brand name of the medication SHALL be given which SHALL match the name in the pharmaceutical database.
- When the medication can not be uniquely identified (no VNR code available), a specific code indicating whether the administered insulin was intermediate or fast acting SHALL be given, from the Finnish PHR Insulin Code ValueSet.
- In addition, the name of the medication SHALL be given as well. The name can be one of the following: 1) brand name of the medication, in which case it must match the name in the pharmaceutical database, 2) name of the active ingredient(s) of the medication if the brand name is not applicable, or 3) some other name entered by the user.
Who received the medication subject The person receiving the medication. The reference SHALL be to a Patient resource stored in Kanta PHR (that conforms to the Finnish PHR Patient profile).
Time of administration effectivedateTime/
effectivePeriod		 A specific time during which the administration took place.
- Boluses: use effectiveDateTime (and dosage.dose.value with no rate)
- Extended boluses: use effectivePeriod (and dosage.dose.value with no rate)
- Basal insulin records: use effectivePeriod (and dosage.rate to describe the amount of iU/hour being dosed as basal insulin)

Optional elements for Finnish PHR Insulin Dosing

Optional elements table for Finnish PHR Insulin Dosing profile
Content Name in structure Description / Type of information
Who administered substance performer The individual who was responsible for giving the medication to the patient. The reference SHALL be to a Patient resource stored in Kanta PHR (that conforms to the Finnish PHR Patient profile)
Additional information about the administration note Extra information about the medication administration that is not conveyed by the other attributes.
Dosage dosage Describes the medication dosage details: dose and rate.

Elements in the Insulin Dosing profile filled by the Kanta PHR platform

Elements in the Finnish PHR SelfCarePlan profile filled by the Kanta PHR platform
Content Name in structure Description / Type of information
Application that created or updated the resource extension:
creatingApplication

Is used to represent information about the application (id and name) that created or updated the resource. See the definition for the Finnish PHR Application Information extension.

Kanta PHR platform will fill in this data automatically to each stored resource (if the application has entered some data in this extension, it will be overwitten).

Finnish PHR Insulin DosinNarrative guide

Narrative SHALL contain following mandatory information taken from the elements of the resource instance:

  • Name of the medication: <MedicationAdministration.medicationCodeableConcept.coding.text>
  • VNR Code: <MedicationAdministration.medicationCodeableConcept.coding[VNRCode].display>(<MedicationAdministration.medicationCodeableConcept.coding[VNRCode].code>)
  • Type of insulin:<MedicationAdministration.medicationCodeableConcept.coding[insulinCode].display>(<MedicationAdministration.medicationCodeableConcept.coding[insulinCode].code>)
  • Time: <MedicationAdministration.effectiveDateTime/effectivePeriod>

Narrative SHOULD contain following optional information if given in the resource instance:

  • Dosage: <MedicationAdministration.dosage.dose><MedicationAdministration.dosage.rate><MedicationAdministration.dosage.text>

If element is missing from resource, it shall not be mentioned in narrative.

Example:

Name of the medication: Actrapid
VNR Code: Glucose In Blood (15074-8)
Type of insulin: Fast-acting insulin (ins-short-fast)
Time: 18.5.2019 15:05

Examples of Finnish PHR Insulin Dosing resources in Simplifier