HSOMedication

HL7 FHIR provides the data structure definitions (FHIR resources) that will be used when integrating different health systems in general, including the Medication domain. The EU initiative IPS (International Patient Summary) has defined FHIR profiles to support the need for exchange of health information for cross-border patient care, for which Medication is an important part. HSØ aims to adapt to the IPS standard. The Medication resource represents an actual medication that can be given to a patient. The resource is referenced by the other FHIR resources in the Medications module, among others. A medication can be specified either as generic (by substance/strength/unit/dosage form), by product or package, or by the anatomic therapeutic classification system (ATC). In HSØ today, FEST is the authoritative drug catalogue. In the future, there will be a transition to the use of the international standard for identification of medicinal products (IDMP).

According to IDMP, a generic medication (pharmaceutical product – PhPID, ISO 11616) can be specified in any of these four levels:

  • Level 1: Substance (ISO 11238)
  • Level 2: Substance + strength + unit (ISO 11238, ISO 11240)
  • Level 3: Substance + dosage form (ISO 11238, ISO 11239)
  • Level 4: Substance + strength + unit + dosage form (ISO 11238, ISO 11239, ISO 11240)

Non-generic medications can be specified either as a medicinal product identification (MPID, ISO 11615) or a packaged medicinal product (PCID, ISO 11615). ATC is also valid as a medication identifier.

The IPS Medication profile reflects the IDMP standard for the identification of medications. Each of the seven levels has a specific code element with proper flags, cardinality and constraints (e.g. example terminology bindings). Except for the ATC level, there are no fixed values for the system attribute for these code elements, so the profile gives flexibility in regards to using either or both FEST codes and IDMP codes interchangeably. The applied coding system must always be referenced.

identifierΣ0..*Identifier
pharmaceuticalProduct-L1Σ0..*Coding
pharmaceuticalProduct-L2Σ0..*Coding
pharmaceuticalProduct-L3Σ0..*Coding
pharmaceuticalProduct-L4Σ0..*Coding
medicinalProductΣ0..*Coding
packagedProductΣ0..*Coding
atcClassΣ0..*Coding
textΣ0..1string
statusΣ ?!0..1codeBinding
manufacturerΣ I0..1Reference(Organization)
form0..1CodeableConcept
amountΣ I0..1Ratio
itemCodeableConceptCodeableConcept
itemReferenceReference(Substance | Medication)
isActive0..1boolean
strengthI0..1Ratio
lotNumber0..1string
expirationDate0..1dateTime