HdBe-MedicationAgreement
CBB | Description | Status |
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HdBe-MedicationAgreement | A medication agreement is a prescriber’s proposal for a patient to use medication. An agreement to discontinue the use of medication is also a medication agreement. PurposeThe goal of the medication agreement is to provide insight into the agreements reached between the prescriber and the patient on the use of medication. InstructionsMedicationAgreementAdditionalInformation: When choosing a medicine, you can deviate from what is expected or from what the standard is. For example, when the hospital uses a different formulary than the community pharmacy. For reasons of efficiency, for example, one gastric acid inhibitor has been chosen in the hospital: pantoprazole. Upon admission, a patient with omeprazole is converted to pantoprazole for the duration of the stay. When discharged, the patient goes back to omeprazole. It is clear that something can go wrong here and that the patient takes both omeprazole and pantoprazole when there is no intervention. In the hospital's medication agreement for pantoprazole a remark can be made about the deviation so that it is clear that pantoprazole is the substitute for omeprazole or that it should be used in addition to omeprazole. Another example are the half strengths. The hospital sometimes stocks tablets with half the strength of the normal trade preparation (own production). The patient enters the hospital on 25 mg chlortalidone, half a tablet once a day, he receives 12.5 mg intramural chlortalidone, one tablet once a day. Then the nursing does not have to break tablets in this case. Here there is a risk that the patient will use the 25 mg again at home, but then a whole tablet at a time in stead of half a tablet. By means of an explanation in the medication agreement (Additional information) of the last chlortalidone 25 mg, it can be indicated whether this has been an intended increase. | active |
MedicationAgreement | MedicationAgreement | ||
id | 0..1 | string | |
extension | I | 0..* | Extension |
Prescriber | I | 0..1 | Reference(HdBe-HealthProfessional) |
PrescriptionReason | I | 0..1 | Reference(HdBe-Problem) |
AgreedMedicine | I | 1..1 | Reference(HdBe-PharmaceuticalProduct) |
InstructionsForUse | 0..1 | HdBe-InstructionsForUse | |
MedicationAgreementDateTime | 1..1 | dateTime | |
PeriodOfUse | 0..1 | HdBe-TimeInterval | |
MedicationAgreementStopType | 0..1 | CodeableConceptBinding | |
ReasonMedicationAgreement | 0..1 | CodeableConceptBinding | |
MedicationAgreementAdditionalInformation | 0..* | CodeableConceptBinding | |
Comment | 0..1 | string |
MedicationAgreement | 0..* | |
MedicationAgreement.Prescriber | Reference(HdBe-HealthProfessional) | 0..1 |
MedicationAgreement.PrescriptionReason | Reference(HdBe-Problem) | 0..1 |
MedicationAgreement.AgreedMedicine | Reference(HdBe-PharmaceuticalProduct) | 1..1 |
MedicationAgreement.InstructionsForUse | HdBe-InstructionsForUse | 0..1 |
MedicationAgreement.MedicationAgreementDateTime | dateTime | 1..1 |
MedicationAgreement.PeriodOfUse | HdBe-TimeInterval | 0..1 |
MedicationAgreement.MedicationAgreementStopType | CodeableConcept | 0..1 |
MedicationAgreement.ReasonMedicationAgreement | CodeableConcept | 0..1 |
MedicationAgreement.MedicationAgreementAdditionalInformation | CodeableConcept | 0..* |
MedicationAgreement.Comment | string | 0..1 |
MedicationAgreement | |
Definition | Root concept of the MedicationAgreement information model. This root concept contains all data elements of the MedicationAgreement information model. |
Cardinality | 0...* |
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Mappings |
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MedicationAgreement.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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MedicationAgreement.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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Mappings |
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MedicationAgreement.Prescriber | |
Definition | The health professional that entered the medication agreement with the patient. |
Cardinality | 0...1 |
Type | Reference(HdBe-HealthProfessional) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
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MedicationAgreement.PrescriptionReason | |
Definition | The medical reason for the prescription or for use of the medication. This can be used to enter a medical indication which was the direct cause for prescription or for use of the medication in question. It can concern every type of problem (or condition) of the patient, almost all diagnoses, complaints or symptoms. |
Cardinality | 0...1 |
Type | Reference(HdBe-Problem) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
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Mappings |
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MedicationAgreement.AgreedMedicine | |
Definition | The medicine agreed upon to be used. |
Cardinality | 1...1 |
Type | Reference(HdBe-PharmaceuticalProduct) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
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Mappings |
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MedicationAgreement.InstructionsForUse | |
Definition | Instructions for the use of the medication, e.g. dose and route of administration. |
Cardinality | 0...1 |
Type | HdBe-InstructionsForUse |
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Mappings |
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MedicationAgreement.MedicationAgreementDateTime | |
Definition | The time at which the agreement was made. Appointment date + time are required (order of the appointments must be clear in cases with multiple appointments on one day) |
Cardinality | 1...1 |
Type | dateTime |
Invariants |
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Mappings |
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MedicationAgreement.PeriodOfUse | |
Definition | Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original medication agreement. The end date indicates from when the medication is to be discontinued. **Duration:** The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. **End date:** The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date. With medication for an indefinite period only a start date is indicated. |
Cardinality | 0...1 |
Type | HdBe-TimeInterval |
Invariants |
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Mappings |
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MedicationAgreement.MedicationAgreementStopType | |
Definition | Stop type, the manner in which this medication is discontinued (temporary or definitive). |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | MedicationAgreementStopType codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
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MedicationAgreement.ReasonMedicationAgreement | |
Definition | Reason for this agreement. This can be the reason to start, change or stop the medication treatment. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | ReasonMedicationAgreement codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
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Mappings |
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MedicationAgreement.MedicationAgreementAdditionalInformation | |
Definition | Additional information includes details on the structure of the agreement made that are relevant for pharmacovigilance and fulfillment by the pharmacist. This can be used e.g. to indicate that there was a conscious decision to deviate from the norm or that the agreement is to be structured in a certain way. See also the Instructions section for more information about use of the element. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | MedicationAgreementAdditionalInformation codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
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MedicationAgreement.Comment | |
Definition | Comments regarding to the medication agreement. For example: in consultation with the medical specialist. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
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Example instances
MedicationAgreement | |
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Prescriber | Reference to HealthProfessional (E. Penninx) |
PrescriptionReason | Reference to Problem (Listeriosis) |
AgreedMedicine | Reference to PharmaceuticalProduct (Acetaminophen 500 mg) |
InstructionsForUse | Reference to InstructionsForUse (Vanaf 6 maart 2016 1x per week op maandag in de middag 500 mg) |
MedicationAgreementDateTime | 2016-03-04 15:52:30 |
PeriodOfUse | Reference to TimeInterval (start: 2016-03-06 ) |
MedicationAgreementStopType | |
ReasonMedicationAgreement | 266709005 - Medication commenced (code by SNOMED CT) |
MedicationAgreementAdditionalInformation | |
Comment |
zib MedicationAgreement-v1.2 difference
Concept | Category | Description |
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PrescriberReason |
textual | Removed context regarding the Dutch G-standard. |
MedicationAgreementStopType |
terminology | Renamed ValueSet from MedicationAgreementStopType to MedicationStopType, to be able to reuse it at MedicationUse and AdministrationAgreement. Also replaced Dutch SNOMED-CT codes with international codes in ValueSet MedicationStopType. |
ReasonMedicationAgreement |
terminology | Renamed ValueSet from MedicationAgreementReason to MedicationReason, to be able to reuse it at MedicationUse2. Replaced several values in ValueSet. 1. Added SNOMED-CT code for Unknown and Other. 2. Added CodeSystem MedicationReason which replaces all Dutch SNOMED-CT codes. 3. Removed all Dutch SNOMED-CT codes from valueset. |
MedicationAgreementAdditionalInformation |
terminology | Replaced several values in MedicationAgreementAdditionalInformation valueSet. 1. Replaced OTH with SNOMED-CT code for Other. 2. Added SNOMED-CT code for Unknown. 3. Added CodeSystem MedicationAgreementAdditionalInformation which replaces all Dutch SNOMED-CT codes. 4. Removed all Dutch SNOMED-CT codes from valueset. |
description.Instructions | textual | Replaced 'a intended increase' with 'an intended increase'. |
Terminology Bindings
Path | Name | Strength | URL |
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MedicationAgreementStopType | MedicationStopType | required | https://fhir.healthdata.be/ValueSet/MedicationStopType |
ReasonMedicationAgreement | MedicationReason | required | https://fhir.healthdata.be/ValueSet/MedicationReason |
MedicationAgreementAdditionalInformation | MedicationAgreementAdditionalInformation | required | https://fhir.healthdata.be/ValueSet/MedicationAgreementAdditionalInformation |