Long-acting insulin (basal)
The below example is for basal insulin administrated by pump to the patient. The extension parent-device-metric will connect to the device metric which will be connected to device component pump.
{ "id": "eb80911a-95f7-4c31-b4d9-3b2c1e1a2376", "resourceType": "MedicationAdministration", "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric", "valueReference": { "reference": "DeviceMetric/46d24edb-7afa-45c3-a12c-1b7a51d5f519" } } ], "meta": { "profile": [ "http://roche.com/fhir/rdc/StructureDefinition/medication-administration" ] }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "http://roche.com/fhir/rdc/cs", "code": "insulinDose", "display": "Insulin Dose" } ] }, "subject": { "reference": "Patient/SandboxPat3" }, "effectivePeriod": { "start": "2021-02-05T07:02:00+00:00", "end": "2021-02-05T08:02:00+00:00" }, "performer": [ { "actor": { "reference": "Patient/SandboxPat3" } } ], "dosage": { "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type", "valueCodeableConcept": { "coding": [ { "system": "http://roche.com/fhir/rdc/cs", "code": "basal", "display": "Basal" } ] } } ], "rateQuantity": { "value": 1.1, "unit": "[IU]/h", "system": "http://unitsofmeasure.org", "code": "[IU]/h" } } }
The below example is for manual entry on the smart phone. The extension parent-device-metric will connect to the device metric which will be connected to device component of smart phone.
{ "resourceType": "MedicationAdministration", "id": "id-medicationAdministration-pen-manual-basal", "meta": { "profile": [ "http://roche.com/fhir/rdc/StructureDefinition/medication-administration" ] }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "http://snomed.info/sct", "code": "25305005", "display": "Long-acting insulin (substance)" } ], "text": "Novolin" }, "subject": { "reference": "Patient/SandboxPat3" }, "effectiveDateTime": "2020-04-28T10:30:00Z", "performer": [ { "actor": { "reference": "Patient/SandboxPat3" } } ], "dosage": { "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type", "valueCodeableConcept": { "coding": [ { "system": "http://snomed.info/sct", "code": "61968008", "display": "Syringe, device (physical object)" } ] } } ], "dose": { "value": 3, "unit": "[iU]", "system": "http://unitsofmeasure.org", "code": "[iU]" } }, "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric", "valueReference": { "reference": "DeviceMetric/id-deviceMetric-smartPhone-insulin" } } ] }
The below example is entry from Insulin Pen. The extension parent-device-metric will connect to the device metric which will be connected device component of Insulin pen.
{ "resourceType": "MedicationAdministration", "id": "id-medicationAdministration-pen-basal", "meta": { "profile": [ "http://roche.com/fhir/rdc/StructureDefinition/medication-administration" ] }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "http://snomed.info/sct", "code": "25305005", "display": "Long-acting insulin (substance)" } ], "text": "Novolin" }, "subject": { "reference": "Patient/SandboxPat3" }, "effectiveDateTime": "2020-04-28T10:30:00Z", "performer": [ { "actor": { "reference": "Patient/SandboxPat3" } } ], "dosage": { "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type", "valueCodeableConcept": { "coding": [ { "system": "http://ncimeta.nci.nih.gov", "code": "CL936094", "display": "Pen Device" } ] } } ], "dose": { "value": 3, "unit": "[iU]", "system": "http://unitsofmeasure.org", "code": "[iU]" } }, "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric", "valueReference": { "reference": "DeviceMetric/id-deviceMetric-insulinPen-insulin" } } ] }
FHIR example - Short-acting insulin (bolus)
The below example is for manual entry on the smart phone. The extension parent-device-metric will connect to the device metric which will be connected to device component of smart phone.
{ "resourceType": "MedicationAdministration", "id": "id-medicationAdministration-pen-manual-bolus", "meta": { "profile": [ "http://roche.com/fhir/rdc/StructureDefinition/medication-administration" ] }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "http://snomed.info/sct", "code": "411531001", "display": "Short-acting insulin (substance)" } ], "text": "Novolog" }, "subject": { "reference": "Patient/SandboxPat3" }, "effectiveDateTime": "2020-04-28T09:20:00Z", "performer": [ { "actor": { "reference": "Patient/SandboxPat3" } } ], "dosage": { "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type", "valueCodeableConcept": { "coding": [ { "system": "http://snomed.info/sct", "code": "61968008", "display": "Syringe, device (physical object)" } ] } } ], "dose": { "value": 5.1, "unit": "[iU]", "system": "http://unitsofmeasure.org", "code": "[iU]" } }, "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric", "valueReference": { "reference": "DeviceMetric/id-deviceMetric-smartPhone-insulin" } } ] }
The below example is entry from Insulin Pen. The extension parent-device-metric will connect to the device metric which will be connected to device component of Insulin pen.
{ "resourceType": "MedicationAdministration", "id": "id-medicationAdministration-pen-bolus", "meta": { "profile": [ "http://roche.com/fhir/rdc/StructureDefinition/medication-administration" ] }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "http://snomed.info/sct", "code": "411531001", "display": "Short-acting insulin (substance)" } ], "text": "Novolog" }, "subject": { "reference": "Patient/SandboxPat3" }, "effectiveDateTime": "2020-04-28T09:20:00Z", "performer": [ { "actor": { "reference": "Patient/SandboxPat3" } } ], "dosage": { "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type", "valueCodeableConcept": { "coding": [ { "system": "http://ncimeta.nci.nih.gov", "code": "CL936094", "display": "Pen Device" } ] } } ], "dose": { "value": 5.1, "unit": "[iU]", "system": "http://unitsofmeasure.org", "code": "[iU]" } }, "extension": [ { "url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric", "valueReference": { "reference": "DeviceMetric/DeviceMetric/id-deviceMetric-insulinPen-insulin" } } ] }
Medication Adminstration resource - Edited use case
The "edit" approach for medication adminstration will be as below. So this approach applies for any data point that is modelled as medication adminstration resource.
effectiveDateTime- will have the timestamp of the medication administration. This will remain the same unless the user updates also the administration timestampidentifier- will have the same unique identifier with which it has been ingested alreadystatus- will always be "completed" for the updated resource
Below is a sample for updating a pen_basal_injection_unit with internal confidence ID "BBBBB-BBBBB-BBBBB":
| Step | Description | Insulin Units | Injected TimeStamp | Type | Identifier |
|---|---|---|---|---|---|
| 1 | A pen_basal_injection_unit is entered | 4 | 2020-04-28T10:30:00Z | manual entry | BBBBB-BBBBB-BBBBB |
| 2 | The entry is updated | 3 | 2020-04-28T10:30:00Z | manual entry | BBBBB-BBBBB-BBBBB |
The following bundle is generated on Step 2.
{
"resourceType": "MedicationAdministration",
"id": "id-medicationAdministration-pen-manual-basal",
"meta": {
"profile": [
"http://roche.com/fhir/rdc/StructureDefinition/medication-administration"
]
},
"identifier": [
{
"system": "http://roche.com/fhir/rdc/sid/medication-administration/mysugr",
"value": "BBBBB-BBBBB-BBBBB"
}
],
"status": "completed",
"medicationCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "25305005",
"display": "Long-acting insulin (substance)"
}
],
"text": "Novolin"
},
"subject": {
"reference": "Patient/SandboxPat3"
},
"effectiveDateTime": "2020-04-28T10:30:00Z",
"performer": [
{
"actor": {
"reference": "Patient/SandboxPat3"
}
}
],
"dosage": {
"extension": [
{
"url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type",
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "61968008",
"display": "Syringe, device (physical object)"
}
]
}
}
],
"dose": {
"value": 3,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
"extension": [
{
"url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric",
"valueReference": {
"reference": "DeviceMetric/id-deviceMetric-smartPhone-insulin"
}
}
]
}
Medication Adminstration Delete use case
The "Delete" approach for medication adminstration resource will be as below. So this approach applies for any data point that is modelled as medication adminstration.
effectiveDateTime- will have the timestamp of the medication adminstration.identifier- will have the same unique identifier with which it has been ingested alreadystatus- will always be "entered-in-error" for the deleted resource
Below is a sample for deleting pen_basal_injection_unit with internal confidence ID AAAA-AAAA-A
| Step | Description | Insulin Units | Injected TimeStamp | Type | Identifier |
|---|---|---|---|---|---|
| 1 | A pen_basal_injection_unit is entered | 4 | 2020-04-28T10:30:00Z | manual entry | BBBBB-BBBBB-BBBBB |
| 2 | The entry is updated | 3 | 2020-04-28T10:30:00Z | manual entry | BBBBB-BBBBB-BBBBB |
| 3 | The entry is deleted; In FHIR it is logically deleted by replacing it with "entered-in-error" status | 2020-04-28T10:30:00Z |
The following bundle is generated on Step 3.
{
"resourceType": "MedicationAdministration",
"id": "id-medicationAdministration-pen-manual-basal",
"meta": {
"profile": [
"http://roche.com/fhir/rdc/StructureDefinition/medication-administration"
]
},
"identifier": [
{
"system": "http://roche.com/fhir/rdc/sid/medication-administration/mysugr",
"value": "BBBBB-BBBBB-BBBBB"
}
],
"status": "entered-in-error",
"medicationCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "25305005",
"display": "Long-acting insulin (substance)"
}
],
"text": "Novolin"
},
"subject": {
"reference": "Patient/SandboxPat3"
},
"effectiveDateTime": "2020-04-28T10:30:00Z",
"performer": [
{
"actor": {
"reference": "Patient/SandboxPat3"
}
}
],
"dosage": {
"extension": [
{
"url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type",
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "61968008",
"display": "Syringe, device (physical object)"
}
]
}
}
],
"dose": {
"value": 3,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
"extension": [
{
"url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric",
"valueReference": {
"reference": "DeviceMetric/id-deviceMetric-smartPhone-insulin"
}
}
]
}