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",
"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",
{
"actor": {
"reference": "Patient/SandboxPat3"
}
}
],
"dosage": {
{
"url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type",
"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]"
}
},
{
"url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric",
"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",
"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",
{
"actor": {
"reference": "Patient/SandboxPat3"
}
}
],
"dosage": {
{
"url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type",
"coding": [
{
"system": "http://ncimeta.nci.nih.gov",
"code": "CL936094",
"display": "Pen Device"
}
]
}
}
],
"dose": {
"value": 5.1,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"url": "http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric",
"reference": "DeviceMetric/DeviceMetric/id-deviceMetric-insulinPen-insulin"
}
}
]
}

Types of bolus : This page shows how the extension should be updated for different types of bolus types. In the MedicationAdministration - ext admin-type extension the data is updated according to the bolus type.

PUMP_STANDARD : This is most common type of bolus used is a normal bolus, which is similar that would have been used with injections.

                   {
                            "url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "system": "http://roche.com/fhir/rdc/cs",
                                        "code": "bolusStd",
                                        "display": "Standard bolus"
                                    }
                                ]
                            }
                    }


PUMP_EXTENDED : Extended bolus delivers the insulin over a set amount of time decided by the pump user.

                   {
                            "url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "system": "http://roche.com/fhir/rdc/cs",
                                        "code": "bolusExt",
                                        "display": "Extended bolus"
                                    }
                                ]
                            }
                    }


PUMP_MULTIWAVE : This is Combining a standard and extended bolus: the multiwave or dual-wave bolus option delivers a rapid bolus followed by a slower, steady release of insulin.

                   {
                            "url": "http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "system": "http://roche.com/fhir/rdc/cs",
                                        "code": "bolusMul",
                                        "display": "Multiwave bolus"
                                    }
                                ]
                            }
                    }