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" } } ] }
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"
}
]
}
}