Extensions

Several extensions are needed to capture the metadata about formularies and the medications that they list.

TODO: All of these extensions are using http://example.org/fhir as their baseurl, which is not real. Find an authoritative location to store these extensions.

For each formulary:

  • {{link:USMedicationFormulary/Formulary-EffectiveFrom}}
  • {{link:USMedicationFormulary/Formulary-EffectiveTo}}
  • {{link:USMedicationFormulary/Formulary-PlanYear}}
    • TODO: this is currently an integer. Should it be a string for the plans that span multiple years (e.g., 2007-2008)?
  • {{link:USMedicationFormulary/Formulary-HealthPlan}}
    • TODO: this is currently a string. Should it be a reference instead?
    • TODO: should the reference be on the other side - plans reference the formularies that they include?
  • TODO: Formulary ID, for handling associations between Health Plans and their respective formularies
    • Do plans ever have multiple formularies associated with them, or is it just a 1:1 relationship?
  • TODO: Number of Drug Tiers as an integer (3, 4, 5, 6, others?)
  • TODO: Co-payment/co-insurance amounts associated with each tier

For each medication:

  • TODO: Drug Tier as an integer
  • TODO: Drug Classification Code
    • This could be a WHO ATC code or a First Data Bank code?
    • This may also be a string, if no code system is widely used/available
  • {{link:USMedicationFormulary/Formulary-CoPayRequired}}
    • TODO: Is this necessary if the drug tier dictates the copay amount?
  • {{link:USMedicationFormulary/Formulary-CoInsuranceRequired}}
    • TODO: Is this necessary if the drug tier dictates the co-insurance amount?
  • {{link:USMedicationFormulary/Formulary-PriorAuthRequired}}
  • {{link:USMedicationFormulary/Formulary-PriorAuthDescription}}
  • {{link:USMedicationFormulary/Formulary-StepTherapyRequired}}
  • {{link:USMedicationFormulary/Formulary-StepTherapyDescription}}
  • {{link:USMedicationFormulary/Formulary-QuantityLimitImposed}}
  • {{link:USMedicationFormulary/Formulary-QuantityLimitDescription}}
  • {{link:USMedicationFormulary/Formulary-AgeLimitImposed}}
  • {{link:USMedicationFormulary/Formulary-AgeLimitDescription}}
  • {{link:USMedicationFormulary/Formulary-LimitedAccessImposed}}
  • {{link:USMedicationFormulary/Formulary-LimitedAccessDescription}}
  • {{link:USMedicationFormulary/Formulary-Injectable}}
  • {{link:USMedicationFormulary/Formulary-MailOrder}}
  • {{link:USMedicationFormulary/Formulary-PartBOrPartD}}

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