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The item hl7:entryRelationships 'IHE MTP Reason' references the template 1.3.6.1.4.1.19376.1.5.3.1.4.4.1, which is missing.
The template exists in CH-PHARM, it should be linked/imported from there.-
hl7:manufactureMaterial.code has a description
For all elements listed in the minimum data set in the IPAG report the corresponding FHIR elements ‘mustSupport’ flag have been set to true. ‘MustSupport’ flags are currently only defined for the Medication Card document.
The flag mustSupport follows the IHE use of R2 as defined in Appendix Z. It demands that the content creator must support these elements if they are known. If the sending application has data for the element, it is required to populate the element with a non-empty value. If the value is not known, the element may be omitted. A receiving application may ignore the information conveyed by the element. A receiving application shall not raise an error solely due to the presence or absence of the element.
Define the meaning of must-support, harmonize it with CH-EMED.
Raised as an issue in the current ballot for CDA-CH EMED.
The entryRelationship substitution permission is annotated with "where [hl7:observation [hl7:templateId [@root='1.3.6.1.4.1.19376.1.9.1.3.9.1']]]". In the linked template, the root tag is an “hl7:act”, not an “hl7:observation”.
IHE Pharmacy MTP also describes it as an hl7:act.-
The precondition/criterion/text tag and the inner reference tag have a cardinality of 0…*. In the Prescription item entry content module (2.16.756.5.30.1.1.10.4.43), both have a cardinality of 1…1.
The XML Schema (https://github.com/hl7ch/hl7ch-cda/blob/master/schemas/extPHARM/POCD_MT000040_extPHARM.xsd#L359) specifies a cardinality of 0…1, so 1…1 seems to be the right one.
Currently effectiveTime.low and high are specified as TS and not enforcing the Timezone. This gives problems when converting/mapping. For CDA-CH TS.CH.TZwas defined as a restriction for TS datatypes that the timezone is included.
Change all TS entries like in effectiveTime to TS.CH.TZ.
see example in https://ehealthsuisse.ihe-europe.net/EVSClient//detailedResult.seam?type=CDA&oid=1.3.6.1.4.1.12559.11.25.1.13.47845
Medications in reserve are often used in the Swiss prescription workflow and it seems important to properly support them.
The flag is supported by CHMED16A and will be added to CHMED21A and CH-EMED.
Consequences of status quo are poor usability and context-fit for integrated applications, which may lead to patient safety issues. Thus, the adoption by patients and professionals depends on this change.
Propositions:
1. Templates Medication Treatment Plan Item Entry Content Module , Prescription Item Entry Content Module , Dispense Item Entry Content Module : add an entryRelationship element with cardinality 0..1 that contains the new “in reserve” flag. If absent, the medication is a regular one. A new Swiss template ID is assigned.
2. These changes are definitive.
< entryRelationship typeCode =" COMP "> <act classCode =" ACT " moodCode =" DEF "> <templateId root ="TO BE DEFINED"/>
<code code ="TO BE DEFINED" codeSystem ="" displayName ="" codeSystemName =""/>
<statusCode code =" completed "/>
</act>
</ entryRelationship >
By example:
· Regular
· In reserve
Or we only define a single value to make it “in reserve” (but a code system is still needed), the absence of the entryRelationship makes it regular.
Drafted by HUG and CARA.