3.9.2.1.2 Supply activity

ASTM CCR defines a <FulfillmentHistory> element, used to indicate details about a dispensing activity. This corresponds to a supply event (a supply activity in “EVN” mood) in CCD, used to report what was actually filled.

CONF-316: A supply activity (templateId 2.16.840.1.113883.10.20.1.34) SHALL be represented with Supply.
CONF-317: The value for “Supply / @moodCode” in a supply activity SHALL be “EVN” or “INT” 2.16.840.1.113883.5.1001 ActMood STATIC.
CONF-318: A supply activity SHALL contain at least one Supply / id.
CONF-319: A supply activity SHOULD contain exactly one Supply / statusCode.
CONF-320: A supply activity SHOULD contain exactly one Supply / effectiveTime, to indicate the actual or intended time of dispensing.
CONF-321: A supply activity MAY contain exactly one Supply / repeatNumber, to indicate the number of fills. (Note that Supply / repeatNumber corresponds to the number of “fills”, as opposed to the number of “refills”).
CONF-322: A supply activity MAY contain exactly one Supply / quantity, to indicate the actual or intended supply quantity.
CONF-323: A supply activity MAY contain one or more Supply / author, to indicate the prescriber.
CONF-324: A supply activity MAY contain one or more Supply / performer, to indicate the person dispensing the product.
CONF-325: A supply activity MAY contain exactly one Supply / participant / @typeCode = “LOC”, to indicate the supply location.
CONF-326: A supply activity SHALL contain one or more sources of information, as defined in section 5.2 Source.

3.9.2.2.3 Fulfillment instructions

Fulfillment instructions are additional information provided to the dispensing party (e.g. “label in spanish”).

CONF-334: A supply activity MAY contain one or more fulfillment instructions.
CONF-335: A fulfillment instruction (templateId 2.16.840.1.113883.10.20.1.43) SHALL be represented with Act.
CONF-336: The value for “Act / @moodCode” in a fulfillment instruction SHALL be “INT” “Intent” 2.16.840.1.113883.5.1001 ActMood STATIC.
CONF-337: The value for “entryRelationship / @typeCode” in a relationship between a supply activity and fulfillment instruction SHALL be “SUBJ” “Subject” 2.16.840.1.113883.5.1002 ActRelationshipType STATIC.

3.9.2.3 Representation of “status” values

The template identifier for a medication status observation is 2.16.840.1.113883.10.20.1.47.

CONF-350: A medication activity MAY contain exactly one medication status observation.
CONF-351: A supply activity MAY contain exactly one medication status observation.
CONF-352: A medication status observation (templateId 2.16.840.1.113883.10.20.1.47) SHALL be a conformant status observation (templateId 2.16.840.1.113883.10.20.1.57) (as defined in section 5.1 “Type” and “Status” values).
CONF-353: The value for “Observation / value” in a medication status observation SHALL be selected from ValueSet 2.16.840.1.113883.1.11.20.7 MedicationStatusCode STATIC 20061017.

3.9.2.4 Representation of a product

The template identifier for a product is 2.16.840.1.113883.10.20.1.53.
The template identifier for a product instance is 2.16.840.1.113883.10.20.1.52.

CONF-354: A medication activity SHALL contain exactly one SubstanceAdministration / consumable, the target of which is a product template.
CONF-355: A supply activity MAY contain exactly one Supply / product, the target of which is a product template.
CONF-356: A product (templateId 2.16.840.1.113883.10.20.1.53) SHALL be represented with the ManufacturedProduct class.
CONF-357: A ManufacturedProduct in a product template SHALL contain exactly one manufacturedProduct / manufacturedMaterial.
CONF-358: A manufacturedMaterial in a product template SHALL contain exactly one manufacturedMaterial / code.
CONF-359: The value for “manufacturedMaterial / code” in a product template SHOULD be selected from the RxNorm (2.16.840.1.113883.6.88) code system for medications, and from the CDC Vaccine Code (2.16.840.1.113883.6.59) code system for immunizations , or MAY be selected from ValueSet 2.16.840.1.113883.1.11.20.8 MedicationTypeCode STATIC 20061017.
CONF-360: The value for “manufacturedMaterial / code” in a product template MAY contain a precoordinated product strength, product form, or product concentration (e.g. “metoprolol 25mg tablet”, “amoxicillin 400mg/5mL suspension”).
CONF-361: If manufacturedMaterial / code contains a precoordinated unit dose (e.g. “metoprolol 25mg tablet”), then SubstanceAdministration / doseQuantity SHALL be a unitless number that indicates the number of products given per administration.
CONF-362: If manufacturedMaterial / code does not contain a precoordinated unit dose (e.g. “metoprolol product”), then SubstanceAdministration / doseQuantitySHALL be a physical quantity that indicates the amount of product given per administration.
CONF-363: A manufacturedMaterial in a product template SHALL contain exactly one Material / code / originalText, which represents the generic name of the product.
CONF-364: A manufacturedMaterial in a product template MAY contain exactly one Material / name, which represents the brand name of the product.

ASTM CCR defines an optional product size element which can be used to describe the physical characteristics of a product. CDA R2 has no corresponding field, but can uniquely identify a given manufacturer’s product, thereby enabling a complete lookup of any detail related to the product.

CONF-365: A ManufacturedProduct in a product template MAY contain exactly one manufacturedProduct / manufacturerOrganization, which represents the manufacturer of the Material.
CONF-366: A ManufacturedProduct in a product template MAY contain one or more manufacturedProduct / id, which uniquely represent a particular kind of product.
CONF-367: If ManufacturedProduct in a product template contains manufacturedProduct / id, then ManufacturedProduct SHOULD also contain manufacturedProduct / manufacturerOrganization.
CONF-368: A medication activity MAY contain one or more product instance templates (templateId 2.16.840.1.113883.10.20.1.52) (see section 3.14.2.2 Procedure related products), to identify a particular product instance.
CONF-369: A supply activity MAY contain one or more product instance templates (templateId 2.16.840.1.113883.10.20.1.52) (see section 3.14.2.2 Procedure related products), to identify a particular product instance.
CONF-370: Supply / participant / participantRole / idSHOULD be set to equal a [Act | Observation | Procedure] / participant / participantRole / id (see section 3.14.2.2 Procedure related products) to indicate that the Supply and the Procedure are referring to the same product instance.