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History (40)
Date Author Status Type
2022-06-08 17:37:53 Quentin Ligier Draft version
2022-06-08 15:53:04 Quentin Ligier Draft version
2022-03-03 10:27:06 Quentin Ligier Draft version
2022-03-03 10:15:19 Quentin Ligier Draft version
2022-02-23 17:59:56 Quentin Ligier Draft version
2022-02-23 17:11:07 Quentin Ligier Draft version
2022-02-23 17:00:51 Quentin Ligier Draft version
2022-02-23 16:56:17 Quentin Ligier Draft version
2022-02-23 16:52:59 Quentin Ligier Draft version
2021-06-09 08:31:57 Quentin Ligier Draft version
2021-05-25 10:19:09 Quentin Ligier Draft version
2021-05-11 09:35:55 Quentin Ligier Draft version
2021-05-05 15:26:45 Quentin Ligier Draft version
2021-05-05 09:45:02 Quentin Ligier Draft version
2021-05-05 09:37:51 Quentin Ligier Draft version
2021-04-08 15:00:12 Annatina Foppa Draft version
2021-02-19 00:51:23 Pero Grgic Draft version
2021-02-19 00:36:46 Pero Grgic Draft version
2020-09-30 12:03:10 Johannes Gnaegi Draft version
2020-09-30 11:56:19 Johannes Gnaegi Draft version
2020-09-30 11:46:07 Johannes Gnaegi Under pre-publication review version
2020-07-29 14:03:49 Oliver Egger Draft version
2020-07-10 20:20:58 Tony Schaller Draft version
2020-07-10 20:19:54 Tony Schaller Under pre-publication review version
2020-07-09 16:26:13 Tony Schaller Draft version
2020-07-09 12:14:54 Tony Schaller Draft version
2020-07-09 07:59:46 Oliver Egger Draft version
2020-07-09 07:56:26 Oliver Egger Draft version
2020-07-09 07:56:25 Oliver Egger Draft version
2020-07-09 07:56:07 Oliver Egger Draft version
2020-07-09 07:48:37 Oliver Egger Under pre-publication review version
2020-05-08 13:46:31 Oliver Egger Draft version
2020-02-06 13:14:43 Oliver Egger Draft version
2020-02-06 13:13:11 Oliver Egger Draft version
2020-02-06 11:34:45 Oliver Egger Draft version
2020-02-06 11:31:24 Oliver Egger Draft version
2020-02-06 11:29:46 Oliver Egger Draft version
2020-02-06 11:25:17 Oliver Egger Draft version
2020-02-03 18:16:44 Oliver Egger Draft version
2019-12-11 11:42:09 Oliver Egger Draft version
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Issues (8)
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Change Request Status = Closed ( cdachemed-issue-12 ): Wrong namespace for numerator and denominator tags
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2020-07-29 14:08:46 : Tracking by Oliver Egger
Description
now all pharm numerator/denominator should have been fixed by Tony/Oliver
Tracking / Status = Open 2020-07-09 14:48:29 : Tracking by Quentin Ligier
Description
It has now been fixed in the eHealthConnector .
I've been in touch with HL7 and they've partially fixed CDA R2 Extensions .
#cdachemed-issue-13 was the last example I've seen with the wrong namespace.
Tracking / Status = Open 2020-05-14 10:26:46 : Tracking by Oliver Egger
Description
numerator, denominator should not be in the pharm namespace. this issue was discussed already with Stéphane Spahni / IHE Pharmacy,
the reasoning behind is/was the following:

1. IHE PRE lists the example without name space   https://www.ihe.net/uploadedFiles/Documents/Pharmacy/IHE_Pharmacy_Suppl_PRE.pdf , Line 620 - 625

 <!-- strength of ingredient -->
 <pharm:quantity>
 <numerator xsi:type="PQ" value=" " unit=" "/>
 <denominator xsi:type="PQ" value=" " unit=" "/>
 </pharm:quantity>
625 <pharm:ingredient clas

2. There was a discussion with Stéphane in April/2017 where he stated:  I had a deeper look at the pharm:PQ problem. It seems I was influenced by epSOS spec ! Indeed the PHARM PRE profile does not ask for that!

3. There was a discussion also with Tony concerning the pharm namespace, conclusion was that currently wiki of hl7, XSD schemas and IHE PRE are not consistent. in this project we follow IHE PREf.

The ch-pharm template should be changed to be consistent, thanks! 




Tracking / Status = Open 2020-05-13 16:56:59 : Tracking by Quentin Ligier
Description
Finding:

The tags hl7:manufacturedMaterial/pharm:ingredient/pharm:quantity/{numerator, denominator} are placed in the hl7 namespace but should probably be in the pharm namespace.
The XML schema, usual CDAR2 models and CH-PHARM (https://art-decor.org/art-decor/decor-templates--ch-pharm-?id=1.3.6.1.4.1.19376.1.9.1.3.1&effectiveDate=dynamic) indicate so.
The example is also wrong on this point.

-

Suggestion:

-

Further explanation:

-

Incident Status = Closed ( chdachpharm-issue-13 ): Wrong cardinality for the inner pharm:ingredient
Type Incident Status Incident Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-02-19 00:39:12 : Tracking by Pero Grgic
Description
The cardinality of the inner pharm:ingredient changed to 1…1
Tracking / Status = Open 2021-02-15 16:54:56 : Tracking by Quentin Ligier
Description
I have discussed this with Stéphane and we agree on this:

The cardinality of the outer pharm:ingredient is correct.
The cardinality of the inner pharm:ingredient shall be 1…1, because:
  • The inner pharm:name is required, so the minimal cardinality shall be 1.
  • It makes no sense to associate multiple substances with a single quantity (each substance should have its own outer pharm:ingredient structure), so the maximal cardinality shall be 1.
Do you see an issue with that?
Tracking / Status = Open 2021-01-21 21:05:58 : Tracking by Quentin Ligier
Description
Finding:

The inner pharm:ingredient has a cardinality of 0*, whereas IHE PHARM PRE §6.3.4.1.3.10 indicates that:

- "the <pharm:name> element SHALL be present", so the minimal cardinality should be 1.
- the maximal cardinality should also be 1, because the outer pharm:ingredient is associating a name and a code to a quantity.

The XML schema has a cardinality of 01 for this element (it can also be improved).

Suggestion:

Set the cardinality of the inner pharm:ingredient to 11.

Further explanation:

-

Change Request Status = Closed ( chdachpharm-issue-17 ): Improve cardinalities of ingredient quantities
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-05-10 13:28:45 : Tracking by Annatina Foppa
Description
checked, okay -> close issue
Tracking / Status = Feedback needed 2021-05-05 15:37:58 : Tracking by Quentin Ligier
Description
I agree, it's an useless source of mistakes.
So:
- cardinalities of manufacturedMaterial/ingredient/quantity/numerator and manufacturedMaterial/ingredient/quantity/denominator have been set to 1...1 and nullFlavors are disallowed.
- cardinalities of @value and @unit are not modified (1...1).
Tracking / Status = In Progress 2021-04-20 13:09:43 : Tracking by Annatina Foppa
Description
Note: in CH FHIR, cardinalities 1...1 were chosen for numerator AND denominator, see  CH.FHIR.IG.CH-EMED\CH EMED Ratio with units - FHIR v4.0.1
Reason: omittance of units or interpretation as "if absent it is the unit of medication" is too unclear and dangerous, see example of conversion at Projectathon 2020
Therefore, I would leave the denominator as it is now.
See also ticket  CH EMED Medication Profile - amount / ingredien.strength with uni (Oliver Egger, ahdis) · Issue #23 · ehealthsuisse/ch-emed (github.com)
Tracking / Status = Open 2021-03-01 22:43:02 : Tracking by Annatina Foppa
Description
denominator: @unit was set to required (1...1) but should be optional (0...1) -> issue reopened
Tracking / Status = Closed 2021-02-19 00:47:09 : Tracking by Pero Grgic
Description
hl7:numerator: @value & @unit attribute added

hl7:denominator: @value & @unit attribute added
Tracking / Status = Open 2021-02-15 18:00:15 : Tracking by Quentin Ligier
Description

After discussion with Stéphane, we are proposing the following changes to the ingredient quantity:

The ingredient quantity (pharm:ingredient/pharm:quantity) is represented as a ratio, it does not make sense to only have the numerator or the denominator and the IHE PRE profile does not explain how to process an incomplete ratio. The cardinalities of hl7:numerator and hl7:denominator should then be set to 1…1; if it's unknown, the whole pharm:quantity can be omitted.

To improve the template, the following changes can also be made:

  • In hl7:numerator:
  • The @value attribute is required (1…1) and is a strictly positive number (integer?).
  • The @unit attribute is required (1…1) and can be restricted to a specific value set (UCUM or UnitsOfPresentation?).
  • The null flavor is forbidden.
  • In hl7:denominator:
  • The @value attribute is required (1…1) and is a strictly positive number (integer?).
  • The @unit attribute is optional (0…1) and can be restricted to a specific value set (UCUM or UnitsOfPresentation?). If absent, the denominator unit is the unit of medication.
  • The null flavor is forbidden.
      What do you think?
      Change Request Status = Closed ( chdachpharm-issue-35 ): package size defined as optional or required?
      Type Change Request Status Change Request Status = Closed Priority Normal
      Events
      Tracking / Status = Closed 2021-06-07 19:16:05 : Tracking by Annatina Foppa
      Tracking / Status = Feedback needed 2021-05-25 10:27:08 : Tracking by Quentin Ligier
      Description
      The description has been fixed.
      The unit attribute has been set to required and bound to the UnitCode value set to match the CH-EMED specification.
      Tracking / Status = In Progress 2021-05-10 13:40:28 : Tracking by Annatina Foppa
      Description
      Two points to reconsider:
      Tracking / Status = Feedback needed 2021-05-05 09:46:16 : Tracking by Quentin Ligier
      Description
      The cardinality of capacityQuantity has been changed to  0...1 and the nullFlavor disallowed on this element.
      Tracking / Status = In Progress 2021-05-04 14:31:13 : Tracking by Annatina Foppa
      Description
      according to your answer, Quentin, cardinalities of capacityQuantity have to be changed to 0...1, NullFlavor disallowed. see ticket  CH EMED Medication Profile (MedicationStatement) (Michaela Ziegler, ahdis ag) · Issue #27 · ehealthsuisse/ch-emed (github.com)
      Assignment 2021-04-14 12:18:22 : Assigned To Quentin Ligier by Annatina Foppa
      Tracking / Status = Open 2021-04-14 12:18:21 : Tracking by Annatina Foppa
      Description
      Finding:

      - comes from CH-EMED Ticket #27, CH EMED Medication Profile (MedicationStatement) (Michaela Ziegler, ahdis ag) · Issue #27 · ehealthsuisse/ch-emed (github.com) , I copy from there:

      Is the package size defined as optional or required? There are currently different requirements.

      • CH EMED: Medication.amount 0..1
      • CDA CH EMED: pharm:capacityQuantity 1..1
      • IPAG: Does not say anything about the package size for the Medication Card document.
      Suggestion:

      Check with IHE PHARM MTP if optionality is really 1..1 and if yes, a NullFlavor would be possible. If yes we would leave FHIR Medication.amount 0..1 for MedicationStatment but with mustSupport.

      from pharm PRE, line 735f: "
      The element SHALL be present and describes the capacity of the packaging. If the capacityQuantity is given in countable units, the unit attribute SHALL NOT be present. If the capacityQuantity is given in non-countable units, the unit attribute SHALL be present and the value SHALL be out of the UCUM code system." 

      Further explanation:

      - Quentin, how do you see this: "Check with IHE PHARM MTP if optionality is really 1..1 and if yes, a NullFlavor would be possible"

      For future consideration Status = Closed ( chdachpharm-issue-47 ): Product code: GTIN has replaced ATC
      Type For future consideration Status For future consideration Status = Closed Priority Normal
      Events
      Tracking / Status = Closed 2022-04-19 10:37:54 : Tracking by Quentin Ligier
      Description
      ATC has been re-added in #57.
      Tracking / Status = Open 2021-06-10 16:08:02 : Tracking by Patrick Jolo
      Description
      As discussed in the EMED meeting of 08.06.2021:
      - In the IPAG report, GTIN is used for the identification of products
      -Remain with the current solution
      -Another solution for identifying the medication product should be found later on 


      Tracking / Status = Open 2021-06-09 08:33:52 : Tracking by Quentin Ligier
      Description
      I've updated the descriptions and added a Schematron assert to ensure both GTIN codes are equal.

      To do: validate the Schematron.
      Tracking / Status = Open 2021-06-08 18:20:54 : Tracking by Quentin Ligier
      Description
      That's the IPAG recommendation, but we should find another identifier for the medication product. The GTIN is perfect for the medication package, that won't change.
      Tracking / Status = Open 2021-06-08 11:59:14 : Tracking by Quentin Ligier
      Description
      In the material, the GTIN code has replaced the ATC code. The same value appears now twice, in code and in asContent/containerPackagedMedicine/code .

      It's not expected and doesn't conform to the specifications.
      PCC 6.3.4.19.3:
      The <code> element of the <manufacturedMaterial> describes the medication. This may be coded using a controlled vocabulary, such as RxNorm, First Databank, or other vocabulary system for medications, and should be the code that represents the generic medication name and strength (e.g., acetaminophen and oxycodone -5/325), or just the generic medication name alone if strength is not relevant (Acetaminophen).

      IHE Pharm PRE 6.3.4.1.3.3:
      The medication may be either
      • a brand/product or
      • described as a generic/scientific name or
      • a descriptor of a magistral preparation/compound medicine
      GTIN is only attributed to packages, not to the generic product. The ATC code did. Was there a strong reason to change it?

      In any way, the two code descriptions shall be updated. If we're to keep the GTIN in both, we could also ensure the same value is used (Schematron assert).
      Change Request Status = Closed ( chdachpharm-issue-57 ): Product code
      Type Change Request Status Change Request Status = Closed Priority Normal
      Events
      Tracking / Status = Closed 2022-02-24 08:10:56 : Tracking by Patrick Jolo
      Description
      Reviewed and closed
      Tracking / Status = Feedback needed 2022-02-23 17:11:27 : Tracking by Quentin Ligier
      Description
      The template has been adapted, an example has been added.
      Tracking / Status = Open 2022-02-10 09:59:20 : Tracking by Quentin Ligier
      Description
      The IPAG report says:
      GTIN Wichtig für CH-Präparate
      ATC-Code nach WHO Wichtig für nicht CH-Präparate
      Tracking / Status = Open 2022-02-01 18:10:36 : Tracking by Quentin Ligier
      Description

      The product code (as well as the package code) is a GTIN, thus preventing the coding of active ingredients (e.g. paracetamol instead of DAFALGAN cpr 500 mg), drugs unavailable in Switzerland imported legally by pharmacies or patients (e.g. Colchicine has no GTIN but is included in guidelines from the Schweizerische Gesellshaft für Rheumatologie; prescription from a foreign physician documented in the medication plan by a swiss clinician) or magistral preparation.

      Consequences for adoption and quality of care are likely, if the exchange format is constraining the ability of a clinician to document accurate information based on the situation.

      Propositions:

      1.     Template Manufactured Material Entry Content Module : allow an ATC or a GTIN as product code. The description is updated to recommend using the GTIN code and to require it if it’s known in the case of a dispense. The packaging code remains the GTIN.

      2.     This change is probably definitive, we don’t foresee any reason to change it again in the future.

      Drafted by HUG and CARA with the help of specialists from Pharma24 and imad

      Change Request Status = Closed ( chdachpharm-issue-61 ): Magistral preparations
      Type Change Request Status Change Request Status = Closed Priority Normal
      Events
      Tracking / Status = Closed 2022-03-15 09:00:48 : Tracking by Patrick Jolo
      Description
      Issue verified and issue closed
      Tracking / Status = Feedback needed 2022-03-03 10:27:50 : Tracking by Quentin Ligier
      Description
      I've updated the descriptions, cardinalities and examples of the template.
      Tracking / Status = Open 2022-02-02 11:09:19 : Tracking by Quentin Ligier
      Description

      Magistral preparations are not so common but require much more data (and implementation work) than a regular drug. If we were not to support them, some part of the specifications could be ignored for now: the form code and the ingredients are not important when the GTIN is known, as drug databases usually contain them. The compendium can be used by patients too to get such information.

      Propositions:

      1.     Magistral preparations are not supported for now.

      2.     Template Manufactured Material Entry Content Module : the product code and name elements shall be filled and cannot contain a null flavor.

      3.     Template Manufactured Material Entry Content Module : the form code element is not supported, its description is updated.

      4.     Template Manufactured Material Entry Content Module : the ingredients are not supported, their description is updated.

      1.     These changes are temporary. Whether they are implemented in the aggregator only or reflected in the ArtDecor specifications is up for discussion.

      Drafted by HUG and CARA.
      Change Request Status = Open ( chdachpharm-issue-67 ): Package capacity quantity is required
      Type Change Request Status Change Request Status = Open Priority Normal
      Events
      Tracking / Status = Open 2022-06-10 15:42:55 : Tracking by Quentin Ligier
      Description
      In the template, the package capacity quantity ( pharm:capacityQuantity ) is optional. In the IHE Pharm PRE specification, it's mandatory:

      The element SHALL be present and describes the capacity of the packaging.

      The cardinality should be set to 1..1 and the "SHOULD" in the description should be replaced by "SHALL"
       
       
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