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Medication Treatment Plan Item Entry Content Module
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History (29)
Date Author Status Type
2022-06-08 18:21:52 Quentin Ligier Draft version
2022-06-08 18:21:44 Quentin Ligier Draft version
2022-02-24 11:24:47 Quentin Ligier Draft version
2022-02-24 11:10:02 Quentin Ligier Draft version
2022-02-24 10:52:27 Quentin Ligier Draft version
2022-02-24 09:38:20 Quentin Ligier Draft version
2022-02-24 09:33:26 Quentin Ligier Draft version
2022-02-23 09:17:54 Quentin Ligier Draft version
2022-02-23 09:12:23 Quentin Ligier Draft version
2022-02-22 17:49:36 Quentin Ligier Draft version
2022-02-22 17:45:48 Quentin Ligier Draft version
2022-02-22 17:39:52 Quentin Ligier Draft version
2022-02-22 17:37:43 Quentin Ligier Draft version
2021-06-14 11:20:19 Quentin Ligier Draft version
2021-06-10 11:59:48 Quentin Ligier Draft version
2021-06-10 11:59:14 Quentin Ligier Draft version
2021-06-08 17:58:06 Quentin Ligier Draft version
2021-06-08 16:40:58 Quentin Ligier Draft version
2021-06-08 14:28:32 Quentin Ligier Draft version
2021-05-05 10:12:16 Quentin Ligier Draft version
2021-02-18 11:13:08 Pero Grgic Draft version
2021-02-18 11:10:24 Pero Grgic Under pre-publication review version
2020-07-29 14:04:02 Oliver Egger Draft version
2020-05-14 09:50:58 Oliver Egger Draft version
2020-05-14 09:49:13 Oliver Egger Under pre-publication review version
2020-05-08 14:09:00 Oliver Egger Draft version
2020-04-29 23:13:21 Oliver Egger Draft version
2020-04-29 22:55:03 Oliver Egger Draft version
2019-12-11 11:33:38 Oliver Egger Draft version
false
Issues (11)
false
Change Request Status = Closed ( cdachemed-issue-10 ): Incomplete descriptions in the Medication Treatment Plan Item Entry Content Module
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2020-04-29 23:15:59 : Tracking by Oliver Egger
Description
entryRelationship labelled as "Amount of units of the consumable to dispense" is also incomplete. -> references now  2.16.756.5.30.1.1.10.4.38
Assignment 2020-04-29 22:58:34 : Assigned To Oliver Egger by Oliver Egger
Description
Fullfillment Instructions (1.3.6.1.4.1.19376.1.5.3.1.4.3.1) has been added as own template with act/text and statusCode
Tracking / Status = Open 2020-03-03 11:33:42 : Tracking by Quentin Ligier
Description
Finding:

The entryRelationship labelled as " Fulfillment Instructions " is incomplete in its description. The contained <act/> is missing a <text/> and a <statusCode/> tags.
There is such a template in the other Art-Decor instance:  http://ehealthsuisse.art-decor.org/cdachemed-html-20180503T170351/tmp-1.3.6.1.4.1.19376.1.5.3.1.4.3.1-2013-12-20T000000.html .

The entryRelationship labelled as " Amount of units of the consumable to dispense " is also incomplete.
In the " Prescription Item Entry Content Module ", it has the " Contains 2.16.756.5.30.1.1.10.4.38 Prescribed Quantity Entry Content Module (DYNAMIC) " annotation.

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Suggestion:

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Further explanation:

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Incident Status = Closed ( cdachemed-issue-16 ): Missing referenced template 1.3.6.1.4.1.19376.1.5.3.1.4.4.1
Type Incident Status Incident Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-02-11 11:26:28 : Tracking by Annatina Foppa
Description
Linked from CH-PHARM  into CDE-CH-EMED Entry Level templates. Thanks for pointing this out
Tracking / Status = Open 2021-01-20 16:13:26 : Tracking by Quentin Ligier
Description
Finding:

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.

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Suggestion:

The template exists in CH-PHARM, it should be linked/imported from there.
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Further explanation:

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Change Request Status = Open ( cdachemed-issue-33 ): Definition of must support
Type Change Request Status Change Request Status = Open Priority Normal
Events
Tracking / Status = Open 2022-09-08 10:08:58 : Tracking by Oliver Egger
Description
Finding:

hl7:manufactureMaterial.code has a description 

RMust support. The element SHALL be present and describes the code of the medication package (GTIN) or the drug classification (WHO ATC). The @nullFlavor "NA" for magistral preparations is currently disallowed.

it is nowhere defined (or I can't find it) what the meaning of must support is for the CDA CH EMED specification. For the CH-EMED specification the meaning of must support is defined here:

http://fhir.ch/ig/ch-emed/index.html#mustsupport

MustSupport

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.

Meaning of the Flag MustSupport for this Implementation Guide

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.


Suggestion:

Define the meaning of must-support, harmonize it with CH-EMED.

Further explanation:

Raised as an issue in the current ballot for CDA-CH EMED.

Change Request Status = Closed ( chdachpharm-issue-2 ): Wrong annotation of the substitution permission entryRelationship
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2020-05-14 10:01:16 : Tracking by Oliver Egger
Description
1.3.6.1.4.1.19376.1.9.1.3.2Containmentdraft IHE Prescription Item Entry Content Module (2020)
1.3.6.1.4.1.19376.1.9.1.3.7Containmentdraft IHE Medication Treatment Plan Item Entry Content Module (2020)
2.16.756.5.30.1.1.10.4.34Containmentdraft Medication Treatment Plan Item Entry Content Module (2020)

2.16.756.5.30.1.1.10.4.43Containmentdraft Prescription Item Entry Content Module (2020)

fixed templates for schematron generation
Tracking / Status = Open 2020-05-14 09:48:48 : Tracking by Oliver Egger
Description
it is also integrated as an act, however the schematron preselector with hl7:observation is wrong, schema need to be adapted for that
Tracking / Status = Open 2020-05-13 16:45:59 : Tracking by Quentin Ligier
Description
Finding:

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.
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Suggestion:

-

Further explanation:

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Incident Status = Closed ( chdachpharm-issue-11 ): Suspicious cardinality for precondition criterion text
Type Incident Status Incident Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-05-10 13:45:40 : Tracking by Annatina Foppa
Description
checke, ok -> issue closed
Tracking / Status = Feedback needed 2021-05-05 10:15:29 : Tracking by Quentin Ligier
Description
The cardinality of elements  precondition/criterion  and  precondition/criterion/text  have been changed to  1…1 .
Tracking / Status = Open 2021-03-24 16:29:50 : Tracking by Quentin Ligier
Description
Reopening, the elements hl7:criterion and  hl7:text  should also be set to 1…1.
Tracking / Status = Closed 2021-02-18 11:15:47 : Tracking by Pero Grgic
Description
Cardinality of  inner  reference  tag of  precondition/criterion/text  in  Medication Treatment Plan item entry content module fixed
Tracking / Status = Open 2021-02-12 09:10:32 : Tracking by Quentin Ligier
Description
I guess we have been misreading this yesterday, the impacted template is not Prescription item entry content module ( 2.16.756.5.30.1.1.10.4.43 ) but Medication Treatment Plan item entry content module ( 2.16.756.5.30.1.1.10.4.34 ). I still see wrong cardinalities there (for some reasons I couldn't find it yesterday...).

If you compare the Prescription and Medication Treatment Plan items, the tags hl7:criterion, hl7:text and hl7:reference (in "Precondition Criterion") have different cardinalities. I guess the three should be  1…1.
Tracking / Status = Closed 2021-02-11 14:47:10 : Tracking by Pero Grgic
Description
Cardinality fixed
Tracking / Status = Open 2021-01-21 09:40:24 : Tracking by Quentin Ligier
Description
Finding:

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.


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Suggestion:

-

Further explanation:

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Change Request Status = Closed ( chdachpharm-issue-26 ): effectiveTime with Timezone
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-06-08 13:59:09 : Tracking by Annatina Foppa
Description
Time zones have been changed whereever possible. There are a few cases where it couldn't be introduced (see notes below) but this won't have an impact on conversion which was at the root of this issue. Ticket closed
Tracking / Status = In Progress 2021-04-08 16:44:23 : Tracking by Quentin Ligier
Description
Thanks Annatina.

2.16.756.5.30.1.1.10.4.35 DosageInstructionsStartStopFrequency
EIVL_TS and SXPR_TS do not contain dates (as far as I can see), so it's not needed.

2.16.756.5.30.1.1.10.4.36 DosageInstructionsEntryDosageChange
Same remark about EIVL_TS.

1.3.6.1.4.1.19376.1.9.1.1.1 IHECommunityPrescriptionContentModule
My guess is that you can't modify an IHE template; a custom one should be introduced (in the same way 
MTPReferenceEntryContentModule [2.16.756.5.30.1.1.10.4.45] is a specialization of IHEMTPReferenceEntryContentModule [1.3.6.1.4.1.19376.1.9.1.3.10], by example).

2.16.840.1.113883.10.12.113 CDAcomponentOf
I'd say yes only if we have a use-case for componentOf (I'm not quite sure we do). If so, I think it should be specialized by a custom template too.

2.16.756.5.30.1.1.10.4.43 PrescriptionItemEntryContentModule
That's one of the issues I've not reported yet, the author is badly defined and missing a lot of content here (and in other templates as well). I'm not sure it's worth fixing the date type before fixing the whole author.
Assignment 2021-04-08 16:04:08 : Assigned To Quentin Ligier by Annatina Foppa
Tracking / Status = In Progress 2021-04-08 16:03:30 : Tracking by Annatina Foppa
Description
I have changed these time zones and checked on other time datatypes as well. please find my findings below. Quentin, can you have a look at it and response to the questions:

Generally
- most Time datatypes are already set to TS.CH.TZ

2.16.756.5.30.1.1.10.4.35 DosageInstructionsStartStopFrequency
- EIVL_TS : precision to EIVL_TS.CH.TZ was not an option >> should this datatype be added?
- SXPR_TS : presicsion to SXPR_TS.CH.TZ was not an option  >> should this datatype be added?
- changed all other TS datatypes to TS.CH.TZ

2.16.756.5.30.1.1.10.4.36 DosageInstructionsEntryDosageChange
- EIVL_TS : precision to EIVL_TS.CH.TZ was not an option >> see above, should this datatype be added?
- no other Time datatypes

1.3.6.1.4.1.19376.1.9.1.1.1 IHECommunityPrescriptionContentModule
- could not change Time dataypes due to error messagage: "Template id SHALL have matching second level element templateId @root when context id='**'. For mode 'new' and 'adapt' there SHALL be at least 1 letter [A-Z-a-z] to indicate that this id needs to be replaced with the actual id after saving." >> do you see why?

2.16.840.1.113883.10.12.113 CDAcomponentOf
- didn't change TS to TS.CH.TZ >> should we do it here as well? (for hl7:encompassingEncounter and hl7:encounterParticipant) ... I ask because the template goes back to "CDA R2 Standard - Templates" which cannot be changed by us. Appears in all eMed Documents

2.16.756.5.30.1.1.10.4.33 ManufacturedMaterialEntryContentModule
- changed TS of pharm:expirationTime to TS.CH.TZ

2.16.756.5.30.1.1.10.4.43 PrescriptionItemEntryContentModule
- no time datatype is indicated for hl7:author; hl7:time; but cannot be added >> should we?

2.16.756.5.30.1.1.10.9.45 HeaderTemplateCompilationMedicationPrescriptionDocument
- changed hl7:documentationOf from TS to TS.CH.TZ

1.3.6.1.4.1.19376.1.9.1.3.15 IHERenewalPeriodContentModule
- changed all TS to TS.CH.TZ
Tracking / Status = Open 2021-04-06 18:28:55 : Tracking by Quentin Ligier
Description
Stéphane has contacted Keith Boone about this, his response is that the format  YYYY[MM[DD[HH[MM[SS[.S[S[S[S]]]]]]]]][+/-ZZZZ] (HL7 DTM) is allowed by PCC.
The TS entries can therefore be changed to TS.CH.TZ.
Assignment 2021-03-17 10:09:52 : Assigned To Annatina Foppa by Annatina Foppa
Description
discussion (17.3):
> PCC requires HL7 DTM format, but don't include Timezones -> inconsistency within PCC
> Stéphane will inquire on this with PCC (Quentin sends him the issue)
Tracking / Status = Open 2021-03-12 10:48:54 : Tracking by Oliver Egger
Description
Finding:

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.TZ
was defined as a restriction for TS datatypes that the timezone is included.

Suggestion:

Change all TS entries like in effectiveTime to TS.CH.TZ.

Further explanation:

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

For future consideration Status = Closed ( chdachpharm-issue-29 ): Substitution permissions
Type For future consideration Status For future consideration Status = Closed Priority Normal
Events
Tracking / Status = Closed 2022-04-19 10:46:38 : Tracking by Quentin Ligier
Description
Discussed in #59.
Tracking / Status = Open 2021-03-16 08:42:13 : Tracking by Quentin Ligier
Description
I'd like to propose to restrict substitution permissions to a single value, 0…1 instead of 0…*.

Pros:
  • It prevents bad combinations, by example N + any other code that isn't currently disallowed.
  • It's easier to process for data consumers.
  • It's not harder, probably easier to choose for the data enterer.
  • Some of the combinations can be resolved to a single code.
Cons:
  • Some of the combinations are not possible anymore.
  • N + any other code: it should be disallowed anyway.
  • (BC or G) + (TB or TG): it doesn't seem to make much sense. Is there an interest to only allow substitution for the same brand or for generics only?
Change Request Status = Closed ( chdachpharm-issue-52 ): Missing template id for Dosage Instructions Content Modules
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2022-03-15 08:44:52 : Tracking by Patrick Jolo
Description
Template ID verified and issue closed
Tracking / Status = Feedback needed 2022-03-03 09:57:48 : Tracking by Quentin Ligier
Description
The template ID has been added to both templates.
Tracking / Status = Open 2021-10-04 15:39:55 : Tracking by Quentin Ligier
Description
The template id for Dosage Instructions Content Modules (1.3.6.1.4.1.19376.1.9.1.3.6) is missing in some places.
It should appear it the templates:
Change Request Status = Closed ( chdachpharm-issue-55 ): Reference to the orginal Medication Treatment Plan Item
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2022-02-25 08:44:42 : Tracking by Patrick Jolo
Description
Verified and closed
Tracking / Status = Feedback needed 2022-02-24 10:52:58 : Tracking by Quentin Ligier
Description
The description has been updated to reflect that the reference is mandatory if the original MTP item exists.
Tracking / Status = Open 2021-12-09 09:38:09 : Tracking by Quentin Ligier
Description
The description of the reference to the orginal Medication Treatment Plan Item element ( entryRelationship ) should be updated to say that the reference is mandatory if the original MTP item exists.
We could also change the cardinality to  but that would prevent the creation of medication card documents without MTP documents (which is the current eHealth Suisse use case?).
Change Request Status = Closed ( chdachpharm-issue-56 ): Medications in reserve
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2022-03-01 09:40:50 : Tracking by Patrick Jolo
Description
verified and closed
Tracking / Status = Feedback needed 2022-02-25 13:40:43 : Tracking by Quentin Ligier
Description
The template and value set have been created, it has been included in the 3 main item entry content modules.
Tracking / Status = Open 2022-02-01 18:06:30 : Tracking by Quentin Ligier
Description

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.

Change Request Status = Open ( chdachpharm-issue-70 ): Can't validate two entry authors
Type Change Request Status Change Request Status = Open Priority Normal
Events
Assignment 2022-08-11 09:54:03 : Assigned To Quentin Ligier by Quentin Ligier
Tracking / Status = Open 2022-08-11 09:54:02 : Tracking by Quentin Ligier
Description
In the item entry content modules, the author is added twice with cardinality 0…1 instead of once with cardinality 0…2. This prevents validating two authors in the Schematron.
 
 
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