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Pharmaceutical Advice Item Entry Content Module
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History (32)
Date Author Status Type
2022-02-22 17:50:31 Quentin Ligier Draft version
2022-02-17 12:21:40 Quentin Ligier Draft version
2022-02-17 10:06:55 Quentin Ligier Draft version
2021-06-14 11:23:22 Quentin Ligier Draft version
2021-06-14 11:23:17 Quentin Ligier Draft version
2021-06-10 12:23:35 Quentin Ligier Draft version
2021-06-08 15:07:08 Quentin Ligier Draft version
2021-06-08 14:33:16 Quentin Ligier Draft version
2021-05-18 13:28:45 Quentin Ligier Draft version
2021-02-18 23:35:04 Pero Grgic Draft version
2021-02-11 17:44:05 Pero Grgic Draft version
2021-02-11 17:21:51 Pero Grgic Draft version
2021-02-11 16:03:02 Pero Grgic Under pre-publication review version
2020-05-08 13:48:09 Oliver Egger Draft version
2020-03-02 10:14:00 Oliver Egger Draft version
2020-03-02 10:13:55 Oliver Egger Draft version
2020-02-24 22:50:25 Oliver Egger Draft version
2020-02-24 22:50:22 Oliver Egger Draft version
2020-02-24 22:46:36 Oliver Egger Draft version
2020-02-24 22:43:50 Oliver Egger Draft version
2020-02-24 22:43:04 Oliver Egger Under pre-publication review version
2018-04-29 08:36:54 Oliver Egger Draft version
2018-04-11 16:32:06 Oliver Egger Draft version
2018-04-11 16:26:44 Oliver Egger Draft version
2018-04-11 16:16:32 Oliver Egger Draft version
2018-04-05 23:25:45 Oliver Egger Draft version
2018-02-04 12:34:12 Oliver Egger Draft version
2018-01-16 12:55:23 Oliver Egger Draft version
2018-01-16 12:55:06 Oliver Egger Draft version
2018-01-16 11:49:03 Oliver Egger Draft version
2018-01-16 11:41:38 Oliver Egger Draft version
2018-01-15 09:40:21 Oliver Egger Draft version
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Issues (10)
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Change Request Status = Closed ( cdachemed-issue-6 ): Inconsistencies in the PRE/DIS references
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2020-02-24 09:41:48 : Tracking by Quentin Ligier
Description
Finding:

The PRE item reference says: “Contains 2.16.756.5.30.1.1.10.4.47 (PRE Reference Entry Content Module) where [@typeCode='REFR' and hl7:substanceAdministration [hl7:templateId [@root='2.16.756.5.30.1.1.10.4.46']]]”. When opening this template (https://art-decor.org/art-decor/decor-templates--cdachemed-?id=2.16.756.5.30.1.1.10.4.47&effectiveDate=dynamic), the templateId is “2.16.756.5.30.1.1.10.4.47” (not “.46”).
 
The DIS item reference says: “Contains 2.16.756.5.30.1.1.10.4.46 (DIS Reference Entry Content Module) where [@typeCode='REFR' and hl7:substanceAdministration [hl7:templateId [@root='2.16.756.5.30.1.1.10.4.47']]]”. But when opening this template (https://art-decor.org/art-decor/decor-templates--cdachemed-?id=2.16.756.5.30.1.1.10.4.46&effectiveDate=dynamic), the root tag is an “hl7:supply”, not an “hl7:substanceAdministration” and the templateId is “2.16.756.5.30.1.1.10.4.46”, not “.47”.
 
The "Choice" block also has these mistakes, I don't know if it automatically copies the content of its child nodes.

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Suggestion:

Change the DIS reference tag name to "hl7:supply", fix the "46/47" templateIds inversion.

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Further explanation:

Fixed

Change Request Status = Closed ( cdachemed-issue-9 ): Wrong cardinality in the reference choice
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2020-03-02 10:16:45 : Tracking by Oliver Egger
Description
The template https://art-decor.org/art-decor/decor-templates--ch-pharm-?section=templates&id=2.16.756.5.30.1.1.10.4.44&effectiveDate=2016-06-25T00:00:00&language=en-US  is not replaced
by  https://art-decor.org/art-decor/decor-templates--ch-pharm-?id=1.3.6.1.4.1.19376.1.9.1.3.3&effectiveDate=  but specialised from it.

Adjusted the minimum cardinality to 1, so that the template is conforming to the ihe pharm spec, thanks for pointing it out. The schematrron rules will be updated with the next release.
Tracking / Status = Open 2020-02-27 17:26:14 : Tracking by Quentin Ligier
Description
Is it replaced in v2.1 by the template IHE Pharmaceutical Advice Item Entry Content Module of CH-PHARM?
https://art-decor.org/art-decor/decor-templates--ch-pharm-?id=1.3.6.1.4.1.19376.1.9.1.3.3&effectiveDate=
The cardinality is correct there.
Tracking / Status = Open 2020-02-27 17:11:42 : Tracking by Quentin Ligier
Description
Finding:

In the Pharmaceutical Advice Item Entry Content Module, the "Choice" block for the referenced MTP, PRE, DIS or CMA Item has a cardinality of 0 ...1 . IHE Pharm PADV rev1.9 section 6.3.4.3.3.10 says that a reference to exactly one item shall be present (including CMA). Since CMA documents are not part of CDA-CH-EMED, it would make sense to set the cardinality to 1 .

The Schematron v2.0 only asserts that the count is 0 or 1:  https://github.com/hl7ch/hl7ch-cda/blob/master/schematrons/HL7.ch/CDA-CH/v2.0/include/2.16.756.5.30.1.1.10.4.44-2016-06-25T000000.sch#L71-L75 .
The file does not exist in the v2.1 release, so I'm not sure if it has changed since.

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Suggestion:

Set the cardinality to 1 and assert it in the Schematron.

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Further explanation:

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Change Request Status = Closed ( chdachpharm-issue-7 ): Missing definition of 'Changed MTP Item'
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-02-18 15:50:24 : Tracking by Pero Grgic
Description
substanceAdministration in 'Changed Medication Treatment Plan Item' is fixed.
Tracking / Status = Open 2020-10-18 15:35:52 : Tracking by Quentin Ligier
Description
Finding:

The substanceAdministration in 'Changed Medication Treatment Plan Item' is empty. It should probably contain/inherit from/extend the 'Medication Treatment Plan Item Entry Content Module'.

There also is an issue with the IHE Pharm PADV profile numbering: starting with 'Reference to Pharmaceutical Advice Concerns', there is an offset of 1 in the section reference. E.g. 'Changed Medication Treatment Plan Item' is described in section 6.3.4.3.12, not .11.

Change Request Status = Closed ( chdachpharm-issue-8 ): Suspicious definition of 'Changed PRE Items'
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-02-11 17:19:55 : Tracking by Pero Grgic
Description
Inclusion changed from IHE  Prescription Item Entry Content Module to  Prescription Item Entry Content Module.
Tracking / Status = Open 2020-10-18 15:41:27 : Tracking by Quentin Ligier
Description
Finding:

The definition of the substanceAdministration in "Changed or Recommended Prescription Items" is inherited from "IHE Prescription Item Entry Content Module" and is different than the definition given in "Prescription Item Entry Content Module". The latter should probably be used here.

Change Request Status = Closed ( chdachpharm-issue-16 ): Wrong cardinality for 'Changed Medication Treatment Plan Item'
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-02-18 23:37:26 : Tracking by Pero Grgic
Description
Cardinality of  hl7:entryRelationship   " Changed Medication Treatment Plan Item"  set to  0…1
Tracking / Status = Open 2021-02-12 10:11:51 : Tracking by Quentin Ligier
Description
Finding:

In the template, the hl7:entryRelationship "Changed Medication Treatment Plan Item" has a cardinality of 0…*. According to IHE PHARM PADV §6.3.4.3.3.12, it should be 0…1:
(1) Only one element SHALL be present, if the status of the Pharmaceutical Advice (<code> Element) is set to “CHANGE” and a reference to a Medication Treatment Plan Item is given.
(2) In all other cases this element SHALL NOT be present.

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Suggestion:

-

Further explanation:

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Change Request Status = Closed ( chdachpharm-issue-43 ): Bad Schematron rule
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2021-06-07 19:13:35 : Tracking by Annatina Foppa
Description
fine, good that you got the upgraded account to do it!
Tracking / Status = Feedback needed 2021-06-02 11:13:18 : Tracking by Quentin Ligier
Description
The Schematron rule is properly fixed.
Tracking / Status = In Progress 2021-05-19 13:09:56 : Tracking by Quentin Ligier
Description
I will test the new Schematron generation.
Tracking / Status = Feedback needed 2021-05-18 13:33:37 : Tracking by Quentin Ligier
Description
Because the substanceAdministration and templateId are exactly the same as in  2.16.756.5.30.1.1.10.4.34 , I've deactivated them in this template.
Is it possible to generate the Schematron from the current ArtDecor specification to test it?
Assignment 2021-05-18 13:19:56 : Assigned To Quentin Ligier by Quentin Ligier
Tracking / Status = Open 2021-05-18 13:19:55 : Tracking by Quentin Ligier
Description
As found in  https://github.com/ehealthsuisse/ch-emed/issues/33


(PharmaceuticalAdviceItemEntryContentModule)/d265989e15-true-d266227e0: 'substanceAdministration' is defined as closed, and this element 'templateId' is not allowed, or not allowed with this content. This may concern the templateId, code or id. Expected in this context: hl7:templateId[@root = '1.3.6.1.4.1.19376.1.9.1.3.7'] (rule-reference: d265989e15-true-d266227e0)

I think a Schematron rule has been generated to check that the substanceAdministration only contains the defined templateId  despite the inclusion of the template  2.16.756.5.30.1.1.10.4.34  (because the template is defined as closed).
Change Request Status = Closed ( chdachpharm-issue-58 ): Forbid PADV CHANGE to multiple prescriptions
Type Change Request Status Change Request Status = Closed Priority Normal
Events
Tracking / Status = Closed 2022-02-22 15:09:58 : Tracking by Patrick Jolo
Description
reviewed and closed
Tracking / Status = Feedback needed 2022-02-17 12:25:59 : Tracking by Quentin Ligier
Description
I've added a description on the hl7:component element and a Schematron assert in the hl7:organizer element.
Tracking / Status = Open 2022-02-02 08:52:09 : Tracking by Quentin Ligier
Description

Currently, a PADV CHANGE can replace a single PRE entry to multiple new ones. When doing so, a single MTP item entry further leads to multiple prescriptions, what should be prohibited. It's not allowed to change an MTP entry by a combination of others.

The aggregator will forbid it, at least in the first iteration.

Consequences of status quo are confusion for integration, and risks of information discontinuities in clinical practice.

Propositions:

1.     Template Pharmaceutical Advice Item Entry Content Module : the element entryRelationship/organizer/component has its description clarified to indicate the cardinality is 1..1 in a PADV CHANGE but the cardinality isn’t modified (in a PADV OK, we might still use it to recommend substituting this medication by a combination of others). A Schematron rule can be created to assert the cardinality.

2.     When a single medication is to be substituted by multiple medications, a PADV CANCEL is issued and a MTP document is created for each new medication.

Drafted by HUG and CARA.

Change Request Status = Feedback needed ( chdachpharm-issue-65 ): Error validating recommended/changed prescription item
Type Change Request Status Change Request Status = Feedback needed Priority Normal
Events
Assignment 2022-06-21 09:49:48 : Assigned To Quentin Ligier by Patrick Jolo
Tracking / Status = Feedback needed 2022-06-20 22:10:45 : Tracking by Dr. Kai Heitmann
Description
Quentin, I think the definition in the  Pharmaceutical Advice Item Entry Content Module are in error and cause the problem.
The Organizer with the component there in  Changed or Recommended Prescription Items is defined as an inclusion . With that the seperatableInd is in scope of the validation. It shall be a component with the  Prescription Item Entry Content Module as a containment:

component 1.. R contains  Prescription Item Entry Content Module
__ 
seperatableInd 1..1 M
____ @value F false

Hope this helps.

An observation: I see that you used inclusion very often which makes your templates often illegible. In most cases in the body, containment is the right thing to do.
Assignment 2022-02-24 10:42:12 : Assigned To Dr. Kai Heitmann by Quentin Ligier
Tracking / Status = Open 2022-02-24 10:41:31 : Tracking by Quentin Ligier
Description
Kai, is there a way to fix that without opening the  prescription item entry content module template?
Tracking / Status = Open 2022-02-17 12:45:59 : Tracking by Quentin Ligier
Description
While validation a PADV OK or CHANGE with recommended/changed prescription item(s), an assert from the prescription item entry content module is triggered:

(PrescriptionItemEntryContentModule)/d141e5821-true-d234733e0: 'component' is defined as closed, and this element 'seperatableInd' is not allowed, or not allowed with this content. This may concern the templateId, code or id. Expected in this context: hl7:substanceAdministration[hl7:templateId[@root = '2.16.756.5.30.1.1.10.4.43'] and hl7:templateId[@root = '1.3.6.1.4.1.19376.1.9.1.3.2'] and hl7:templateId[@root = '2.16.840.1.113883.10.20.1.24'] and hl7:templateId[@root = '1.3.6.1.4.1.19376.1.5.3.1.4.7']] (rule-reference: d141e5821-true-d234733e0)

The hl7:seperatableInd element is mandatory in this template. The weird thing is the hl7:component element is defined in this template, not in the prescription item entry content module so a rule is leaking from there.
The rule is defined in 2.16.756.5.30.1.1.10.4.43-2019-09-11T170549-closed.sch:

<!-- Checking undefined contents for template/element @isClosed="true". Match context that we did not already match -->
<rule fpi="RUL-QQQ" context="*[hl7:substanceAdministration[hl7:templateId[@root = '2.16.756.5.30.1.1.10.4.43'] and hl7:templateId[@root = '1.3.6.1.4.1.19376.1.9.1.3.2'] and hl7:templateId[@root = '2.16.840.1.113883.10.20.1.24'] and hl7:templateId[@root = '1.3.6.1.4.1.19376.1.5.3.1.4.7']]]/*[not(@xsi:nil = 'true')][not(self::hl7:substanceAdministration[hl7:templateId[@root = '2.16.756.5.30.1.1.10.4.43'] and hl7:templateId[@root = '1.3.6.1.4.1.19376.1.9.1.3.2'] and hl7:templateId[@root = '2.16.840.1.113883.10.20.1.24'] and hl7:templateId[@root = '1.3.6.1.4.1.19376.1.5.3.1.4.7']])]" id="d141e5821-true-d234733e0">
        <assert role="error" see="http://art-decor.org/art-decor/decor-templates--cdachemed-?id=2.16.756.5.30.1.1.10.4.43" test="not(.)">(PrescriptionItemEntryContentModule)/d141e5821-true-d234733e0: '<value-of select="name(..)"/>' is defined as closed, and this element '<name/>' is not allowed, or not allowed with this content. This may concern the templateId, code or id. Expected in this context:  hl7:substanceAdministration[hl7:templateId[@root = '2.16.756.5.30.1.1.10.4.43'] and hl7:templateId[@root = '1.3.6.1.4.1.19376.1.9.1.3.2'] and hl7:templateId[@root = '2.16.840.1.113883.10.20.1.24'] and hl7:templateId[@root = '1.3.6.1.4.1.19376.1.5.3.1.4.7']] (rule-reference: d141e5821-true-d234733e0)</assert>
    </rule>

The matched context is too large and the rule is created because the template is defined as closed.

Not sure how to fix that except by setting the prescription item entry content module open.
Change Request Status = Open ( chdachpharm-issue-68 ): Missing elements in changed dosage instructions
Type Change Request Status Change Request Status = Open Priority Normal
Events
Assignment 2022-07-11 09:53:28 : Assigned To Quentin Ligier by Quentin Ligier
Tracking / Status = Open 2022-07-11 09:53:27 : Tracking by Quentin Ligier
Description
The changed dosage instructions is missing two elements:
  • The dosage type Prescription Item Entry Additional Template ID.
  • The narrative dosage instructions Dosage Instructions Non Structured Entry Content Module.
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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