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IPS Medication Statement
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History (15)
Date Author Status Type
2021-09-02 12:17:54 Giorgio Cangioli Under pre-publication review version
2018-07-17 11:18:15 Giorgio Cangioli Draft version
2018-07-17 11:16:36 Giorgio Cangioli Draft version
2018-06-01 17:31:29 Giorgio Cangioli Draft version
2018-05-18 14:41:20 Giorgio Cangioli Draft version
2018-05-18 14:03:22 Giorgio Cangioli Draft version
2018-05-18 13:03:10 Giorgio Cangioli Draft version
2018-05-18 12:58:09 Giorgio Cangioli Draft version
2018-04-26 13:44:29 Giorgio Cangioli Draft version
2018-04-26 13:37:15 Giorgio Cangioli Draft version
2018-04-26 13:35:10 Giorgio Cangioli Draft version
2018-04-04 09:55:44 Giorgio Cangioli Draft version
2017-10-30 18:08:06 Giorgio Cangioli Draft version
2017-10-30 18:06:27 Giorgio Cangioli Draft version
2017-07-21 08:47:40 Giorgio Cangioli Draft version
false
Issues (14)
false
Request for Information/Education Status = Closed ( hl7ips-issue-8 ): Medication entry : diversification of templates
Type Request for Information/Education Status Request for Information/Education Status = Closed Priority Normal
Current Labels
 
 (Meds) Medications 
 
 (CDA) CDA Implementation 
 
 (IHE) For IHE consideration 
 
 (eHDSI) For eHDSI consideration 
Events
Tracking / Status = Closed 2017-02-21 15:44:02 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Confirmed the idea of having only one template covering normal, tapered ,.. cases
Tracking / Status = Feedback needed 2017-01-09 17:33:54 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Call  20161228
For the time being, consider only a common template
Tracking / Status = Open 2016-11-15 15:12:53 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Tracking / Status = Open 2016-11-11 10:12:37 : Tracking by Giorgio Cangioli
Description
Finding:

IHE PCC defined a a lot of different types of templates for the medication entry depending - for example - on the dosage regimen (normal dosing; split dosing; and so on...)

Should we follow the same approach ? Should we define a generic template covering all those cases (if in the scope of this document) ?

Suggestion:

-

Further explanation:

-

Request for Information/Education Status = Closed ( hl7ips-issue-9 ): SBADM effective time: IVL_TS or IVL_TS and TS
Type Request for Information/Education Status Request for Information/Education Status = Closed Priority Normal
Current Labels
 
 (Meds) Medications 
 
 (CDA) CDA Implementation 
 
 (IHE) For IHE consideration 
 
 (eHDSI) For eHDSI consideration 
Events
Tracking / Status = Closed 2017-04-11 15:37:15 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Solution identified (subordinate SBADM) and applied for the medication template entry
Tracking / Status = Feedback needed 2017-02-15 16:54:47 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Call 2017/02/08
Use the approach proposed by the Pharma WG.
Tracking / Status = In Progress 2017-02-03 21:10:35 : Tracking by Rob Hausam
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Kai, is there documentation (minutes or otherwise) from the Pharmacy WG on this that we can reference for this?  The minutes from San Antonio aren't showing as available yet on the Wiki.
Tracking / Status = In Progress 2017-02-03 18:59:07 : Tracking by Dr. Kai Heitmann
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
HL7 International Pharmacy Work Group (where I am a member of) had discussed this issue in San Antonio. Re/ “Medication on CDA” the Pharmacy WG says:
  • There is only one effectiveTime element in the SubstanceAdministration Act that reflects the period of administration (usable period), data type IVL_TS, maybe nullFlavored or omitted
  • All other dosage information (frequency) goes always into subordinate SubstanceAdminstration Acts. 
One important rational came from vendors implementing Medication related stuff. They definitely prefer to find dosage information always at the same location and not – like in IHE as of now – sometimes here and sometimes there. The data types of these elements are pre-defined. This also applies to single shots, tapered dose, split dose.
 
I advise to go that direction and not to make any other decisions. I think this solves every concern we had.
Tracking / Status = In Progress 2017-02-03 17:14:53 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
to be better understood the meaning of two effectiveTime linked by an "A" operator in which one of the two elements is nullFlavored.

That is the itersection of an undefined with a defined set is undefined ......
Tracking / Status = In Progress 2017-01-10 13:14:39 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
I don't see a different meaning : the first one is when you get / will get medications; the second one the frequency of intake.

The question was how to deal when we have one shot administration:
(a) should we have a first effectiveTime with an interval with low and high equal set to a specific datetime and a second effective time with datatype TS  set to that datetime;
(b) or have simply only one effectiveTime with datatype TS  set to a specific datetime.

The first one is the solution adopted by IHE PCC the second one by C-CDA (as far as i can understand).

I've no strong opinion on this...so i leave the choice to the group... :-)
Tracking / Status = Open 2017-01-09 18:32:00 : Tracking by Dr. Kai Heitmann
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Hmm, the meaning of the two effectiveTimes is different. Here is what many implementations do:
  • First effectiveTime is the use period, e.g. take these medication from 1-10 January 2017. It is always an interval. If not specified this first effectiveTime shall be nullFlavored.
  • The second effectiveTime is the frequency pattern, like two times a day, once a week etc. This must be optional as e.g. tapered or split dose specifications will cause the need to specify the patterns in subsequent substanceAdministrations (see the entryRelationship in this template).
If I may I strongly suggest to follow that rule. It is by the way conformant with what we at the Pharmacy Workgroup HL7 International defined in the "Medication in CDA" project.
Furthermore you can find these definitions in ELGA:
  • SBADM http://art-decor.org/art-decor/decor-templates--elgabbr-?section=templates&id=1.2.40.0.34.11.8.1.3.1&effectiveDate=2014-09-01T00:00:00
  • Use Period http://art-decor.org/art-decor/decor-templates--elgabbr-?id=1.2.40.0.34.11.30006&effectiveDate=dynamic
or in IHE (as defined by the Swiss colleagues)
  • http://art-decor.org/art-decor/decor-templates--cdachemed-?section=templates&id=2.16.756.5.30.1.1.1.1.3.10.2.10.2.10.4.1&effectiveDate=2016-06-25T00:00:00
  • http://art-decor.org/art-decor/decor-templates--cdachemed-?id=2.16.756.5.30.1.1.1.1.3.10.2.10.10.4.1&effectiveDate=dynamic
Thanks
Tracking / Status = Open 2017-01-09 18:05:23 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Call 20161228
allow for both IVL_TS and TS

in the second case (TS) the second effectiveTime is not required
Tracking / Status = Open 2016-11-15 15:10:10 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Tracking / Status = Open 2016-11-11 10:17:23 : Tracking by Giorgio Cangioli
Description
Finding:

IHE PCC template (and the epSOS one) requests that the first effective time is an IVL_TS (not demoted to TS)
C-CDA allow both IVL_TS and TS

What we would like to do here and why ?

Suggestion:

-

Further explanation:

-

Request for Information/Education Status = Closed ( hl7ips-issue-10 ): SBADM.code : clarification on their documentation
Type Request for Information/Education Status Request for Information/Education Status = Closed Priority Normal
Current Labels
 
 (CDA) CDA Implementation 
Events
Tracking / Status = Closed 2017-04-11 15:58:47 : Tracking by Giorgio Cangioli
 
 CDA 
Description
It should be "DRUG" or "IMMUNIZ"or a known absent / unknown code.
Tracking / Status = Open 2016-11-15 15:05:01 : Tracking by Giorgio Cangioli
 
 CDA 
Tracking / Status = Open 2016-11-14 17:48:22 : Tracking by Giorgio Cangioli
Description
Finding:

to be clarified which kind of information we'd like to document in the template for this kind of element.

The <code> element is used to supply a code that describes the <substanceAdminstration> act, this may be a procedure code, but for the time being there is not part of the data set, so we will not try to define d a common value set.

Should we document in any case what this element could be used for, even though not used for this purpose in the IPS ? or just ignore....

Suggestion:

-

Further explanation:

-

Request for Information/Education Status = Closed ( hl7ips-issue-26 ): cardinality of id (SBADM)
Type Request for Information/Education Status Request for Information/Education Status = Closed Priority Normal
Current Labels
 
 (eHDSI) For eHDSI consideration 
Events
Tracking / Status = Closed 2017-01-09 17:45:38 : Tracking by Giorgio Cangioli
 
 eHDSI 
Tracking / Status = Open 2017-01-09 17:45:03 : Tracking by Giorgio Cangioli
 
 eHDSI 
Description
Finding:

The cardinality of the SBADM id is 1...1 in epSOS 1..* in the other cases

Call 20161228

cardinality 1..* required

Request for Information/Education Status = Closed ( hl7ips-issue-27 ): SBADM status code
Type Request for Information/Education Status Request for Information/Education Status = Closed Priority Normal
Current Labels
 
 (Meds) Medications 
 
 (CDA) CDA Implementation 
 
 (IHE) For IHE consideration 
 
 (eHDSI) For eHDSI consideration 
Events
Tracking / Status = Closed 2017-04-11 15:46:14 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Statuscode limited to active and completed. See Paris Meeting Minutes
Tracking / Status = Feedback needed 2017-01-09 17:58:36 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 IHE 
 
 eHDSI 
Description
Call 20161228

Align the value set with the values used in FHIR, excluding "entered-in-error" and "intended".

the new value set should therefore be 

  • (Active) equal active ;
  • (Completed) equal completed
  • (Stopped) equal aborted
  • (On Hold) equal suspended
Tracking / Status = Open 2017-01-09 17:56:11 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
Finding:

Different value sets are used for the status code

  • epSOS: active" or "completed". 
  • IHE PCC: fixed to completed
  • CCDA no constrains (all ActStatus)
Request for Information/Education Status = Closed ( hl7ips-issue-28 ): SBADM: datatype constrain for the second effectiveTime
Type Request for Information/Education Status Request for Information/Education Status = Closed Priority Normal
Current Labels
 
 (IHE) For IHE consideration 
 
 (CDA) CDA Implementation 
 
 (Meds) Medications 
Events
Tracking / Status = Closed 2017-04-11 15:38:37 : Tracking by Giorgio Cangioli
 
 IHE 
 
 CDA 
 
 Meds 
Description
There is no more second effective time. This information is povided in the subordinated SBADM.effective time.
Datatypes have been identified and applied to the new template
Tracking / Status = Feedback needed 2017-02-03 19:02:41 : Tracking by Dr. Kai Heitmann
 
 IHE 
 
 CDA 
 
 Meds 
Description
It is sure that
  • TS
  • PIVL_TS
  • EIVL_TS
is needed. Unsure about SPRX_TS as this mean the above and anything else re/ timing. Hard to implement. What are the use cases?
PIVL_PPD_TS is not used in CDA. We might consider pre-adopt the datatypes type URG (by informal extension).
Tracking / Status = Feedback needed 2017-02-01 18:26:44 : Tracking by Giorgio Cangioli
 
 IHE 
 
 CDA 
 
 Meds 
Description
Call 2017/02/01

consider thje following data types.'TS|PIVL_TS|EIVL_TS| SXPR_TS

PIVL_PPD_TS is not validated for this element by the CDA.xsd.

Tracking / Status = Feedback needed 2017-01-11 16:34:04 : Tracking by Dr. Kai Heitmann
 
 eHDSI 
 
 IHE 
 
 CDA 
 
 Meds 
Description
Typically this is a choice of elements (effectiveTime) with the different allowed datatypes. Leaving the datatype unconstraint is ugly and opens a can of worms which not all implementers love :-)
Tracking / Status = Feedback needed 2017-01-11 15:50:20 : Tracking by Giorgio Cangioli
 
 eHDSI 
 
 IHE 
 
 CDA 
 
 Meds 
Description
No constrains applied to the datatype
Tracking / Status = Open 2017-01-11 15:49:24 : Tracking by Giorgio Cangioli
 
 eHDSI 
 
 IHE 
 
 CDA 
 
 Meds 
Description
Finding:

There are different constrains defined for the second effectiveTime 

  • TS|PIVL_TS|EIVL_TS|PIVL_PPD_TS|SXPR_TS for IHE PCC 
  • 'TS|PIVL_TS|EIVL_TS| SXPR_TS'  for epSOS
  • no constrains for CCDA


Suggestion:

Is there any specifc reason for restricting this datatype ? 
Suggest not to define any specific constrain.

Further explanation:

-

Request for Information/Education Status = Closed ( hl7ips-issue-68 ): Define the value set for hl7:routeCode
Type Request for Information/Education Status Request for Information/Education Status = Closed Priority Low
Current Labels
 
 (Vocab) Vocabularies 
Events
Tracking / Status = Closed 2017-06-21 11:10:53 : Tracking by Giorgio Cangioli
 
 Vocab 
Description
An intensional definition of the value set - based on EDQM - has been used.
Tracking / Status = In Progress 2017-05-19 16:48:13 : Tracking by Giorgio Cangioli
 
 Vocab 
Description
Changed the name of the issue. The VS has been added to the template.

The value set defintion has to be completed
Tracking / Status = Open 2017-05-11 09:52:03 : Tracking by Giorgio Cangioli
 
 Vocab 
Description
Agreed the rule. Used as first reference the Austrian Value Set.
Tracking / Status = Open 2017-05-03 11:08:57 : Tracking by Giorgio Cangioli
Description
Finding:

A value set for the hl7:routeCode shall be specified

Suggestion:

-

Further explanation:

-

Change Request Status = Open ( hl7ips-issue-69 ): Add ASSERTs for the defined constraints
Type Change Request Status Change Request Status = Open Priority Lowest
Current Labels
 
 (Meds) Medications 
 
 (CDA) CDA Implementation 
 
 (STU1Ballot) STU1 Ballot 
Events
Tracking / Status = Open 2017-09-01 16:04:45 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 STU1Ballot 
Description
reported as ballot comment
Tracking / Status = Open 2017-06-21 11:13:14 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Assignment 2017-05-10 17:48:18 : Assigned To Dr. Kai Heitmann by Giorgio Cangioli
Assignment 2017-05-10 17:47:34 : Assigned To Christof Gessner by Giorgio Cangioli
Assignment 2017-05-03 18:26:18 : Assigned To Dr. Kai Heitmann by Dr. Kai Heitmann
Description
I'll add that, is also necessary for the "Medication on CDA" Pharmacy Workgroup activities.
Tracking / Status = Open 2017-05-03 11:28:23 : Tracking by Giorgio Cangioli
Description
Finding:

Add ASSERT for the defined Conatraints:

  1. At least one subordinate <substanceAdministration> element SHALL be present unless medications are unknown or known absent.
  2. The moodCode of this subordinate <substanceAdministration> SHALL be the same of the parent <substanceAdministration> .
  3. The statusCode of this subordinate <substanceAdministration> SHALL be the same of that of the parent <substanceAdministration>.
Suggestion:

-

Further explanation:

-

Change Request Status = Closed ( hl7ips-issue-70 ): Split the effectiveTime element with a choice
Type Change Request Status Change Request Status = Closed Priority Normal
Current Labels
 
 (Meds) Medications 
 
 (CDA) CDA Implementation 
Events
Tracking / Status = Closed 2017-05-23 20:02:40 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
Choice added for differentiating the differtn data types
Tracking / Status = Open 2017-05-03 11:29:24 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
Finding:

Add a choice for handling the different kinds of effectiveTime

Suggestion:

-

Further explanation:

-

Change Request Status = Closed ( hl7ips-issue-71 ): Add a choice for the doseQuantity
Type Change Request Status Change Request Status = Closed Priority Normal
Current Labels
 
 (CDA) CDA Implementation 
 
 (Meds) Medications 
Events
Tracking / Status = Closed 2017-05-03 18:24:52 : Tracking by Dr. Kai Heitmann
 
 CDA 
 
 Meds 
Description
I think it is sufficient to have at least two examples for single quantity and range quantity. We handle that elsewhere in the same way and I don't see the need to really add a choice.
Tracking / Status = Open 2017-05-03 11:45:30 : Tracking by Giorgio Cangioli
 
 CDA 
 
 Meds 
Description
even if it is always a IVL_PQ it better to distinguish between the two cases of range and specified dose
Tracking / Status = Cancelled 2017-05-03 11:39:26 : Tracking by Giorgio Cangioli
 
 CDA 
 
 Meds 
Description
Not needed. It is in any case an IVL_PQ
Tracking / Status = Open 2017-05-03 11:30:27 : Tracking by Giorgio Cangioli
 
 CDA 
 
 Meds 
Description
Finding:

Add a choice for handling the different types of hl7:doseQuantity

Suggestion:

-

Further explanation:

-

Change Request Status = Closed ( hl7ips-issue-72 ): Add value set for event time
Type Change Request Status Change Request Status = Closed Priority Lowest
Current Labels
 
 (CDA) CDA Implementation 
 
 (Meds) Medications 
 
 (Vocab) Vocabularies 
Events
Tracking / Status = Closed 2017-05-23 20:00:13 : Tracking by Giorgio Cangioli
 
 CDA 
 
 Meds 
 
 Vocab 
Description
Added and bindings
Tracking / Status = Open 2017-05-11 09:50:04 : Tracking by Giorgio Cangioli
 
 CDA 
 
 Meds 
 
 Vocab 
Assignment 2017-05-10 18:17:54 : Assigned To Giorgio Cangioli by Giorgio Cangioli
 
 CDA 
 
 Meds 
 
 Vocab 
Tracking / Status = Open 2017-05-03 11:31:53 : Tracking by Giorgio Cangioli
 
 CDA 
 
 Meds 
Description
Finding:

Add a value set for handling the time events

Suggestion:

-

Further explanation:

-

Change Request Status = Closed ( hl7ips-issue-73 ): Value set for doseQuantity and capacityQuantity unit
Type Change Request Status Change Request Status = Closed Priority Normal
Current Labels
 
 (Meds) Medications 
 
 (CDA) CDA Implementation 
 
 (Vocab) Vocabularies 
Events
Tracking / Status = Closed 2020-01-29 12:33:00 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 Vocab 
Description
an agreement was reached at the time of the STU Publication
Assignment 2017-05-19 16:55:43 : Assigned To Christof Gessner by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 Vocab 
Tracking / Status = In Progress 2017-05-10 17:11:45 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
 
 Vocab 
Description
Discussed in Madrid:
  1. clean up the UCUM based values sets (create a new issue)
  2. include a first set of examples of UCUM annotations from the Austrian value set
  3. allow for CWE (open) binding
Tracking / Status = In Progress 2017-05-03 18:30:44 : Tracking by Dr. Kai Heitmann
 
 Meds 
 
 CDA 
Description
I don't think a exhaustive value set is possible. UCUMs {curly braces} notation is always a countable. Any countable has unit=1.
Suggest to add an "example value set" as we do not have a chance to have a complete list and rejecting other UCUM units may be live threatening.
Tracking / Status = Open 2017-05-03 18:20:31 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
See the proposal from Austria.

To be better analyzed the management of the UCUM annotation.
One possibility to consider an external reference reference for presentation form.
(12 codes in Austria)
Tracking / Status = Open 2017-05-03 11:42:21 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
Finding:

  1. Define a value set for the doseQuantity and the cpm:capacityQuantity unit
  2. analyze how to deal with the case of UCUM annotation (mainly form a validation perspective considering that any {xyz} is equivalent to the unit 1
Suggestion:

-

Further explanation:

-

Request for Information/Education Status = Closed ( hl7ips-issue-102 ): IPSBodyAuthor inclusion
Type Request for Information/Education Status Request for Information/Education Status = Closed Priority Normal
Current Labels
 
 (Meds) Medications 
 
 (CDA) CDA Implementation 
Events
Tracking / Status = Closed 2017-06-15 11:10:39 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Tracking / Status = Feedback needed 2017-06-13 16:49:43 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
The medication entry has been modified adding an author element and using the contains relationship.

To  be checked
Tracking / Status = Open 2017-06-13 16:13:08 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
Finding:

The IPSBodyAuthor template is used as inclusion in the  IPS Medication Entry   (http://art-decor.org/art-decor/decor-templates--hl7ips-?section=templates&id=2.16.840.1.113883.3.1937.777.13.10.)

whil ein the other is used as contained...

to be checked

Suggestion:

-

Further explanation:

-

Change Request Status = Open ( hl7ips-issue-105 ): hl7:doseQuantity examples to be checked
Type Change Request Status Change Request Status = Open Priority Low
Current Labels
 
 (Meds) Medications 
 
 (CDA) CDA Implementation 
Events
Assignment 2017-06-21 15:18:30 : Assigned To Dr. Kai Heitmann by Giorgio Cangioli
 
 Meds 
 
 CDA 
Assignment 2017-06-15 11:41:19 : Assigned To Giorgio Cangioli by Giorgio Cangioli
 
 Meds 
 
 CDA 
Assignment 2017-06-15 11:30:13 : Assigned To Dr. Kai Heitmann by Giorgio Cangioli
 
 Meds 
 
 CDA 
Tracking / Status = Open 2017-06-15 11:30:05 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
- revise the descriptions of the examples; 
- obtain from the Pharma group some exaples to be reported here
Tracking / Status = Open 2017-06-13 16:38:40 : Tracking by Giorgio Cangioli
 
 Meds 
 
 CDA 
Description
Finding:

There are two examples with doseQuantity that needs to be checked

Suggestion:

-

Further explanation:

-

 
 
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