Vaccines may not be covered (see immunization resource, in which case immunization substances could be removed from the medication codes valueset).
Should we draw the distinction between products and the more abstract substances and say that only products can be administered?
Jim Case noted that vaccine substances are going to be retired (they also exist as products).
Possible use case for using substances for TPN (total parenteral nutrition). Also for post coordinated expression used in "code", however this could still be a type of product if used as an ingredient.
Can we simplify this then and cover all use cases with a binding of:
< 763158003 |Medicinal product (product)|
421967003 |Drug dose form (qualifier value)| is no longer a sensible binding. It only has 15 descendants.
< 736542009 |Pharmaceutical dose form (dose form)| is a preferable binding.
Options for dealing with conflict (from another resource)
1.Restrict bodySite to [0..0] and require finding site in code
< 105590001 |Substance (substance)|
JR noted that this field could also allow recursive composition with further Medication resources eg for a combination pack. Is this link still valid?
|amount||It is not clear what this element refers to - the pack, the amount|
Other supporting elements
|Dosage.AdministrationSite||Anatomical Structure||This precludes acquired structures, so a more general binding of << 442083009 |Anatomical or acquired body structure (body structure)| might be more helpful.|
Note: Interesting situation with anesthesia where the quantity might be - for example - a rate of flow of medication and the denominator would be time.
Refusal reason is a wrong binding. Those codes in SNOMED relate to the actual medication that was refused. Perhaps better option to use << 182895007 |Drug declined by patient (situation)|
Note that 242990004 |Drug not available for administration (event)| is another item in that valueset, but it is concerning that we're picking from different sub-hierarchies here.