The Medication domain includes a number of related resources
| MedicationRequest | An order for both supply of the medication and the instructions for administration of the medicine to a patient. |
| MedicationDispense | Provision of a supply of a medication with the intention that it is subsequently consumed by a patient (usually in response to a prescription). |
| MedicationAdministration | When a patient actually consumes a medicine, or it is otherwise administered to them |
| MedicationStatement | This is a record of a medication being taken by a patient or that a medication has been given to a patient, where the record is the result of a report from the patient or another clinician, or derived from supporting information (for example, Claim, Observation or MedicationRequest). A medication statement is not a part of the prescribe->dispense->administer sequence, but is a report that such a sequence (or at least a part of it) did take place, resulting in a belief that the patient has received a particular medication. |
| Element | Current | Discussion |
|---|---|---|
| Code |
| 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)| |
| Form |
| 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) See SNOMED on FHIR Meeting (20171017).pptx : 1.Restrict bodySite to [0..0] and require finding site in code |
| Ingredient.item.itemCodeableConcept | << 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
| Element | Current | Discussion |
|---|---|---|
| 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. |