Why only one medication in an activity? And the value set is problematic (but example) - 2016-09 core #517

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    • Type: Change Request
    • Resolution: Not Persuasive
    • Priority: Medium
    • US Core (FHIR)
    • DSTU2
    • Patient Care
    • CarePlan [deprecated]
    • Profiles and Extensions
    • Core Care Plan
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      All Medication* resources (listed below) share a binding to the same value set, which is SNOMED, owned and maintained by Pharmacy WG. Patient Care would like to remain consistent with these other resources because CarePlan.activity.detail.product can be the same as Medication*.medication[x], so any changes to this value set should be raised with Pharmacy WG.

      •Medication.code\\•ActivityDefinition.product[x]\\•CarePlan.activity.detail.product[x]\\•MedicationRequest.medication[x]\\•MedicationAdministration.medication[x]\\•MedicationStatement.medication[x]
      •MedicationDispense.medication[x]

      Because SNOMED is an example binding, the DAF/US-Core profile can decide which value set is best. That said, *CarePlan.activity.detail.product *has a definition that is broader than just medications, so Patient Care doesn't recommend RxNorm. Specifically "Identifies the food, drug or other product to be consumed or supplied in the activity."

      The cardinality of CarePlan.activity.detail.product *is 0..1, which shares the same maxOccurs of 1 with the Medication.medication resources. The reason why this is acceptable is that a single Medication resource can reference multiple Medications using Medication.ingredient.item (e.g. IV or TPN example). If multiple independent medications need to be requested/planned/prescribed, then there can be multiple CarePlan.activity.

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      All Medication* resources (listed below) share a binding to the same value set, which is SNOMED, owned and maintained by Pharmacy WG. Patient Care would like to remain consistent with these other resources because CarePlan.activity.detail.product can be the same as Medication*.medication [x] , so any changes to this value set should be raised with Pharmacy WG. •Medication.code\\•ActivityDefinition.product [x] \\•CarePlan.activity.detail.product [x] \\•MedicationRequest.medication [x] \\•MedicationAdministration.medication [x] \\•MedicationStatement.medication [x] •MedicationDispense.medication [x] Because SNOMED is an example binding, the DAF/US-Core profile can decide which value set is best. That said, *CarePlan.activity.detail.product *has a definition that is broader than just medications, so Patient Care doesn't recommend RxNorm. Specifically "Identifies the food, drug or other product to be consumed or supplied in the activity." The cardinality of CarePlan.activity.detail.product *is 0..1, which shares the same maxOccurs of 1 with the Medication .medication resources. The reason why this is acceptable is that a single Medication resource can reference multiple Medications using Medication.ingredient.item (e.g. IV or TPN example). If multiple independent medications need to be requested/planned/prescribed, then there can be multiple CarePlan.activity.
    • Marten/Michael: 5-0-0
    • Correction

      Existing Wording: CarePlan.activity.detail.product has Control of 0..1.

      Comment:

      Why only one medication in an activity? And the value set is problematic (but example)

      Summary:

      Why only one medication in an activity? And the value set is problematic (but example)

            Assignee:
            Unassigned
            Reporter:
            Rob McClure
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved: