Jenni Syed (mmoseman@cerner.com;

Jenni.Syed@Cerner.com)

Comment:

If there's an application written to query/update MedicationStatement and that application is opened while the patient is actually admitted to the hospital, and the user intends to update the known patient meds, the application probably doesn't want to inadvertently attempt to update an ongoing inpatient medication. How does the application know that it should write a new patient documented med vs. updating one that was returned? The MedicationStatement.informationSource is used to identify the person who provided the information about the taking of this medication, but that doesn't necessarily identify whether the medication was recorded or prescribed. Proposed change: Add an attribute to allow consumers to know which MedicationStatements are recorded (based on patient statement) or prescribed (infer from administration). For example, that could be a boolean (similar to Immunization.recorded) or a reference to the originating MedicationPrescription/MedAdmin, then:

• If there is a link/reference to the originating MedicationPrescription or MedicationAdministration, then the MedicationStatement can't be updated because it is a clinically documented fact that the med was given (prescribed/ordered).

• If there is NO link/reference to the originating MedicationPrescription or Medication Administration, then that MedicationStatement can be updated because it is based on a statement from the patient (recorded).