eMediplan CHMED16AF Implementation Guide: Mapping

Introduction

CHMED16A and CHMED16AF define three different exchange formats:

  1. MedicationPlan (MP)
  2. PolymedicationCheck (PMC)
  3. Prescription (Rx)

These exchange formats are defined in three different document types, which correspond to a Bundle as FHIR Ressource. A Bundle has list of Entries. The first Entry is the Composition where alle contained Entries are then referenced.

MedicatonPlan

The medication plan summarizes the entire, current medication of a patient.

Bundle

Bundle Medication Plan
bundle_medicationplan.png

The FHIR ressource Bundle bundles the corresponding entroes in a document. It contains

  • The profile this bundle correspons to (chmed16af-mp-bundle)
  • The type of the bundle (fixed here on “document”)
  • An entry to the composition, the actual document that references different resources (further entry elements in the bundle)
  • Further entry elements to the patient, medication plan entries, etc.

Profile for Medication Plan | Example for Medication Plan (xml)

Composition

The Composition ressource defines the following parameter for the medication plan:

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
subject Reference to the Patient Patient Patient <P>
identifier Logical identifier for document (GUID) Identifier id @i
date Date of creation dateTime Dt @c
author Author (Gln if available, otherwise name) Practitioner Auth <A>
attester.time Date of validation Practitioner ValDt @at
attester.party Validated by GLN of practitionier Practitioner ValBy @ap
section medications MedicationStatement Medicaments <MS>
section healthconcerns Entry MedicalData <SH>
section notes text Rmk @n
receiver Practitioner GLN if receiver Practitioner Patient.RCV (GLN of receiver) @r

Profile for Medication Plan Composition

Patient

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
identifier Insurance card number for this patient Identifier Patient.PatientId[Type=1] @i
name Name for this patient HumanName name.given = Patient.FName, name.family = Patient.LName @g, @f
telecom telephone number ContactPoint Patient.Phone @t
gender gender code Patient.gender, male=1, female=2 @ag=m or f
birthDate the date of birth date Patient.BDt @b
address address for the patient Address address.line = Patient.Street, address.postalCode = Patient.Zip, address.city = Patient.City @l, @p, @c
communication.language language for the patient CodeableConcept Patient.Lng conversion between ISO 639-1 (de) to urn:ietf:cbp:47 (de_CH) necessary” @cl

Profile for Medication Plan Patient | Example for Patient

Practitioner

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
identifier GLN for this practitioner Identifier Author.GLN @i
name Name for this practitioner HumanName name.given = Author.FName, name.family = Author.LName @g, @f

Profile for Practitioner | Example for Practitioner (xml)

Medication Section

The medication section contains the entries for the current medications for patient.

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
medicationReference reference to Medication Medication Medication.ID with IdTpye 2 (GTIN) @i
informationSource Person or organization that provided the information about the taking of this medication Patient or Practitioner Selfmedication (AutoMed) if Patient is informationSource, PrescrBy if Practitioner @s=1 or 0
reasonCode Reason for why the medication is being/was taken CodeableConcept Medication.TkgRsn (Taking Reason) @r
note Application Instructions Annotation Medication.AppInstr @n
dosage Details of how medication is/was taken or should be taken Dosage Medication.Pos (list of Posology) @n <D>
dosage.timing When medication should be administered Timing Posology.DtFrom, Posology.DtTo, CyDu, InRes @s @e @c @dv @du @f @p @pu @dw @td @w @r
dosage.route How drug should enter body CodeableConect Medication.Roa @o
dosage.doseQuantity Amount of medication per dose. Quantity doseSimpleQuantity: TakingTime.A, doseRange: TakingTime.DoFrom @q @u @q2 @u2
dosage.maxDosePerPeriod Amount of medication per dose. Ratio TakingTime.MA  

Profile for MedicationStatmeent | Profile for Medication

Examples for MedicationStatements 1 | 2 | 3 | 4

Health Concerns Section

The health concern sections contains the medical data for the patient and the possible risks. If the risk category is specified without any risk specified in the code, the entire risk category is considered as explicitly excluded for the current patient. If the risk category does not exist,the risks are considered as unknown for the patient.

Entry Description Resource/Datatype CHMED16A CHMED16AQ
Body Weight Weight measurement for patient in kg Observation MedicalData.Meas.Weight @w
Body Height Weight measurement for patient in cm Observation MedicalData.Meas.Height @h
First day of last menstruation First day of last menstruation Observation MedicalData.DLstMen @m
Premature baby premature baby true only if age <= 18 months Observation MedicalData.Prem @p
Time of gestation Time of gestation only if Premature Baby Observation MedicalData.ToG.Weeks, MedicalData.ToG.Day @tw, @td
Risks per group Renal Insufficiency Condition MedicalData.RC @r1
Risks per group Liver Insufficiency Condition MedicalData.RC @r2
Risks per group Reproduction Condition MedicalData.RC @r3
Risks per group Competitive athlete Condition MedicalData.RC @r4
Risks per group Driver Condition MedicalData.RC @r5
Risks per group Allergies Condition MedicalData.RC @r6

PolymedicationCheck

Swiss community pharmacies can offer a Polymedication Check (PMC) to patients on greater or equals four prescribed drugs taken over more then 3 months.

Bundle

Polymedication Check
bundle_polymedicationcheck.png

The FHIR ressource Bundle bundles the corresponding entroes in a document. It contains

  • The profile this bundle correspons to (chmed16af-pmc-bundle)
  • The type of the bundle (fixed here on “document”)
  • An entry to the composition, the actual document that references different resources (further entry elements in the bundle)
  • Further entry elements to the patient, medication entries, etc.

Profile for PolymedicationCheck | Example for PolymedicationCheck (xml)

Compostion

The Composition ressource defines the following parameter for the PolymedicationCheck:

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
subject Reference to the Patient Patient Patient <P>
identifier Logical identifier for document (GUID) Identifier id @i
date Date of creation dateTime Dt @c
author Author (Gln if available, otherwise name) Practitioner Auth <A>
section medications MedicationStatement Medicaments <M>
section recommendations - Recoms <@r>

Profile for PolymedicationCheck Composition

Patient

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
identifier Insurance card number for this patient Identifier Patient.PatientId[Type=1] @i
name Name for this patient HumanName name.given = Patient.FName, name.family = Patient.LName @g, @f
telecom telephone number ContactPoint Patient.Phone @t
gender gender code Patient.gender, male=1, female=2 @g=m or f
birthDate the date of birth date Patient.BDt @b
address address for the patient date address.line = Patient.Street, address.postalCode = Patient.Zip, address.city = Patient.City @l, @p, @c

Profile for Patient | Example for Patient (xml)

Practitioner

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
identifier GLN for this practitioner Identifier Author.GLN @i
name Name for this practitioner HumanName name.given = Author.FName, name.family = Author.LName @g, @f

Profile for Practitioner | Example for Practitioner (xml)

Medication Section

The medication section contains the entries for the current medications for patient.

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
medicationReference reference to Medication Medication Medication.ID with IdTpye 2 (GTIN) @i
informationSource Person or organization that provided the information about the taking of this medication Patient or Practitioner Selfmedication (AutoMed) if Patient is informationSource, PrescrBy if Practitioner @s=1 or 0
reasonCode Reason for why the medication is being/was taken CodeableConcept Medication.TkgRsn (Taking Reason) @r
note Application Instructions Annotation Medication.AppInstr @n
dosage Details of how medication is/was taken or should be taken Dosage Medication.Pos (list of Posology) <D>
dosage.timing When medication should be administered Timing Posology.DtFrom, Posology.DtTo, CyDu, InRes, SimpliedVersion of taking times onlys @s, @e, @p, @r, (@m, @d, @v, @h)
dosage.dose[x] Amount of medication per dose. Quantity TakingTime.A, TakingTime.DoFrom, TakingTime.doTo) @q @u @q2 @u2
dosage.maxDosePerPeriod Amount of medication per dose. Ratio TakingTime.MA @dm

Profile for MedicationStatmeent | Profile for Medication

Examples for MedicationStatements 1 | 2 | 3 | 4

Recommendation Section

The recommendation section contains the entry for the recommendations of the Poly Medication Check:

1: week dosing system by the pharmacist
2: Intensified compliance support
3: Repeat check in … months
4: Forwarding to doctor / other specialist
5: Needs analysis (e.g., interactions, side effects, duplications)

The answer to this questions are provided in a QuestionnaireResponse resource profile according to the Questionnaire defined if a) which question was raised with the patient b) if the patient agrees and c) if there is an additional remark.

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
item.linkId Questionnaire number QuestionnaireResponse Recommendation.Id <Q> @n
item[linkId=”n.1”]/answer/valueBoolean Question was asked Boolean id @q
item[linkId=”n.2”]/answer/valueBoolean Patient agreed Boolean PatAgr @p
item[linkId=”n.3”]/answer/valueString Patient agreed Boolean Remark @r

Profile for Questionnaire Response | Example for Questionnare Response

Prescription

A prescription can be structured in a bundle according to the prescription bundle profile.

Bundle

Prescription
bundle_prescription.png

The FHIR ressource Bundle bundles the corresponding entroes in a document. It contains

  • The profile this bundle correspons to (chmed16af-rx-bundle)
  • The type of the bundle (fixed here on “document”)
  • An entry to the composition, the actual document that references different resources (further entry elements in the bundle)
  • Further entry elements to the patient, medication entries, etc.

Profile for Prescription | Example for Prescription (xml)

Compostion

The Composition ressource defines the following parameter for the Prescription:

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
subject Reference to the Patient Patient Patient <P>
identifier Logical identifier for document (GUID) Identifier id @i
date Date of creation dateTime Dt @d
author Author (Gln if available, otherwise name) Practitioner Auth <A>
section medications MedicationAdminstration Medicaments <M>
section note - Rmk <@n>

Profile for Prescription Composition

Patient

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
identifier Insurance card number for this patient Identifier Patient.PatientId[Type=1] @i
name Name for this patient HumanName name.given = Patient.FName, name.family = Patient.LName @g, @f
telecom telephone number ContactPoint Patient.Phone @t
gender gender code Patient.gender, male=1, female=2 @g=m or f
birthDate the date of birth date Patient.BDt @b
address address for the patient date address.line = Patient.Street, address.postalCode = Patient.Zip, address.city = Patient.City @l, @p, @c

Profile for Patient | Example for Patient (xml)

Practitioner

Parameter Description Resource/Datatype CHMED16A CHMED16AQ
identifier GLN for this practitioner Identifier Author.GLN @i
identifier ZSR for this practitioner Identifier ZSR-Number of the organisation @z
name Name for this practitioner HumanName name.given = Author.FName, name.family = Author.LName @g, @f

Profile for Practitioner | Example for Practitioner (xml)

Medication Prescribed Section

The medication section contains the entries for the prescriped medications for the patient.

Parameter Description Resource/Datatype CHMED16A CHMED16AQ  
medicationReference reference to Medication Medication Medication.ID with IdTpye 2 (GTIN) @i  
note Application Instructions Annotation Medication.AppInstr @n  
dosage Details of how medication is/was taken or should be taken Dosage Medication.Pos (list of Posology) <D>  
dosage.timing When medication should be administered Timing Posology.DtFrom, Posology.DtTo, CyDu, InRes, SimpliedVersion of taking times onlys @s, @e, @p, @r, (@m, @d, @v, @h)  
dosage.dose[x]   Amount of medication per dose. Quantity TakingTime.A, TakingTime.DoFrom, TakingTime.doTo) @q @u @q2 @u2
dosage.maxDosePerPeriod Amount of medication per dose. Ratio TakingTime.MA @dm  
dispenseRequest.numberOfRepeatsAllowed Number of repetitions allowed Medication Rep @dn  
dispenseRequest.quantity Number of package to be delivered Medication NbPack @dq  
substitution.allowed Medication is substitutable Medication Subs negated @sa  

Profile for MedicationRequest | Profile for Medication

Examples for MedicationRequest 1