Uploaded image for project: 'FHIR Specification Feedback'
  1. FHIR Specification Feedback
  2. FHIR-19694

MedicationRequest.reasonCode - usage requires clarification

    XMLWordPrintableJSON

Details

    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • STU3
    • Pharmacy
    • MedicationRequest
    • Hide

      Will clarify the use of the reason reference attribute that it is only intended to include condition/diagnosis/problem. Not to be used to express goal.

      Work on conditional dosage extension on Dosage will consider how to express goal.

      Show
      Will clarify the use of the reason reference attribute that it is only intended to include condition/diagnosis/problem. Not to be used to express goal. Work on conditional dosage extension on Dosage will consider how to express goal.
    • Jean/Dennis: 5-0-0
    • Enhancement
    • Non-substantive
    • R5

    Description

      MedicationRequest.reasonCode [0..*]
      Type: codeableConcept
      Description: The reason or the indication for ordering or not ordering the medication
      Comments statement: This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference

      In prescription medications, a prescriber may want to include (1) diagnosis/problem, (2) intended therapeutic targets to be achieved

      The cardinality *= 0.., and *description *and *comment *statement as are do not prohibit any clinical users to include both "condtion" and "target" statements in the reasonCode element

      Use case examples:
      (1) in prescription of antihypertensive medications, a prescriber can include in the reasonCode values of: (a) hypertension (condition), (b) achieve BP control to =< 125/80 (target value)
      (2) in prescription of glycaemic control medications, a prescriber can include in the reasonCode values of: (a) Type 2 DM, (b) achieve HbA1C value =< 53mmol/mol (7%) (target 1 value), (c) BSL before meal = 6-8 mmol/L (target 2 value), (d) BSL 2 hours after meal = 6-10mmol/L (target 3 value)

      If the Goal resource (that references MedicationRequest) should be used to transmit the intended therapeutic target values of prescribed medication, then documentation on MedicationRequest.reasonCode should (a) clearly constraints its use for "diagnosis/problem", (b) prohibits its use to transmit goal target information, and (c) provide directions on how to use Goal resource to transmit the intended therapeutic target values for the prescribed medication

      Attachments

        Activity

          People

            Unassigned Unassigned
            chuscmi Stephen Chu
            Watchers:
            1 Start watching this issue

            Dates

              Created:
              Updated:
              Resolved: