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  1. FHIR Specification Feedback
  2. FHIR-26502

Medications may have an alternative that’s only appropriate based on a certain diagnosis…

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    Details

    • Type: Change Request
    • Status: Resolved - change required (View Workflow)
    • Priority: Medium
    • Resolution: Not Persuasive with Modification
    • Specification:
      US CARIN Real-time Pharmacy Benefit Check (RTPBC) (FHIR)
    • Work Group:
      Pharmacy
    • Related Page(s):
      Consumer vs provider RTPBC
    • Grouping:
    • Resolution Description:
      Hide

      Correct the provider-focused vs consumer-focused content graphic (on the Consumer vs provider RTPBC page) to remove Patient Clinical Info: Diagnosis from the provider-focused request and response (it is not part of the NCPDP RTPBC response, and it _is included in the RTPBC request).

      Also: Add to Implementer Guidance section:

      "Clarification: Alternatives returned in the response may or may not be appropriate for the given patient, and other alternatives may be available that are not returned in the RTPBC response."

      (Also see comment about availability of Diagnosis in the request)

      Show
      Correct the provider-focused vs consumer-focused content graphic (on the Consumer vs provider RTPBC  page) to remove Patient Clinical Info: Diagnosis from the provider-focused request and response (it is not part of the NCPDP RTPBC response, and it _is included in the RTPBC request). Also: Add to Implementer Guidance section: "Clarification: Alternatives returned in the response may or may not be appropriate for the given patient, and other alternatives may be available that are not returned in the RTPBC response." (Also see comment about availability of Diagnosis in the request)
    • Resolution Vote:
      Frank McKinney / Daniel Zhang : 12-0-0
    • Change Category:
      Clarification
    • Change Impact:
      Non-substantive
    • Applied for Version:
      0.1.0

      Description

      Payers can use this to identify better alternatives for a patient. Medications may have an alternative that’s only appropriate based on a certain diagnosis, so this would improve the clinical quality of alternatives returned on the response.

      Instead of removing items from the standard, it would be better to leave it to the application to decide whether and how they want to display the information.

      Existing Wording:

      Response > Patient clinical info > Diagnosis is in NCPDP standards, but not in this FHIR IG.

      Proposed Wording:

      Include Diagnosis in the Response.

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              Assignee:
              Unassigned Unassigned
              Reporter:
              dzhang Daniel Zhang
              Request in-person:
              Daniel Zhang
              Watchers:
              2 Start watching this issue

                Dates

                Created:
                Updated:
                Resolved:
                Vote Date: