Details
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Change Request
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Resolution: Persuasive with Modification
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Medium
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US QI Core (FHIR)
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2.0 [deprecated]
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Clinical Quality Information
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QICore MedicationRequest
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D.4.1
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Peter Muir/Rob Samples:15-0-0
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Enhancement
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Non-compatible
Description
QI-Core MedicationRequest lists the following elements as MUST SUPPORT:
- status
- category
- doNotPerform
- medication[x]
- subject
- encounter
- authoredOn
- requester
- dosageInstruction
- site
- dispenseRequest
To adequately address cumulative medication duration, additional timing elements must be supported. Recommend adding MUST SUPPORT for:
- text
- timing
- timing.repeat
- timing.repeat.frequency
- timing.repeat.frequencyMax
- timing.repeat.period
- timing.repeat.periodMax
- timing.repeat.periodUnit
- asNeeded[x]
- doseAndRate
- doseAndRate.dose[x]
And maintain cardinality as currently listed.
Rationale – cumulative medication duration requires information about the expected timing for medication to be administered. Patient self-administration information is not available, nor will it be feasible to collect. Therefore, medication usage must be determined based on the MedicationRequest or MedicationDispense (dispense is not currently supported by US Core in R4). Therefore, the timing elements are essential for expressions and retrieves to evaluated medication usage. The example used for opioid usage shows the need for these elements (http://build.fhir.org/ig/cqframework/opioid-mme-r4/StructureDefinition-mmemedicationrequest.html) The cardinality needed for the opioid use case, however, does not necessarily apply to all use cases and all timing attributes; therefore, the cardinality in QI-Core can remain the same as it is currently stated.