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  1. FHIR Specification Feedback
  2. FHIR-35365

FormularyItem extensions need descriptive descsriptions

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    • Change Request
    • Status: Published (View Workflow)
    • Medium
    • Resolution: Persuasive with Modification
    • US Da Vinci Drug Formulary (FHIR)
    • 1.1.0
    • Pharmacy
    • (NA)
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      The descriptions of the FormularyItem included extensions are derived from the extension StructureDefinition descriptions. These StructureDefinitions will be updated with the following descriptions.

      usdf-FormularyReference-extension   

      • Description: Reference to the formulary this item belongs to.

      usdf-AvailabilityStatus-extension

      • Description: A boolean indicating whether the formulary item is currently available under the formulary. Drugs may appear on a formulary, but not considered "active" for the current year. Drugs may also be removed during the course of a plan year.

      usdf-AvailabilityPeriod-extension

      • Description: The period for which this item is available on the formulary. Drugs may appear on a formulary, but not considered "active" for the current year. 

      usdf-StepTherapyLimit-extension

      • Description: A boolean indicating whether the coverage plan imposes a step therapy requirement on this drug meaning another drug may need to be tried beforehand.

      usdf-StepTherapyLimitNewStartsOnly-extension

      • Description: A boolean indicating whether the coverage plan imposes a step therapy requirement on this drug meaning another drug may need to be tried beforehand for new starts only (Not required if patient has previously met step therapy requirements).  (Only include if StepTherapyLimit = true)

      usdf-QuantityLimitDetail-extension

      • Description: A detailed definition of the quantity limits the coverage plan imposes on this drug. These limit details may include (potentially including a rolling dispense limit, maximum daily, or therapy days for a period of time. (Only include if QuantityLimit = true)
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      The descriptions of the FormularyItem included extensions are derived from the extension StructureDefinition descriptions. These StructureDefinitions will be updated with the following descriptions. usdf-FormularyReference-extension    Description: Reference to the formulary this item belongs to. usdf-AvailabilityStatus-extension Description: A boolean indicating whether the formulary item is currently available under the formulary. Drugs may appear on a formulary, but not considered "active" for the current year. Drugs may also be removed during the course of a plan year. usdf-AvailabilityPeriod-extension Description: The period for which this item is available on the formulary. Drugs may appear on a formulary, but not considered "active" for the current year.  usdf-StepTherapyLimit-extension Description: A boolean indicating whether the coverage plan imposes a step therapy requirement on this drug meaning another drug may need to be tried beforehand. usdf-StepTherapyLimitNewStartsOnly-extension Description: A boolean indicating whether the coverage plan imposes a step therapy requirement on this drug meaning another drug may need to be tried beforehand for new starts only (Not required if patient has previously met step therapy requirements).  (Only include if StepTherapyLimit = true) usdf-QuantityLimitDetail-extension Description: A detailed definition of the quantity limits the coverage plan imposes on this drug. These limit details may include (potentially including a rolling dispense limit, maximum daily, or therapy days for a period of time. (Only include if QuantityLimit = true)
    • Corey Spears / Scott Robertson: 12-0-1
    • Clarification
    • Non-substantive

    Description

      Looking at the extensions in http://hl7.org/fhir/us/davinci-drug-formulary/2022Jan/StructureDefinition-usdf-FormularyItem.html I can’t tell what these are inteded for.
       
      For instance, usdf-AvailabilityStatus-extension is defined as “Availability Status”, but I don’t know what this means. I suspect that “publications status” might not be the appropriate valueset for formulary item availability, but without a definition it’s hard for me to assess.

       

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              jmandel Josh Mandel
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