There are 12 elements in QI-Core related to medications that are listed as Must Support but have example value sets. Suggest the following changes:

• QI-Core MedicationAdministration
  • MedicationAdministration.dosage.route using http://hl7.org/fhir/ValueSet/route-codes SNOMED route of administration codes - Change to "Preferred"
  • MedicationAdministration.reasonCode using http://terminology.hl7.org/CodeSystem/reason-medication-given - Change to "Preferred" status and set up tracker for Pharmacy MedicationAdministration: This value set contains 3 concepts specifying none, given-as-ordered, and emergency. Should the value set be enhanced?
  • MedicationAdministration.statusReason using http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes Note, this is the example value set for MedicationAdministration.statusReason. However,QI-Core uses a different value set for that element: http://build.fhir.org/ig/HL7/fhir-qi-core/ValueSet-qicore-negation-reason.html (extensible) - Confirm this reason-medication-not-given-codes should not replace the existing qicore-negation-reason for this element.

• QICoreMedicationAdministrationNotDone
  • MedicationAdministration.dosage.route using http://hl7.org/fhir/ValueSet/route-codes SNOMED route of administration codes - Change to "Preferred"
  • MedicationAdministration.medication[x] using http://hl7.org/fhir/ValueSet/medication-codes SNOMED medications. Since eCQMs (and dQMs) will be using RxNorm, consider change to "Preferred" or change to RxNorm
• QICoreMedicationDispense
  • MedicationDispense.dosageInstruction.route using http://hl7.org/fhir/ValueSet/route-codes SNOMED route of administration codes - Change to "Preferred"
  • MedicationDispense.statusReason[x] using http://hl7.org/fhir/ValueSet/medicationdispense-status-reason Change to "Preferred" since eCQM generally use the negationReason value set, or confirm that they will now use this MedicationDispense-status-reason value set.
• QICoreMedicationDispenseNotDone
  • MedicationDispense.medication[x] using http://hl7.org/fhir/ValueSet/medication-codes SNOMED medications. Since eCQMs (and dQMs) will be using RxNorm, consider change to "Preferred" or change to RxNorm
  • MedicationDispense.dosageInstruction.route using http://hl7.org/fhir/ValueSet/route-codes uses SNOMED route of administration codes - Change to "Preferred"
• QICoreMedicationStatement
  • MedicationStatement.dosage.route using http://hl7.org/fhir/ValueSet/route-codes SNOMED route of administration codes - Consider change to "Preferred"
• QICoreMedicationNotRequested
  • MedicationRequest.medication[x] using http://hl7.org/fhir/ValueSet/medication-codes SNOMED medications. Since eCQMs (and dQMs) will be using RxNorm, consider change to "Preferred" or change to RxNorm
• QICore ServiceRequest
  • ServiceRequest.asNeeded[x] using value set http://hl7.org/fhir/ValueSet/medication-as-needed-reason uses SNOMED condition value set (from 2019) - Change to "Preferred"