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  1. FHIR Specification Feedback
  2. FHIR-41113

Medication Status

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US C-CDA on FHIR (FHIR)
    • 1.2.0-ballot
    • Cross-Group Projects
    • C-CDA to FHIR Medication Status
      CF-medication
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      FHIR uses separate resources where CDA uses mood. CDA also makes some assertions about Act status that imply that the status is that of the record, not the activity represented by the record. For this reason, we add this guidance.

      Add note to Status code transform steps: “Pay attention to the definitions of active and completed in the FHIR medicationrequest-status code system. C-CDA may list a medication state as “completed” (i.e. the prescription writing has been completed), but containing dates in the future. This may more align with a FHIR status of “active” than “completed” which indicates all actions implied by the prescription have been completed.

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      FHIR uses separate resources where CDA uses mood. CDA also makes some assertions about Act status that imply that the status is that of the record, not the activity represented by the record. For this reason, we add this guidance. Add note to Status code transform steps: “Pay attention to the definitions of active and completed in the FHIR medicationrequest-status code system. C-CDA may list a medication state as “completed” (i.e. the prescription writing has been completed), but containing dates in the future. This may more align with a FHIR status of “active” than “completed” which indicates all actions implied by the prescription have been completed.
    • Jay Lyle/John D'Amore: 18-0-6
    • Clarification
    • Non-substantive

    Description

      Historical versions of C-CDA always required medications to be sent with statusCode="completed". Coupled with general misuse of @statusCode throughout CDA implementations, Redox generally prefers to use the dates of an entry to calculate status when this field is one of the typical "default" values of "completed" or even "active". (i.e. all dates in the past = completed; any date in the future = active).

      In particular, the definition of completed ("All actions that are implied by the prescription have occurred.") seems to imply it is only used once all administrations are complete - though some historical chatter on Zulip indicates that request resources are independent of their execution; but other status values reference administrations, so I'm not 100% sure what this means)

      In short, I'm not sure a direct map from C-CDA statusCode to the FHIR status values is completely appropriate (even codes with the exact same value seem to have a slightly different description in the FHIR MedicationRequestStatus code system vs the CDA ActStatus code system)

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            chunli Chun Li
            benjamin Benjamin Flessner
            Benjamin Flessner
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              Updated:
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