MedicationStatement.informationSource currently allows references to resources representing specific individuals.  

However, when recording a patient’s medication adherence, users may document the information source as a broad category (for example, spouse), not as a specific individual. 

This is used to help indicate what sources information has been collected from, which helps users determine how reliable the data is and whether additional confirmation may be needed. Sometimes, this information will be collected for a newly admitted patient in multiple stages:

• EMS team collects some initial information
  On arrival at the hospital, nurse or pharmacist conducts a verbal interview with the patient or a family member
  Someone validates the information with additional sources over the next several hours (e.g. calling the patient’s pharmacy to confirm when medications were last dispensed, receiving a paper MAR from the LTC facility that transferred the patient, calling the patient’s home care nurse)
• Users might be referencing the information source to figure out where we’re at in this process, and whether there are medications that still need to be followed up on. Some organizations have a policy of always confirming the medications with multiple sources, for example. 

Examples of values that might be documented: 

• People by their relationship to the patient: Self, Spouse, Parent, Sibling, Family Member, Friend, Care Giver, etc.
• Patient’s pharmacy (user called the retail pharmacy the patient uses and confirmed the patient has been filling the medication)
• Transfer facility MAR (for example, if the patient arrived from a long-term care facility and the user is documenting off a paper administration record used by their previous care team)
• Medication bottle (this is less relevant to adherence, but we use the same category list for documenting the source of a newly recorded medication) 

None of these involve documenting a specific individual/organization (that might be documented in an overall note, but not against each individual medication). 

Collecting details about the specific individual requires additional effort by end users to collect and document the details about the specific individual, which in many cases may be unnecessary.

Recommendation:  Allow two different methods of documenting the information source for medication adherence:  1) as a reference to a specific individual (what is there today) and 2) a code that describes the type of individual, rather than the specific individual.