CH EMED Observation Profile (Cistec AG)

[ig-feedback]

ch.fhir.ig.ch-emed#0.2.0 /StructureDefinition-ch-emed-observation.html

The CH EMED Observation Profile used in the Pharmaceutical Advice should be able to change the strucutred dosage for a referencing Medication Treament Plan. As a proposal we could create a "contained" MedicationStatement that is referenced inside the "partOf" Attribut of the CH EMED Observation Profile.

Cistec AG

[eHealth-Suisse]

needs to be clarified if possible and what way would be best

[oliveregger]

same information needs to be transmitted cda pdav

[ziegm]

Additional use case to show how the dosage can be changed

• Initial situation: 1-1 Medication Treatment Plan document
  Triatec: 0.5-0-0-0

• Dosage change: Pharmaceutical Advice document - Change Dosage (equivalent CDA example)
  Triatec: 1-0-0-0

• Profile Observation

  • added Extension to reference the changed MedicationStatement
  • Comments to the proposal above:
    • Observation.partOf
      • FHIR Definition = A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.
      • Observation is rather the larger event and the new MedicationStatement a component of it. Therefore, an extension was added instead of using this element.
    • "contained" MedicationStatement:
      • The changed MedicationStatement is represented as a Bundle.entry (referenced from Observation.extension) and not as a contained resource in Observation. It is an independent and complete MedicationStatement.

• see also IHE_Pharmacy_Suppl_PADV

  • 6.3.4.3.3.12 Changed Medication Treatment Plan Item (page 39)
  • Community Pharmaceutical Advice CDA Document (page 16)

[eHealth-Suisse]

next steps:

• validate CDA (Michaela)
• talk to Quentin (Annatina)
• ask Walter for feedback @walterwellauer
• discuss in the working group 2.6.

[ziegm]

CDA validation:

• E-1: no original representation in CDA document
• E-2 to E-17: 'substanceAdministration' is defined as closed, and this element 'xxx' is not allowed, or not allowed with this content. This may concern the templateId, code or id. Expected in this context: hl7:templateId[@root = '1.3.6.1.4.1.19376.1.9.1.3.7'] (rule-reference: d265989e15-true-d266227e0)
  • Quentin: should this be open instead of closed or isn't the example correct or how are this errors to handle?

[qligier]

E-2 to E-17: This Schematron rule is completely bogus. I'd rather leave the template as closed and prevent the rule from being generated. It's tracked in https://art-decor.org/art-decor/decor-issues--ch-pharm-?id=2.16.756.5.30.1.127.77.4.6.43.

[ziegm]

E-2 to E-17: This Schematron rule is completely bogus. I'd rather leave the template as closed and prevent the rule from being generated. It's tracked in https://art-decor.org/art-decor/decor-issues--ch-pharm-?id=2.16.756.5.30.1.127.77.4.6.43.

Thank you for the feedback!

[ziegm]

Added purposes and links to the PADV examples in the document tab:
http://build.fhir.org/ig/ehealthsuisse/ch-emed/branches/issue33/pharmaceutical-advice-document.html

[eHealth-Suisse]

solution presented in FHIR Work group on 2nd of June, https://github.com/hl7ch/ch-core/wiki#wed-02062021-telco-hl7ch-fhir-work-group-200-pm---300-pm
no further comments; ticket will be closed.
ticketissuer @walterwellauer for information and potential objections.