This is a record indicating that a patient may be taking a medication now, has taken the medication in the past,
or will be taking the medication in the future.
The source for this information can be the patient, significant other (such as a family member or spouse),
or a clinician. A common scenario where this information is captured is during the history taking
process during a patient visit or stay.
A medication statement is not a part of the prescribe->dispense->administer sequence,
but is a report that such a sequence (or at least a part of it) did take place,
resulting in a belief that the patient has received a particular medication.
It may be used to construct a patients 'Current Medications' list.
The MedicationKnowledge resource is draft and is included for comment purposes. This resource represents information about a medication, for example, details about the medication including interactions, contraindications, cost, regulatory status, administration guidelines, etc.
The Immunization resource is intended to cover the recording of current and historical administration of vaccines
to patients across all healthcare disciplines in all care settings and all regions.
This includes immunization of both humans and animals, but does not include the administration of non-vaccine agents,
even those that may have or claim to have immunological effects.
A patient's point-in-time immunization and recommendation (i.e. forecasting a patient's immunization eligibility
according to a published schedule) with optional supporting justification
The ImmunizationEvaluation resource is intended to cover communicating the results of an evaluation of a vaccine administration event (documented using the Immunization resource) against a set of published recommendations (protocols).
The Immunization resource is intended to cover the recording of current and historical administration of vaccines
to patients across all healthcare disciplines in all care settings and all regions.
This includes immunization of both humans and animals, but does not include the administration of non-vaccine agents,
even those that may have or claim to have immunological effects.
A patient's point-in-time immunization and recommendation (i.e. forecasting a patient's immunization eligibility
according to a published schedule) with optional supporting justification
The ImmunizationEvaluation resource is intended to cover communicating the results of an evaluation of a vaccine administration event (documented using the Immunization resource) against a set of published recommendations (protocols).
11.0.3 Common Use Cases
Placing a Medication Request (aka Prescription or Order). The MedicationRequest resource represents the details of
what medication the prescriber intends the patient to receive and other details such as the dose, timing and route.
However, while it represents that order, the actual workflow around the supply (dispensing) and administration
of that medication is
managed by the common workflow functionality, resulting in the creation
of the other medication resources (MedicationDispense, MedicationAdministration) as it executes.
Listing a patient's current medications. This is represented using the List resource, which allows an author
to construct a 'curated' list. This has features beyond a simple collection of resources - such as the ability
to state that the patient is not currently taking any medications at the time that the list is constructed,
or changes that are made at a point in time (sometimes called medication reconciliation). FHIR defines a number of specific
functional lists for this purpose, and a specific
operation to retrieve it. Note that FHIR does not describe how the
list should be maintained by the individual system, as that will vary widely between implementations.
Retrieving a list of Immunizations. This can be achieved using a simple query
against the Immunization resource type. Note that an Immunization resource can specifically state that it was not given,
as well as any reactions that occurred. Note that if the reaction is considered to be an indication of an allergy
or intolerance, then a separate AllergyIntolerance resource should be created.
Retrieving recommendations for a specific patient at a point in time. The recommendation for immunizations to give
would be represented by an ImmunizationRecommendation resource, but the determination of that recommendation is a
part of Decision Support, with the actual immunization schedule being represented by a generic
Plan Definition, individual Care Plan or some other record.
Dispensing a medication based on a Medication Request (aka Prescription or Order). The MedicationDispense resource represents the details of the dispensing event including the actual product provided to the patient and the dosage to be administered or consumed.
Retrieving the planned medication therapy for specific patient at a point in time. The intended medication therapy may be represented by an individual Care Plan.
Retrieving information about a medication either as a stand alone request or as while reviewing a patients' medication list
11.0.4 Other resources
There are other resources that are of particular interest in the medication domain.
SupplyRequest and SupplyDelivery which,
like MedicationRequest, are 'detail' resources used as part of a workflow. They are concerned with
the request of supplies used in the healthcare process. This includes supplies specifically used in the
treatment of patients as well as supply movement within an institution
(transport a set of supplies from materials management to a service unit (nurse station).
This specification also includes a draft set of resources that are used for registration of medications for regulatory purposes:
These resources are under development in association with several medication regulation authorities.
11.0.5 Security and Privacy
As with all clinical data, Medications (in particular) can be sensitive information as specific medications can indicate
the presence of private information such as mental health disorders or HIV. However, withholding information about what
medications a person is taking can lead to catastrophic results, and so needs to be considered very carefully. At the least,
a clinician should be made aware that there is information available that they have not been given when making clinical decisions.
The Pharmacy workgroup has plans to improve all existing resources e.g. adding in features that support detailing
our conditional orders in a structured way; evaluating requirements for supporting drug formularies and medication knowledge. This work is expected to include the development and approval of a new resource and may involve updates to the Medication Resource.
药物治疗
& Public Health and Emergency Response