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- Hur hantera en förskrivning med flera "items"
- Vilka kodverk ska användas?
- I NLL kan en förskrivning ha flera versioner
| ID | Path | Min | Max | Type(s) | Short | Definition | Binding Strength | Binding Description | E-hälsomyndigheten | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EHDSMedicationPrescription | EHDSMedicationPrescription | 0 | * | Medication prescription model | Logical model for medication prescription body. A prescription contains one or more prescription items. | ||||||||
| EHDSMedicationPrescription.header | EHDSMedicationPrescription.header | 1 | 1 | https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSMedicationPrescriptionHeader | Prescription header | Prescription header data elements | |||||||
| EHDSMedicationPrescription.presentedForm | EHDSMedicationPrescription.presentedForm | 0 | * | https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSAttachment | Presented Form | Entire prescription as issued. Various formats could be provided, pdf format is recommended. | inte i NLL | ||||||
| EHDSMedicationPrescription.comment | EHDSMedicationPrescription.comment | 0 | * | string | Additional information or comments | Additional information or comments | |||||||
| EHDSMedicationPrescription.prescriptionItem | EHDSMedicationPrescription.prescriptionItem | 1 | * | Base | Prescription line for one medication. In many countries, only one line is allowed. In case multiple medications are allowed, all lines need to be authored together. | Prescription line for one medication. In many countries, only one line is allowed. In case multiple medications are allowed, all lines need to be authored together. | Svenska recept kan bara innehålla ett läkemedel, dvs. ett item | ||||||
| EHDSMedicationPrescription.prescriptionItem.identifier | EHDSMedicationPrescription.prescriptionItem.identifier | 0 | 1 | Identifier | Identifier for a single line on prescription, if exists. In case of single-line prescription, this identifier is typically the same as prescription identifier. | Identifier for a single line on prescription, if exists. In case of single-line prescription, this identifier is typically the same as prescription identifier. | förskrivnings-id | ||||||
| EHDSMedicationPrescription.prescriptionItem.medication | EHDSMedicationPrescription.prescriptionItem.medication | 1 | 1 | https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSMedication | Prescribed product, branded, generic, virtual, extemporal, etc | Prescribed product, branded, generic, virtual, extemporal, etc | Se "Medication" | ||||||
| EHDSMedicationPrescription.prescriptionItem.indication[x] | EHDSMedicationPrescription.prescriptionItem.indication[x] | 0 | * | CodeableConcept https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSCondition | Reason for the prescription (typically diagnosis, or a procedure) | Reason for the prescription (typically diagnosis, or a procedure) | preferred | shall we have a preferred binding here? | behandlingsorsak Swedish National Medication List - 21.12 | nll-snomed-behandlingsorsak - SIMPLIFIER.NET Snomed CT | ||||
| EHDSMedicationPrescription.prescriptionItem.indicationText | EHDSMedicationPrescription.prescriptionItem.indicationText | 0 | 1 | string | Reason for the prescription in textual form. This might not be allowed by some implementations. | Reason for the prescription in textual form. This might not be allowed by some implementations. | beskrivning annan behandlingsorsak | ||||||
| EHDSMedicationPrescription.prescriptionItem.prescriptionIntent | EHDSMedicationPrescription.prescriptionItem.prescriptionIntent | 0 | 1 | CodeableConcept | Intent of the prescription - prophylaxis, treatment, anesthesia, etc | Intent of the prescription - prophylaxis, treatment, anesthesia, etc | inte i NLL | ||||||
| EHDSMedicationPrescription.prescriptionItem.treatmentPeriod | EHDSMedicationPrescription.prescriptionItem.treatmentPeriod | 0 | 1 | Period | Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.) | Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.) | inte i NLL (är ibland möjlig att räkna ut med hjälp av dosering?) | ||||||
| EHDSMedicationPrescription.prescriptionItem.quantityPrescribed | EHDSMedicationPrescription.prescriptionItem.quantityPrescribed | 0 | 1 | Quantity | Overall quantity of prescribed product (e.g number of packages or number of tablets). | Overall quantity of prescribed product (e.g number of packages or number of tablets). | förskriven mängd Räknas ut av NLL. Antal tabletter, förfyllda sprutor, plåster osv. inte antal förpackningar. Används för att beräkna hur mycket som är kvar på förskrivningen. Hur hantera om någon skickar antal förpackningar? | ||||||
| EHDSMedicationPrescription.prescriptionItem.dosageInstructions | EHDSMedicationPrescription.prescriptionItem.dosageInstructions | 0 | * | https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSDosaging | Dosaging and administration instructions | Dosaging and administration instructions | se "Dosaging" | ||||||
| EHDSMedicationPrescription.prescriptionItem.preparationInstructions | EHDSMedicationPrescription.prescriptionItem.preparationInstructions | 0 | 1 | string | Additional instructions about preparation or dispense | Additional instructions about preparation or dispense | inte i NLL Lite oklart syfte. Finns fritextfält i NLL för kommentarer från förskrivare respektive apotek. | ||||||
| EHDSMedicationPrescription.prescriptionItem.substitution | EHDSMedicationPrescription.prescriptionItem.substitution | 0 | 1 | Base | Whether and which type of substitution is allowed for this medication treatment line | Whether and which type of substitution is allowed for this medication treatment line | |||||||
| EHDSMedicationPrescription.prescriptionItem.substitution.allowed[x] | EHDSMedicationPrescription.prescriptionItem.substitution.allowed[x] | 0 | 1 | boolean CodeableConcept | Whether and to what extent substitution is allowed. | Whether and to what extent substitution is allowed. | substitution tillåten Boolean i NLL. Valfritt att ange. Inget angivet värde tolkas som substitution tillåten. | ||||||
| EHDSMedicationPrescription.prescriptionItem.substitution.reason[x] | EHDSMedicationPrescription.prescriptionItem.substitution.reason[x] | 0 | 1 | CodeableConcept string | Reason for the substitution requirement | Reason for the substitution requirement | inte i NLL | ||||||
| EHDSMedicationPrescription.prescriptionItem.status | EHDSMedicationPrescription.prescriptionItem.status | 1 | 1 | CodeableConcept | Status of a single request/line of the prescription | Status of a single request/line of the prescription | Status finns för hela förskrivningen i NLL. | ||||||
| EHDSMedicationPrescription.prescriptionItem.statusReason[x] | EHDSMedicationPrescription.prescriptionItem.statusReason[x] | 0 | 1 | CodeableConcept string | Reason for the current status of prescription, for example the reason why the prescription was made invalid or why the prescription was changed from previous | Reason for the current status of prescription, for example the reason why the prescription was made invalid or why the prescription was changed from previous | förskrivningsstatusorsak | ||||||
| EHDSMedicationPrescription.prescriptionItem.repeatsAllowed | EHDSMedicationPrescription.prescriptionItem.repeatsAllowed | 0 | 1 | integer | Number of refills authorized | How many times the prescription item can be dispensed in addition to the original dispense. | Förskrivet antal uttag Kan i NLL anges som Number of dispenses allowed eller Number of repeats allowed. | ||||||
| EHDSMedicationPrescription.prescriptionItem.minimumDispenseInterval | EHDSMedicationPrescription.prescriptionItem.minimumDispenseInterval | 0 | 1 | Duration | Minimum Dispense Interval | If a prescription allows for repeated dispensations, the interval between dispensations shall be stated here. | expedieringsintervall Dag, vecka eller månad i NLL: UCUM | ||||||
| EHDSMedicationPrescription.prescriptionItem.offLabel | EHDSMedicationPrescription.prescriptionItem.offLabel | 0 | 1 | Base | Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the drug | Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the drug | |||||||
| EHDSMedicationPrescription.prescriptionItem.offLabel.isOffLabelUse | EHDSMedicationPrescription.prescriptionItem.offLabel.isOffLabelUse | 1 | 1 | boolean | Indicates off-label use. Must be 'true' when .reason is provided. | Indicates off-label use. Must be 'true' when .reason is provided. | inte i NLL Det som finns i NLL är "Obs överstiger rekommenderad dos" (bool) som ligger i doseringen. | ||||||
| EHDSMedicationPrescription.prescriptionItem.offLabel.reason[x] | EHDSMedicationPrescription.prescriptionItem.offLabel.reason[x] | 0 | * | CodeableConcept string | Reason or related clarification for off-label use | Reason or related clarification for off-label use | inte i NLL | ||||||
| EHDSMedicationPrescription.prescriptionItem.comment | EHDSMedicationPrescription.prescriptionItem.comment | 0 | * | string | Additional information or comments | Additional information or comments | förskrivarens kommentar? |
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Dosaging model - EHDS Logical Information Models v0.1.0
Allmänna funderingar
- I NLL har vi många regler kring hur doseringar ska vara strukturerade. Hur ska sådant hanteras här? Modellen är väldigt öppen.
- NLL har ett antal extensions för att bl.a. hantera doseringsscheman. Följande attribut finns i NLL:
doseringsdelsteg
längd doseringsdelsteg + enhet
obs överstiger rekommenderad dos
administreringsinstruktion
medicinteknisk produkt för läkemedelsadmininistrerig
doseringstyp
precisering av administreringsställe
möjlighet till fritext för administreringskoderna
| ID | Path | Min | Max | Type(s) | Short | Definition | Binding Strength | Binding Description | E-hälsomyndigheten | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EHDSDosaging | EHDSDosaging | 0 | * | Dosaging model | Logical model for usage instructions for administring the requested product. Based on FHIR Dosage complex data type. When implemented, this model may be reduced significantly according to the specific use case. | |||||||
| EHDSDosaging.sequence | EHDSDosaging.sequence | 0 | 1 | integer | Order of the dosage instruction, in case one treatment consists of several dosaging schemes | Order of the dosage instruction, in case one treatment consists of several dosaging schemes | sekvens I NLL finns även subsekvens. | |||||
| EHDSDosaging.text | EHDSDosaging.text | 0 | 1 | string | Free text usage/dosage instructions | Free text usage/dosage instructions | fritextdosering | |||||
| EHDSDosaging.additionalInstruction | EHDSDosaging.additionalInstruction | 0 | * | CodeableConcept | Coded instructions, e.g warnings to the patient, like 'may cause drowsiness' etc | Coded instructions, e.g warnings to the patient, like 'may cause drowsiness' etc | annan instruktion Fritext i NLL. | |||||
| EHDSDosaging.patientInstruction | EHDSDosaging.patientInstruction | 0 | 1 | string | Patient oriented instructions as free text | Patient oriented instructions as free text | doseringsinstruktion Strukturerade doseringen omvandlad till patientvänlig text. | |||||
| EHDSDosaging.doseAndRate | EHDSDosaging.doseAndRate | 0 | * | Base | Amount of medication administered per one dose (= one timing) | Amount of medication administered per one dose (= one timing) | ||||||
| EHDSDosaging.doseAndRate.type | EHDSDosaging.doseAndRate.type | 0 | 1 | CodeableConcept | The kind of dose or rate specified (e.g calculated, ordered, etc). | The kind of dose or rate specified (e.g calculated, ordered, etc). | inte i NLL | |||||
| EHDSDosaging.doseAndRate.dose[x] | EHDSDosaging.doseAndRate.dose[x] | 0 | 1 | Quantity Range | Amount of medication per one dose. (1 tablet, 2-3 tablets, 20ml) | Amount of medication per one dose. (1 tablet, 2-3 tablets, 20ml) | dos och dosenhet dos min och dos max och dosenhet min och dosenhet max Swedish National Medication List - 21.12 | Dosenhet (nll-ucum-unit) - SIMPLIFIER.NET | |||||
| EHDSDosaging.doseAndRate.rate[x] | EHDSDosaging.doseAndRate.rate[x] | 0 | 1 | Ratio QuantityRange | Time period during which one defined dose is administered (per 1 hour, per 5-10 minutes) | Time period during which one defined dose is administered (per 1 hour, per 5-10 minutes) | doseringshastighet och doseringshastighetsenhet Ingen range i NLL. Hur ska en sådan användas? | |||||
| EHDSDosaging.timing | EHDSDosaging.timing | 0 | 1 | Base | When medication should be administered (period, time of day, frequency, etc) | When medication should be administered (period, time of day, frequency, etc) | ||||||
| EHDSDosaging.timing.event | EHDSDosaging.timing.event | 0 | * | dateTime | Exact date and/or time of the administration | Exact date and/or time of the administration | inte i NLL | |||||
| EHDSDosaging.timing.code | EHDSDosaging.timing.code | 0 | 1 | CodeableConcept | Timing abbreviation (AM - morning, Q4H - once in every 4 hours, BID - twice a day, etc) | Timing abbreviation (AM - morning, Q4H - once in every 4 hours, BID - twice a day, etc) | inte i NLL | |||||
| EHDSDosaging.timing.repeat | EHDSDosaging.timing.repeat | 0 | 1 | Base | Repetition of the administration. | Repetition of the administration. | ||||||
| EHDSDosaging.timing.repeat.bounds | EHDSDosaging.timing.repeat.bounds | 0 | 1 | Base | Time bounds for the treatment (current dosaging scheme). Only one of the following can exist. | Time bounds for the treatment (current dosaging scheme). Only one of the following can exist. | ||||||
| EHDSDosaging.timing.repeat.bounds.duration | EHDSDosaging.timing.repeat.bounds.duration | 0 | 1 | Quantity | Number of time units, e.g 10 days | Number of time units, e.g 10 days | längd doseringssteg och längdenhet doseringssteg (dag) UCUM | |||||
| EHDSDosaging.timing.repeat.bounds.range | EHDSDosaging.timing.repeat.bounds.range | 0 | 1 | Range | A range of numbers of time units, 5-10 days | A range of numbers of time units, 5-10 days | längd doseringssteg min, längd doseringssteg max längdenhet doseringssteg min, längdenhet doseringssteg max (dag) UCUM | |||||
| EHDSDosaging.timing.repeat.bounds.period | EHDSDosaging.timing.repeat.bounds.period | 0 | 1 | Period | Start and end date, 05.08.2023 - 10.08.2023 | Start and end date, 05.08.2023 - 10.08.2023 | inte i NLL | |||||
| EHDSDosaging.timing.repeat.count | EHDSDosaging.timing.repeat.count | 0 | 1 | Base | Number of times to repeat, exact or range | Number of times to repeat, exact or range | ||||||
| EHDSDosaging.timing.repeat.count.count | EHDSDosaging.timing.repeat.count.count | 0 | 1 | integer | Number of times (e.g 'once', '10 times') | Number of times (e.g 'once', '10 times') | antal upprepningar Används endast för engångsdosering, anges då till 1. | |||||
| EHDSDosaging.timing.repeat.count.countMax | EHDSDosaging.timing.repeat.count.countMax | 0 | 1 | integer | Maximum number of times (e.g 'maximum 10 times') | Maximum number of times (e.g 'maximum 10 times') | inte i NLL | |||||
| EHDSDosaging.timing.repeat.duration | EHDSDosaging.timing.repeat.duration | 0 | 1 | Base | Duration of one administration, exact or range | Duration of one administration, exact or range | ||||||
| EHDSDosaging.timing.repeat.duration.duration | EHDSDosaging.timing.repeat.duration.duration | 0 | 1 | Quantity | Duration of administration (e.g '5 minutes', '1 hour') | Duration of administration (e.g '5 minutes', '1 hour') | administreringstillfällets varaktighet enhet för administreringstillfällets varaktighet (minut och timme) UCUM | |||||
| EHDSDosaging.timing.repeat.duration.durationMax | EHDSDosaging.timing.repeat.duration.durationMax | 0 | 1 | Quantity | Maximum duration of administration (e.g 'maximum 1 hour') | Maximum duration of administration (e.g 'maximum 1 hour') | inte i NLL | |||||
| EHDSDosaging.timing.repeat.frequency | EHDSDosaging.timing.repeat.frequency | 0 | 1 | Base | Frequency of intake/administration (e.g 'three times a day') | Frequency of intake/administration (e.g 'three times a day') | ||||||
| EHDSDosaging.timing.repeat.frequency.numberOfTimes | EHDSDosaging.timing.repeat.frequency.numberOfTimes | 0 | 1 | integer | Number of times per period (e.g '3 times') | Number of times per period (e.g '3 times') | antal administreringar | |||||
| EHDSDosaging.timing.repeat.frequency.maxNumberOfTimes | EHDSDosaging.timing.repeat.frequency.maxNumberOfTimes | 0 | 1 | integer | Maximum number of times per period (e.g. 'maximum 3 times') | Maximum number of times per period (e.g. 'maximum 3 times') | antal administreringar max | |||||
| EHDSDosaging.timing.repeat.frequency.period | EHDSDosaging.timing.repeat.frequency.period | 0 | 1 | Quantity | Duration to which the frequency applies (e.g '... / 1 day') | Duration to which the frequency applies (e.g '... / 1 day') | period periodenhet (dag, timme) Swedish National Medication List - 21.12 | Periodenhet (dose-period-units) - SIMPLIFIER.NET UCUM | |||||
| EHDSDosaging.timing.repeat.frequency.periodMax | EHDSDosaging.timing.repeat.frequency.periodMax | 0 | 1 | Quantity | Upper limit of the period (e.g ... / 4-6 hours) | Upper limit of the period (e.g ... / 4-6 hours) | period max | |||||
| EHDSDosaging.timing.repeat.dayOfWeek | EHDSDosaging.timing.repeat.dayOfWeek | 0 | * | CodeableConcept | The day of the week of administration, e.g Mon, Tue, etc | The day of the week of administration, e.g Mon, Tue, etc | veckodag | |||||
| EHDSDosaging.timing.repeat.timeOfDay | EHDSDosaging.timing.repeat.timeOfDay | 0 | * | time | Time of day of administration (e.g '10:00') | Time of day of administration (e.g '10:00') | klockslag | |||||
| EHDSDosaging.timing.repeat.eventTime | EHDSDosaging.timing.repeat.eventTime | 0 | * | Base | An event the administration is bound to, e.g 'before meal', '30 min before meal' | An event the administration is bound to, e.g 'before meal', '30 min before meal' | ||||||
| EHDSDosaging.timing.repeat.eventTime.when | EHDSDosaging.timing.repeat.eventTime.when | 0 | * | CodeableConcept | Time period or event ('before meal', 'immediately', 'morning') | Time period or event ('before meal', 'immediately', 'morning') | period på dygnet (morgon, lunchtid, kväll, natt) Swedish National Medication List - 21.12 | Period på dygnet (nll-event-timing) - SIMPLIFIER.NET | |||||
| EHDSDosaging.timing.repeat.eventTime.offset | EHDSDosaging.timing.repeat.eventTime.offset | 0 | 1 | integer | minutes from event, before or after (?not sure how to show before/after with only positive integers) | minutes from event, before or after (?not sure how to show before/after with only positive integers) | inte i NLL | |||||
| EHDSDosaging.asNeeded | EHDSDosaging.asNeeded | 0 | 1 | boolean | Take as needed | Take as needed | vid behov | |||||
| EHDSDosaging.asNeededFor | EHDSDosaging.asNeededFor | 0 | * | CodeableConcept | Take as needed for the coded reason | Take as needed for the coded reason | inte i NLL | |||||
| EHDSDosaging.bodySite | EHDSDosaging.bodySite | 0 | 1 | CodeableConcept | Body site of administration | Body site of administration | administreringsställe Swedish National Medication List - 21.12 | nll-snomed-site - SIMPLIFIER.NET Snomed CT | |||||
| EHDSDosaging.routeOfAdministration | EHDSDosaging.routeOfAdministration | 0 | 1 | CodeableConcept | Route of administration | Route of administration | administreringsväg Swedish National Medication List - 21.12 | nll-snomed-route - SIMPLIFIER.NET Snomed CT | |||||
| EHDSDosaging.methodOfAdministration | EHDSDosaging.methodOfAdministration | 0 | 1 | CodeableConcept | Method of administration | Method of administration | administreringsmetod Swedish National Medication List - 21.12 | nll-snomed-method - SIMPLIFIER.NET Snomed CT | |||||
| EHDSDosaging.maxDose | EHDSDosaging.maxDose | 0 | * | Base | Maximum dose for the patient | Maximum dose for the patient | ||||||
| EHDSDosaging.maxDose.maxDosePerPeriod | EHDSDosaging.maxDose.maxDosePerPeriod | 0 | * | Ratio | Upper limit on medication per unit of time | Upper limit on medication per unit of time | maxdos maxdosenhet Swedish National Medication List - 21.12 | Dosenhet (nll-ucum-unit) - SIMPLIFIER.NET maxdosperiod maxdosperiodenhet (endast dygn) | |||||
| EHDSDosaging.maxDose.maxDosePerAdministration | EHDSDosaging.maxDose.maxDosePerAdministration | 0 | 1 | Quantity | Upper limit on medication per one administration | Upper limit on medication per one administration | inte i NLL | |||||
| EHDSDosaging.maxDose.maxDosePerLifetime | EHDSDosaging.maxDose.maxDosePerLifetime | 0 | 1 | Quantity | Upper limit on medication per lifetime of the patient | Upper limit on medication per lifetime of the patient | inte i NLL |
...