Uniqueness of records / ICD convention

[Sakthithasan Sripirakas1]

Hi there,

We have recently accessed data about patients and medications from CERNER sandbox. Based on our analysis on the data, we would like to clarify the following:

* Medication has the attribute 'code' which is based on SNOWMED convention. Similar code is used for disease too. We are curious to know if ICD codes are also available for the above? If not, is there a way to map SNOWMED to ICD codes?

* The medication statement seems to contain almost identical records with minor changes to timestamp. We would like to know why it is replicated in this way?

* Can we be assured that the ingredients of a medication is a complete list provided by the manufacturer in all circumstances? If not, what are the exceptions?

 

Thank you for your support with clarifying the above questions.

Sri.

[Fenil Desani (Cerner)]

Hello,

Cerner's FHIR APIs for R4, have only implemented the MedicationRequest resource as of today - http://fhir.cerner.com/millennium/r4/clinical/medications/medication-request/

And the Terminology Bindings are http://fhir.cerner.com/millennium/r4/clinical/medications/medication-request/#terminology-bindings

We will get back to you on the ingredients part.

Thank You,

Fenil

[Kathy Pickering (Cerner)]

Hello Sri,

Currently, Medication.code only supports RxNorm.  MedicationOrder and MedicationStatement are very similar resources.  Timestamps for comparable fields will be the same.  All medications (ordered and historical) are returned in MedicationStatement where as only ordered medications return in MedicationOrder in DSTU2.

The ingredients in the list are complete.

Kathy (Cerner)

[Sakthithasan Sripirakas1]

Thanks @Kathy and @Fenil for your responses.

I have some follow up questions:

• Would it be possible for us to know when we could expect other elements such as MedicationKnowledge and MedicationStatement will be implemented?

• Are the elements under the sections Base (such as Patient, Practitioner, RelatedPerson, Person) , Clinical (such as AllergyIntolerance, Condition, Procedure, FamilyMemberHistory) and Financial in the documentation at http://fhir.cerner.com/millennium/r4/ fully implemented already?

• Can we safely assume that whenever a coding system is used, it is specified in the response? For example, for Condition.severity, we get the following in the response. 

              "coding": [ { "system": "http://snomed.info/sct", "code": "255604002", "display": "Mild" } ]. 

               It contains the "system" used along with the "code". Is this how codes are always returned in the responses?

Thanks again,

Sri.

[Fenil Desani (Cerner)]

Hello,

• As per group guidelines, we cannot comment on timelines
• Unless otherwise stated, all resources are fully functional.
• Yes, if a coding system is associated, then you would get that back in the response. The code can be either a standard code or a proprietary code - http://fhir.cerner.com/millennium/r4/clinical/summary/condition/#terminology-bindings

Thanks,

Fenil