Obtain MedicationStatements related to a MedicationOrder

[Federico Nieto]

Hi, we are working on a provider facing app and would like to obtain all the MedicationStatements for a given MedicationOrder.

In the Smart Health IT sandbox, we can fetch that information by passing the search parameter `code` to the MedicationStatement search request. This code we pass is the MedicationOrder.medicationCodeableConcept code.  

As we can see, this is not supported for the Cerner sandbox. Are we right? Is there any way of achieving this in the Cerner sandbox?

Thanks in advance, 
Fede.

[Jenni Syed (Cerner)]

Fede,

In our sandbox, there would only ever be 1 Statement per Order (prior statements about that order are "history"). To identify which MedicationOrder a statement is tied to, you would look at the MedicationStatement.supporting information: https://fhir.cerner.com/millennium/dstu2/medications/medication-statement/#overview

You can see an example of this in the search example response: https://fhir.cerner.com/millennium/dstu2/medications/medication-statement/#example

Note: searching by code wouldn't necessarily link you to the statement for a specific order. In real usage, we've seen patients with multiple orders for the same medication (sometimes different dosage, other times it's the expired prescription/an old order).

Regards,

Jenni

[Federico Nieto]

Hi Jenni,

Thanks I can now show the Statement related to a MedicationOrder by filtering the statements with the reference to the medicationOrder. As I said, I'm trying to create a medicationStatement. So for example, ff there is a statement created for a medicaitonOrder for the patient Wilma Smart what happens if I try to create another statement for that medicationOrder? 

[Federico Nieto]

When I try to create a medicationStatement for Wilma Smart the status of the response is 400 Bad Request and the X Request ID is the following: "f36cb8dc7391240e7d5e3e80d536ebc4" .

Thanks!
Fede.

[Max Philips (Cerner)]

Hi Fede,

You should have seen the error message "medicationReference: cannot be blank" returned in the response body for that request.

Thanks,

Max (Cerner)

[Jenni Syed (Cerner)]

Fede,

Creating a new MedicationStatement won't associate it to an existing statement/order. That would be done by updating the existing statement. However, we do not allow updates to statements that are associated to actual prescriptions right now. This starts to get into compliance, which isn't supported well via FHIR's MedicationStatement resource.

In the create documentation, you can see that the supportingInformation field is not currently supported: https://fhir.cerner.com/millennium/dstu2/medications/medication-statement/#body-fields

I've logged an issue to get the documentation for create and update clarified that it's intended use is to update statements about home or historical medications rather than prescription/orders.

~ Jenni

[Federico Nieto]

Thanks Max and Jenni,

So from what I understand there is no way we can add new medicationStatements for a given medicationOrder in Cerner. 

Thanks,
Fede.