Questions about PHARM-PML profile (STATUS field)
Ibaa Hanbali
SPAHNI Stéphane
Hello,
I would recommend to go for CMPD Workflow Scenario 1 (Including a validation step by a Pharmaceutical Adviser) and consider the following PADV Pharmaceutical Advice Status for changing the status of the prescription:
* None --> Requested status
* CANCEL --> Cancelled status
* OK, CHANGE --> Approved or validated status (exact meaning of each to be clarified)
* REFUSE --> Rejected status
What is the difference between "Approved" and "Validated"? If you need both and only one means "ready to be dispensed", you may use the "COMMENT" for the status "not ready to be dispensed" and "OK" or "CHANGE" for the stage "ready to be dispensed". If both
means ready to be dispensed, what is the reason for having two status?
Best regards,
Stéphane
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Stéphane Spahni, PhD
Systems Architect
University Hospitals of Geneva
Division of eHealth and telemedicine
4, rue Gabrielle-Perret-Gentil
CH-1211 Geneva 14
Switzerland
Tel +41 22 37 26 278
Web http://www.hug-ge.ch/cybersante-et-telemedecine
Ibaa Hanbali
SPAHNI Stéphane
There is no such field currently available in the CDAs. Computing the state is the role of CMPD actor, a PRE is not republished when it is confirmed.
I think you may add a custom field as part of a national extension.
Stéphane
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Jürgen Brandstätter
Hi,
just a bit of addtional background out of the making of CMPD, PRE, PML, … :
Yes, accrording to the concept we figured out, the status of a prescription (PRE) is about to be "determined" (computed), since it's depending on the actions which happend from its placement up to the point of time you are now. And be aware that it might be different 1 hour later, because some new action has happened on it.
So, for example, at some point of time, some prescription items on the prescription could be dispensed, some partially dispensed, some not dispensed at all because they were not available, thus the status of the PRE would be something like "incomplete" - but 1 day later, all of them are finally dispensed and the the status of the PRE would be something like "complete".
You see, even to find correct names for all status-possibilities is difficult :)
This means that the status of a prescription (PRE) is something very dynamic and thus we decided to craft the concept in the way, that it needs to be "determined" every time, rather than that we "persist" it into the document.
So, we intentionally(!)have not foreseen a status-data element in the content structure of a PRE document (of prescription items within) because we considered it as too complex. If such a status-data element would be present at a PRE document (and the status is persistet in it), it would change the whole concept we have figured out. In that case, the prescription document needs to be updated at every time of the workflow lateron, by for example the Pharmaceutical Advisor issuing PADV(s) to it or Dispensers issueing DIS(es) to it. As a consequence all of those would need to have the permission to update that document and other implications -> that's why we decided against it.
But be aware that it must be clearly distinguished between the PRE document (including one to many prescription items) and a single prescription item within, which can also be a part of a PML. All what I wrote so far relates mainly to the PRE document!
The case is slightly different, if we talk about a single "prescription item" which is delivered in a PML (= outside of a PRE).
It could be considered to flag these prescription items with a persistent status data-element, but you must be aware that be doing so, you are "freezing" the status of the prescription item in that PML document to the status is had at the point of time of the creation of the PML.
So basically we have to scenarios here:
Scenario 1) Current: PML carries prescription items with NO persisted status: The PML is created at a specific point of time, but the status of the prescription-items within are determined at the point of time the PML is viewed(!) -> Viewing one and the same PML might result into a DIFFERENT picture over time.
Scenario 2) Your intention: PML carries prescription items WITH persisted status: The PML is created at a specific point of time, and status of the prescription-items within are permanentely carrying the status they had at the point of creation -> Viewing one and the same PML might result into the SAME picture every time.
If that important characteristic is ok with your implementation, just go for it.
Finally, thanks for bringing that up. Scenario (2) seems to be a requirement of a real implementation.
-> I think it could be worth to discuss that thought within the IHE Pharmacy group - perhaps it would be a meaningful upgrade to our profiles.
Thoughts?
Greetings,
Jürgen
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