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IHE Pharmacy domain Conjunction and Differences to epSOS. Jürgen Brandstätter IHE Pharmacy co-chair. Introduction. 5 profiles for … … Community Pharmacy CMPD Community Medication Prescription and Dispense PRE Content Profile: Medication Prescription

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ihe pharmacy domain conjunction and differences to epsos

IHE Pharmacy domainConjunctionandDifferencestoepSOS

Jürgen Brandstätter

IHE Pharmacy co-chair

introduction
Introduction
  • 5 profilesfor …
    • … Community Pharmacy
      • CMPD Community MedicationPrescriptionand Dispense
      • PRE Content Profile: MedicationPrescription
      • PADV Content Profile: PharmaceuticalAdvice
      • DIS Content Profile: Medication Dispense
    • … Hospital Pharmacy
      • HMW Hospital Medication Workflow
slide3

IHE Pharmacy – Key process

Validation oftheprescription

(ICA check)

Not for Community Pharmacy

common data model
Common Data Model
  • Data Model describe the data elements and their relations
  • Common for hospital pharmacy and community pharmacy
  • Derived from the model: HL7v2 messages and CDA documents
    • HL7v2, Version 2.5/2.6
    • HL7v3 CDA
      • HL7v3 Pharmacy CMETs

Not for Community Pharmacy

community pharmacy profiles
Community Pharmacy profiles

Existing Profiles with High Uptake

  • CMPD (Community Medication Prescription and Dispense)
    • Basic use case
      • GP prescribes
      • Pharmacist validates the prescription
      • Community pharmacist or pharmacy dispenses
    • Systems it would impact:
      • Prescription placer module in GP systems
      • Pharmaceutical validation software
      • Pharmacy software
    • Based on IHE ITI XDS:
      • Strong integration with existing CDA/XDS-based solutions

+ PRE Medication Prescription

+ PADV Pharmaceutical Advice

+ DIS Medication Dispense

genealogy
Genealogy
  • First profile development
    • Conjunction with epSOS
      • Contact to epSOS is maintained, communication flows to and fro
      • Decision for „Document based“ architecture aligned to epSOS
      • Same approach to use Pharmacy CMETs embedded in CDA for Prescription and Dispense Document
      • Same LOINC codes for PRE and DIS docs and section
      • 90% of the content constraints for the PRE and DIS section and entries
        • 1..n Prescription items within PRE
        • 1..1 Dispense item within DIS(?? ambigous specification in Impl. Guide)
        • Linkage to Prescription item in DIS
genealogy1
Genealogy
  • First profile development
    • Differences to epSOS
      • Document headers and addtional sections (to Prescription and Dispense section)
        • IHE Pharmacy allows more additional information
        • IHE strictly conforms to other IHE Content templates
      • Introduction of Pharmaceutical Advice (PADV)
        • Approvement and Steering of status to be able to manage partly-dispensed Prescriptions
      • Introduction of CMPD for the process
        • Process differs significantly in epSOS by excluding the „Approvement step“
        • Partly-dispensed Prescriptions are not supported in epSOS
genealogy2
Genealogy
  • Duringtworevisionsof IHE Pharmacy
    • ContacttoepSOSisgettingless, communicationmoreandmorereduced
      • AlignmenttoepSOSreducedbecauseepSOS Implementation guidebecamestableand IHE developmentproceeded
    • DifferencestoepSOS
      • Differences in contentconstraintsforthe PRE and DIS sectionandentriesincreasewitheveryrevision
      • IHE clarifiessomedetailedissueswith HL7 andcorrectserrors in specification
differences summary
Differences Summary
  • Differences in Architecture and Process
  • Differences in Prescription Document structure
  • Differences in Dispense Document structure
differences in architecture
Differences in Architecture

IHE Pharmacy

NCP

A

NCP

B

PRE

A

B

DIS

epSOS

differences in architecture1
Differences in Architecture

PrescriptionPlacer

PharmaceuticalAdviser

MedicationDispenser

Next task:

„Validation“

Validation

Next task:

„Dispensing“

Dispensing

Ordering

Condition: Always

Condition: if PADV exists with

statusCode=completed

AND

code=OK or CHANGE

Next task:

„Ordering“

Condition: if PADV exists with

statusCode=completed

AND

code=REFUSE

Stop

Condition: if PADV exists with

statusCode=completed

AND

code=CANCEL

PHARM-1 , Query:

FindPrescriptionsForDispense

PHARM-1, Query: FindPrescriptionsForValidation

  • Prescription document contains at least one Prescription Item ready to be validated.
    • A Prescription Item is ready to validate if there exists no Pharmaceutical Advice Item related to it which has statusCode set to “completed”.
  • Prescription document contains at least one Prescription Item ready to be dispensed.
    • A Prescription Item is ready to dispense if there exists a Pharmaceutical Advice Item related to it which has statusCode set to “completed” and code=OK or CHANGE.
links
Links
  • Technical Frameworks
    • http://www.ihe.net/Technical_Framework/index.cfm#pharmacy
  • Pharmacy Wiki
    • http://wiki.ihe.net/index.php?title=Pharmacy
    • Strategic planning page
      • http://wiki.ihe.net/index.php?title=PHARM_Strategic_Planning
    • Roadmap
      • http://wiki.ihe.net/index.php?title=PHARM_Roadmap
    • Committees
      • http://wiki.ihe.net/index.php?title=Pharmacy_Planning_Committee
      • http://wiki.ihe.net/index.php?title=Pharmacy_Technical_Committee
  • Google group
    • http://groups.google.com/group/ihe-pharmacy
thank you
Thank you

Jürgen Brandstätter

IHE Pharmacy co-chair

CodeWerk Software Services and Development GmbH

j.brandstaetter@codewerk.at