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IHE Pharmacy domain Conjunction and Differences to epSOS

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

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  1. IHE Pharmacy domainConjunctionandDifferencestoepSOS Jürgen Brandstätter IHE Pharmacy co-chair

  2. 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

  3. IHE Pharmacy – Key process Validation oftheprescription (ICA check) Not for Community Pharmacy

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. Differences Summary • Differences in Architecture and Process • Differences in Prescription Document structure • Differences in Dispense Document structure

  10. Differences in Architecture IHE Pharmacy NCP A NCP B PRE A B DIS epSOS

  11. 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.

  12. Differences in PRE

  13. Differences in DIS

  14. Content structure in PRE and DIS

  15. 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

  16. Thank you Jürgen Brandstätter IHE Pharmacy co-chair CodeWerk Software Services and Development GmbH j.brandstaetter@codewerk.at

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