Supporting SNapp: Lists of medications

In this post we’re going to look at representing the Medication List using a List resource as part of supporting the SNapp event at the SNOMED conference in New Zealand next month. As we discussed in the last post – this is a preferable, albeit more complex way than just using queries against MedicationStatement resources.

To understand how this works, take a look at this image:

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It’s a screen dump from clinFHIR that shows how the List resource in the middle of the graph refers to the individual MedicationStatement resources that are part of the List (as well as the patient). Yes, I know, I really need to work on those colours! Oh, and BTW take a look at this post to see how you can create your own sample patients on a FHIR server

What you can see is that you still need the individual MedicationStatement resources that represent each medication, but you now have an additional resource that adds the extra information about the list – e.g.

  • When the list was created, and by whom.
  • Type of list eg a comprehensive review of all mediations, or just updating it in the context of a specific event (an antibiotic for a fixed period)
  • Medications that have been stopped in this review (you can indicate why they were stopped using an extension)
  • Notes about the list

And we can be explicit about stating that the patient is not taking any medications (as far as we know), plus versioning of the list as it changes.

So lets see how we can do that.

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Managing the Medication List in SNapp, part 1.

So, in the last post we talked about setting up a FHIR server, and populating it with some sample data. Let’s turn our attention now to how we would interact with that server in the context of a ‘Medication List’, and we’ll use the STU-3 release candidate (as used at the recent Baltimore connectathon) as the basis of the discussion, though this should work just as well in older versions.

(Our discussion will generally apply to other lists – such as Allergies and Problem lists – though it’s not uncommon for there to be multiple Problem Lists for a patient that are ‘clinician focussed’ e.g. the list of significant problems from the perspective of a respiratory physician tends to be different to that from the perspective of an orthopedic surgeon. But I digress…)

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Supporting the SNOMED SNAPP hackathon

So there’s a ‘hackathon’ (I actually don’t like that word) associated with the SNOMED conference in Wellington next month. They’re calling it a ‘SNAPP’ event (SNOMED App) – which is much nicer!

As part of supporting this event, HL7 New Zealand is going to stand up a server that can be used for the ‘My List of Medicines’ challenge. (The other challenge – Machine Mapping – is a bit esoteric for me).

So there are a couple of things we need to do.

  • Stand up a FHIR server for participants to use that can respond to appropriate requests (we’ll talk about what they will be in the next post).
  • Populate that server with the sample data given on the web site

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Baltimore Working Group Meeting

Well, the Baltimore Working Group Meeting is finished – and what a time it was!

For me the WGM was all about Connectathons – one way or another.

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FHIR and Version 2: the Location

So last week  Simone Heckman  (CTO of Gefyra GmbH) wrote a piece in the FHIR chat in response to a query about mapping data from an HL7 v2 message into FHIR – specifically about representing the location of a patient as shown in the PV1 segment of the message into FHIR resources. It was a great response so I asked her if I could repeat it here and she was kind enough to not only say yes, but also beef it up a bit!

Over to you Simone…

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Terminology services

Just a short post to call peoples attention to terminology services in FHIR. Rob Hausam (who co-ordinates the Terminology track at the connectathon) made the excellent comment in the Zulip chat that terminology is a ‘cross-cutting’ concern that can be integrated into many different applications – and tracks at connectathon.

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