Comment

Highly support and agree with the addition of this new data element. This will ensure patient safety during medication administration and when exchanging information, the receiver will have full image of medication.

CDC's Consolidated Comment for USCDI v5

 

• “Directions for administering or taking a medication. Examples include but are not limited to prescription directions for taking a medication, and package instructions for over-the-counter medications. Usage notes: May include route, quantity, timing/frequency, and special instructions (PRN, sliding scale, taper).”
• As a new addition in USCDI v4 Standards, the data element “Medication Instructions” includes information on prescription medication route, quantity dispensed, timing/frequency and instructions on use, e.g. PRN, in a single field. This information is essential for a more complete understanding of the medication usage; information on the dose, alone, does not fully quantify the amount or duration of use of the medication. However, unstandardized text in a combined field will have limited utility as the content and format may vary by data source and each piece of information will be difficult and resource-intensive to extract. CDC suggests standardized, separate variables for route of administration, quantity (or, alternatively, days’ supply), frequency, and unit of frequency, in addition to a text field with special instructions.

NACCHO Comment: Support - Separate elements will ensure that LHDs receive coded values, rather than combined text. This will reduce the burden of data preparation on LHDs.

NCPDP Comment

NCPDP recommends updating the data element definition to “Directions for administering or taking a medication including route of administration (e.g., oral), dose quantity (e.g., take 1 pill), timing or hours of administration (e.g., once a day or every 12 hours), special instructions (e.g., as needed, for pain, for cough)

• Include several specific components:
  • Route of administration
  • Dose quantity
  • Timing or hours
  • Special instructions
  • Duration”

THIA Comment on Medications: Medication Instructions

The Texas Health Informatics Alliance (THIA) Policy and Standards Working Group supports the proposal for medication instructions. It is important to know if medications have been changed at discharge. It is frustrating for end-users to have to reconcile medications from outside entities. Patients can bring their discharge paperwork, but discharge paperwork is often lost during the follow-up process. The proposal for medication instructions may make it easier for physicians when receiving an accurate medication list from other institutions.

If it's good enough for US Core...

Considering MedicationRequest and most of its elements are Must Support in US Core, and the central aspect of prescription records in healthcare, I'm surprised that this isn't bread and butter part of USCDI