Submitted by kelly.clarke@j… on
Comment
Recommend adding Medication Start Date and Medication End Date as data elements. This will ensure patient safety during medication administration and support the future of FHIR resources.
Pharmacologic agents used in the diagnosis, cure, mitigation, treatment, or prevention of disease.
Data Element |
Applicable Vocabulary Standard(s) |
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Medications
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Data Element |
Applicable Vocabulary Standard(s) |
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Medications
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Data Element |
Applicable Vocabulary Standard(s) |
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Medications
Pharmacologic agent used in the diagnosis, cure, mitigation, treatment, or prevention of disease. |
Optional:
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Dose
Amount of a medication for each administration. |
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Dose Units of Measure
Units of measure of a medication. (e.g., milligrams, milliliters) |
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Indication
Sign, symptom, or medical condition that leads to the recommendation of a treatment, test, or procedure. |
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Fill Status
State of a medication with regards to dispensing or other activity. (e.g., dispensed, partially dispensed, not dispensed) |
Data Element |
Applicable Vocabulary Standard(s) |
---|---|
Medications
Pharmacologic agent used in the diagnosis, cure, mitigation, treatment, or prevention of disease. |
Optional:
|
Dose
Amount of a medication for each administration. |
|
Dose Unit of Measure
Unit of measure of a medication. Examples include but are not limited to milligram (mg) and milliliter (mL). |
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Indication
Sign, symptom, or medical condition that is the reason for giving or taking a medication. |
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Fill Status
State of a medication with regards to dispensing or other activity. Examples include but are not limited to dispensed, partially dispensed, and not dispensed. |
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Medication Instructions
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). |
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Medication Adherence
Statement of whether a medication has been consumed according to instructions. Examples include but are not limited to taking as directed, taking less than directed, and not taking. |
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Data Element |
Applicable Vocabulary Standard(s) |
---|---|
Medications
Pharmacologic agent used in the diagnosis, cure, mitigation, treatment, or prevention of disease. |
Optional:
|
Dose
Amount of a medication for each administration. |
|
Dose Unit of Measure
Unit of measure of a medication. Examples include but are not limited to milligram (mg) and milliliter (mL). |
|
Route
Physiological administration path of a therapeutic agent into or onto a patient. Examples include but are not limited to oral, topical, and intravenous. |
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Indication
Sign, symptom, or medical condition that is the reason for giving or taking a medication. |
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Fill Status
State of a medication with regards to dispensing or other activity. Examples include but are not limited to dispensed, partially dispensed, and not dispensed. |
|
Medication Instructions
Directions for administering or taking a medication. Usage note: May include route, quantity, timing/frequency, and special instructions Examples include but are not limited to prescription directions for taking a medication, and package instructions for over-the-counter medications. |
|
Medication Adherence
Statement of whether a medication has been consumed according to instructions. Examples include but are not limited to taking as directed, taking less than directed, and not taking. |
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Data Element |
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Data Element |
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Submitted by kelly.clarke@j… on
Recommend adding Medication Start Date and Medication End Date as data elements. This will ensure patient safety during medication administration and support the future of FHIR resources.
Submitted by yale-coredQMRoadmap on
Management of medications is critical to patient care and coordination between providers, as well as related quality and public health enterprises. The current concept of medications in USCDI does not differentiate among medications that are active, ordered, and actually administered/prescribed to the patient. Given these complexities, more clarity and structure are necessary in this data class to accurately evaluate and provide clinical care.
We continue to urge adding more specificity to the USCDI Medications Data Class. These medication data elements are necessary for understanding adverse drug events, opioid use and misuse, and medication access.
The highlighted additional data elements serve the ONC USCDI v4 stated priorities related to mitigating health inequities and disparities, addressing needs of underserved populations, and addressing public health reporting needs.
Submitted by pwilson@ncpdp.org on
For all of data elements under Medication data class in Level 2, NCPDP recommends a review and restructure because it currently creates confusion and potential duplication.
Submitted by joshualegler on
Consider adding data elements for:
This comment is submitted on behalf of the National Emergency Medical Services Information System (NEMSIS) Technical Assistance Center.
Submitted by jenna.stern on
Vizient recommends adding the below Level 2 data elements to USCDI v3 to the Medications class. In support of these additions, use cases are also provided for consideration:
o Medication Administration: This allows for further insight and analyses of which medications were administered within visits.
o Negation Rationale: This will allow for analyses as to what medication orders are being placed and then subsequently cancelled on a regular basis in addition to why they are being cancelled.
o Dosage: This information allows for sharing of detailed dose information to patients and other parties rather than simple medication name which can lead to additional insights on dosing patterns.
o Discharge Medications: This distinguishes which medications were prescribed for a patient to start/continue from the point of discharge and minimize confusion with medications prescribed as an inpatient.
o Medications Dispensed: The allows for differentiation of which ordered medications were actually dispensed (e.g., generic). This may be different from what was ordered or administered as it is the result of a pharmacy system responding to a medication order.
Submitted by Lantana Consul… on
The details of prescribing, dispensing, and administering medications are essential to patient care, care coordination, and quality measurement. Adverse drug events and opioid use/misuse is difficult to properly evaluate without the specifics of when a medication was administered or prescribed.
Relying on Medication Request as the only USCDI medication data element limits the representation of medication exposure in healthcare data in the U.S and provides a distorted and inaccurate picture of the medication workflows in the healthcare system. A medication request is the clinician’s prescription but is a separate event from dispensing and administering the medication. A different medication may be dispensed or administered.
We support data elements for full range of medication events to support public health, regulatory, research, and pandemic response. Lantana recommends the following elements for inclusion in USCDI V3:
The current Medication data elements specify the actual medication but does not differentiate medication order, medication administrations, and medication dispensing activities. It also does not provide information about when the medication was ordered, dispensed, and administered to the patient.
The current MedicationRequest profile should emphasize that it represents requests or orders. The MedicationAdministration profile which would represent medications received at the hospital remains at USCDI Level 2 which impedes accurate medication data collection.
Submitted by aphillips@imoh… on
Data Elements for Medications: Meet Level 2 Critiera
These data elements are incorporated in eCQMs reported in CMS quality programs, represented in implemented terminology specifications, and incorporated in requirements for ONC Certified HIT.
Data Elements for Medications: Do Not Meet Level 2 Critiera
The following technical specifications are cited in support of proposed Level 2 data elements. These technical specifications vary in maturity and do not yet have widespread implementation in ONC Certified Health IT. Specifications include:
As the technical specifications that include these proposed data elements mature and are implemented in production environments these data elements could be reconsidered in future versions of USCDI.
Submitted by palapal on
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime provides total drug management solutions for health plans, employers, and government programs including Medicare and Medicaid. We serve nearly 33 million people and are collectively owned by 19 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans.
Prime Therapeutics requests ONC add National Drug Code (NDC) as an identifier for medications all. RXNORM codes do not contain the specificity to identify specific drug manufacturer, all the active and inactive ingredients, etc.
Submitted by sg999 on
Management of medications is critical to patient care and coordination between providers, as well as related quality and public health enterprises. The current concept of medications in USCDI Draft version 3 does not differentiate those that are active, ordered, or actually administered to the patient, and do not provide necessary details for patient safety (i.e., dose and route). Medication details support an ONC criteria for public health reporting and investigation including using data to support safer use of opioids.
CMS-CCSQ recommend the following Medication data elements be added to Final USCDI v3:
Maturity:
Submitted by EmoryHealthcare on
Medications Data Class - L2 Data Elements as of 9.20.2023