Submitted by jenna.stern on 2022-04-29
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. |
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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. |
|
Dose
Amount of a medication for each administration. |
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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, 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. |
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Medication Adherence
Medication is consumed according to instructions. Examples include but are not limited to taking as directed, taking not as directed, and not taking. |
Data Element |
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Comment
Submitted by Lantana Consul… on 2022-04-29
Lantana Consulting Group Comment
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:- Medication Administration
- Code
- Performer
- Reason Reference
- Date/DateTime
- Medication Prescribed
- Code
- Date
- Reason Reference
- Medication Dispensed
- Discharge Medications (Medication Request)
- Dosage
- Dosage/Route
- Administered Dose
- Administered Dose Units
- Prescribed Dose
- Prescribed Dose Units
- Negation Rationale
Submitted by aphillips@imoh… on 2022-04-28
Data Class: Medications
IMO would like to note while many the proposed Level 2 data elements for the Medication data class are collected and exchanged by ONC certified HIT, not all the proposed Level 2 data elements meet ONC criteria for inclusion in USCDI V3. We have categorized our review of the proposed data elements by these criteria. 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.- Level 2 Data Element: Medication Administration
- Level 2 Data Element: Negation Rationale
- Level 2 Data Element: Dosage
- Level 2 Data Element: Discharge medications
- Level 2 Data Element: Date Medication Prescribed
- Level 2 Data Element: Medication Prescribed Code
- Level 2 Data Element: Medication Prescribed Dose
- Level 2 Data Element: Medication Prescribed Dose Units
- Level 2 Data Element: Date Medication Administered
- Level 2 Data Element: Medications Dispensed
- Level 2 Data Element: Medication Request
- Level 2 Data Element: Medication Statement
- FHIR US Core MedicationRequest Profile - FHIR v4.0.1
- FHIR US Core MedicationStatement Profile - FHIR v4.0.1
- HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) Release 1, STU Release 3.0
- Making EHR Data More Available for Research and Public Health (MedMorph) Reference Architecture
- Level 2 Data Element: Therapeutic Medication Response
- Level 2 Data Element: Medication Prescription Do-Not-Perform
- Level 2 Data Element: Medication Prescription Status
- Level 2 Data Element: Medication Prescription Patient
- Level 2 Data Element: Medication Knowledge
- Level 2 Data Element: Medication Administration Status
- Level 2 Data Element: Medication Administered Performer
- Level 2 Data Element: Medication Prescribed Reason Reference
- Level 2 Data Element: Reported Medication (unique)
Submitted by palapal on 2022-04-22
Prime Therapeutics Comments on USCDI V3
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 2022-03-22
CMS-CCSQ Continued Support of Medication data elements: USCDI v3
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:- Medications Administration/Medication Administered Code; defined as a code (or set of codes) that specifies the medication administered to a patient
- Medications Dispensed; defined as a code (or set of codes) that specifies the medication dispensed
- Discharge Medications; specifies the medication(s) active at discharge which should be taken by the patient upon release from a facility
- Dosage (and route); defined as the dose and route instructions for medications
- Current standards:
- In FHIR US Core, there is a distinction between Medication and MedicationRequest; base FHIR and FHIR QI Core IG includes MedicationAdministration and MedicationDispense profiles.
- Within MedicationRequest, the ‘category’ is used to define discharge medications.
- Dose and route instructions are also contextualized within the MedicationRequest, MedicationAdministration, and MedicationDispense profiles in US/QI Core IGs.
- Current uses, exchange, and use cases: Medication data is routinely captured in EHR systems used by hospitals, providers, and other healthcare stakeholders including pharmacies. Medication details are routinely exchanged across providers and payers. Medication data is used extensively in CMS quality measurement. Additionally, when prior authorization is necessary for a medication, details related to the medication (e.g., why the medication is given, the quantity needed) are exchanged to support the approval process.
Submitted by sg999 on 2021-09-28
CMS-CCSQ Support for Medication data elements for USCDI v3
CMS-CCSQ recommend the following Medication data elements be added to USCDI V3:- Data Element: Medication Administration; defined as a code (or set of codes) that specifies the medication administered to a patient.
- Data Element: Discharge Medications; specifies the medication(s) active at discharge which should be taken by the patient upon release from a facility.
- Data Element: Medications Dispensed; defined as a code (or set of codes) that specifies the medication dispensed
- Data Element: Medication Dosage (and Route); defined as the dose and route instructions for medications
- Data Element: Medication Negation Rationale; defined as the reason a medication was not ordered/administered
- Current standards:
- In FHIR US Core, there is a distinction between "Medication" and "Medication Request”; base FHIR and FHIR QI Core IG includes "Medication Administration" and “Medication Dispensed” profiles.
- Within Medication Request, the ‘category’ is used to define discharge medications.
- Dose and route instructions are also contextualized within the Medication Request, Medication Administration, and Medication Dispense profiles in US/QI Core IGs.
- Negation details are expressed within the status reason (for not done) in Medication Request profile and Not Done profiles within QI Core.
- Current uses, exchange, and use cases: Medication data is routinely captured in EHR systems used by hospitals, providers, and other healthcare stakeholders including pharmacies. Medication details are routinely exchanged across providers and payers. Medication data is used extensively in CMS quality measurement. Additionally, when prior authorization is necessary for a medication, details related to the medication (e.g., why the medication is given, the quantity needed) are exchanged to support the approval process.
Submitted by LisaRNelson on 2021-03-20
More clarity is needed sooner for the Medications Data Class
Currently, the Medications data class presents many interoperability challenges. Work done within C-CDA shows there remains a great deal of confusion over how to represent medication information that is gathered from a patient's report of the medications they say they take versus actual medication administration reports documented by providers who are administering medications to the patient. Also challenging is the representation of medications that are prescribed by a provider. Prescribed medications may or may not actually be taken by the patient. The growing number of data elements in the Medications data class is a sign of the complexity of this data class. A much larger effort is needed to straighten out the definitions and representations of the many nuanced aspects of this data class. The assessment and planning for this data class needs to be done sooner rather than later. It needs to be a top-down exercise, not a bottom-up exercise in order for all the many data element parts to actually make sense together.Submitted by ishcahealth on 2021-03-30
Medication Data Class
Please consider adding ContraIndications which automatically calculates the patients current medication to see if there is a health safety issues with their combined medications. I expect this functionaliy to be in all ehrs but needs to be pulled in and with an alert or notifications. This would expedite decision making and ultimately save livesSubmitted by LisaRNelson on 2021-03-20
Submitted by joshualegler on 2022-08-02
Medication Administration Date/Time and Route
Consider adding data elements for:- Date/Time of Medication Administration
- Route of Medication Administration
This comment is submitted on behalf of the National Emergency Medical Services Information System (NEMSIS) Technical Assistance Center.