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US Medications Implementation Guide Update
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1393
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No
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No
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1f. Name of standard being reaffirmed
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1h. ISO/IEC Standard to Adopt
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Pharmacy
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Brett Marquard and Nagesh Bashyam
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Clinical Quality Improvement
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Brett Marquard
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Nagesh Bashyam
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2i. Domain Expert Representative
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Melva Peters
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Nagesh Bashyam
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Outreach in progress
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Prescription Drug Monitoring Programs (PDMPs) are databases deployed in each US State to track controlled substance prescriptions in a state. PDMPs provide health authorities timely information about prescribing and patient behaviors.
Full Background on PDMPs is provided by CDC (https://www.cdc.gov/drugoverdose/pdmp/states.html).
PDMPs primarily exchange information with an EHR using a non-HL7 standard (NCPDP).
HL7 published the original version of the US Medications implementation guide based on FHIR R3 in 2017 to provide guidance for patient and provider access to patient medications. A future release improved the guidance, and added a section mapping FHIR to NCPDP and PMIX to support PDMP exchange. The PDMP FHIR mappings are FHIR 3 based, and based on prior industry standards.
Broad industry adoption of FHIR R3 in the US did not occur, and the latest US regulation requires certified HIT systems support FHIR R4, and US Core.
Fortunately, many of the lessons from the US Meds guide were included in the US Core upgrade to FHIR R4. For example, the following guidance is now included in US Core:
• Fetching All Medications, Active Medications, and All Medications for an Encounter
• Get All Medications
• Get All Active Medications
• Get All Medications for an Encounter
The MedicationDispense and MedicationAdministration profiles are not included in US Core due to minimal adoption.
This project will upgrade the PDMP mappings to FHIR R4, addAmerican Society for Automation in Pharmacy (ASAP) mappings, upgrade the MedicationDispense/MedicationAdministration profiles to FHIR R4, and remove any Medication List guidance from the guide, and any profiles, that are superseded by US Core.
This project will not enhance US Core profiles, nor provide additional guidance on profiles that belong in US Core. Any relevant lessons for US Core will be logged as trackers for a future US Core release.
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Prescription Drug Monitoring Programs are being deployed in every state in the US to address prescription drug misuse, abuse, and diversion. They provide critical health information to physicians and other health care providers about an individual’s history of controlled substance prescriptions.
The current connections from PDMPs primarily utilize non-HL7 standards. This project plans to give guidance on using FHIR for application developers to connect with and exchange information with PDMP systems.
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No
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None
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Submit for STU Ballot August 2020
STU Reconciliation September - December 2020
Request STU Publication January 2021
Close project February 2021
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PDMP, ASAP
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https://github.com/HL7/FHIR-ONC-Meds
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No
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No
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Unknown
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FHIR Extensions, FHIR Implementation Guide, FHIR Profiles
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Supplement to a current standard
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5a. Revising Current Standard Info
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STU to Normative
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No
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no
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Other
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Patients
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EHR, PHR
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Local and State Departments of Health
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U.S. Realm Specific
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