Xt-EHR / xt-ehr-common

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Medication in prescription - explicit concepts vs "the item prescribed" #1

Open costateixeira opened 2 months ago

costateixeira commented 2 months ago

Leaving this here for eventual discussion: When defining a medication, it is important to be able to support different types of medication and provide Pharmaceutical identifiers, medicinal product identifiers, packages etc.

In prescription and dispense those may all exist, but it is important to see what was the product that the prescription indicates vs other product identifiers which may be present too.

Typically: if the prescription is done at Pharmaceutical Level, then we only have that and possibly classifications if the prescription is at package level, it is common to indicate also the medicinal product (Actual/Branded product) and the pharmaceutical/generic product. But those are not "binding". The one that matters should be clearly indicated, and it is commonly the lowest level indicated.

So, looking at the model in the guidelines, I would suggest, instead of using the identifiers at the different levels, and making them optional or depending on assumptions like "when 2 levels of granularity are present, the lower prevails" which may not always be true (e.g. when the lower level is indicated as a possible option?), to consider separating "the product at the level that was meant" and there include name, identifier etc" and another block whic is other identifiers. Technically we will have several options, but i think that clarification is due in the logical model