Dispensable (MyHealth@EU requirement catalogue) in logical model and FHIR

Xt-EHR / xt-ehr-common

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Dispensable (MyHealth@EU requirement catalogue) in logical model and FHIR #33

Open rlindstrm opened 2 weeks ago

rlindstrm commented 2 weeks ago

For crossborder prescription, there is a dispensable/non-dispensable flag on prescriptions. Only active prescriptions are sent crossborder, but NCP has a set of rules to choose which one of those are dispensable crossborder and which are not. This decision is different for every country, the rules are for example:

All narcotic product prescriptions non-dispensable (all countries)
Medications with too general dose form non-dispensable (Estonia)
Prescription where product amount is given as a time duration, e.g "1 year supply" (Finland)
etc.

This data element is not filled in at the time of creating the prescription and it is not relevant on a national level. Should we add it to our logical model or FHIR profile or is it something so specific that we would leave it for MyHealth@EU to add?

costateixeira commented 2 weeks ago

Which NCP chooses which lines are dispensable crossborder? I guess of the country of prescription? Are the rules conveyed in the message? Or just a flag?

rlindstrm commented 2 weeks ago

Country A NCP (not prescription system!) decides according to some set of rules that the prescription is not dispensable crossborder.

Today, the reasoning for this is not included in the message (which means pharmacists are defenseless from the anger of the patient who knows for a fact that this is a valid prescription).

costateixeira commented 2 weeks ago

so, a big red flag that is appended to the prescription and says "not to be dispensed outside of country of original prescription"?

rlindstrm commented 2 weeks ago

Yes, and it functionally stops you from sending the dispensation. It says "not dispensable". It does not say "... outside of country of original" because you only see that flag when you are a pharmacist in another country. Of course, we can discuss if these flags should appear to domestic users as well in some contexts. It might be helpful for someone who has the urge to rely on crossborder services.

rlindstrm commented 1 week ago

Added to the data model as a separate element 'dispensable'. Description implies it's more relevant for crossborder.