V3 - 2015-02-06

PRE DIS DIS PADVChange

Plan

Actual

ActionPhysician starts

medication treatment

Physician changes dosage

Patient runs out of

medications

Physician changes

dosage again

Logical flow Leads to

PRE DIS

MTP PADVChange

PADVChange

Reference to MTP Reference to PRE Reference to DIS

The first situation illustrates the inclusion of a new medication in the patient’s treatment plan. A medication treatment plan item is created, a prescription is issued and dispensed in two steps (partial dispense). Then the dosage is changed. After a while the patient runs out of medication and the prescription is renewed and dispensed again. Finally a second dosage change is performed.

Time

…

I have a problem here: PRE and DIS are linked to the original MTP no knowledge of the

change. I would suggest a link to the Plan/PADV

V3 - 2015-02-06

DIS PADVChange

Plan

Actual

ActionPhysician starts

medication treatment

Physician changes dosage

Logical flow Leads to

DIS

MTP PADVChange

Reference to MTP

The second situation illustrates the inclusion of a new medication in the patient’s treatment plan. No prescription is required for getting it from a pharmacy. A medication treatment plan item is created and dispensed. Then the dosage is changed. Finally the patients goes back to the pharmacy because he ran out of medication.

Time

Reference to DIS Reference to PADV

Same question as on previous slide

V3 - 2015-02-06

MTP

PMIPRE

typeCode=SUBJ, inversionInd=trueclassCode=ACT, moodCode=INTcode=PINSTRUCT

FFI

Amount

typeCode=SUBJ, inversionInd=trueclassCode=ACT, moodCode=INTcode=FINSTRUCT

Reason typeCode=RSONclassCode=ACT, moodCode=EVN

typeCode=COMPclassCode=SPLY, moodCode=RQO

SubstittypeCode=COMPclassCode=SPLY, moodCode=RQOpharm:subjectOf4

0..1

0..n

0..1

0..1

0..1

0..1 typeCode=REFRsubstanceAdministration classCode=SBADM moodCode=INT

PRE entryRelationshipCP: NEW

entryRelationship

V3 - 2015-02-06

PRE

DIS PADVChange

MTP

PMI

FFN

Dosage

typeCode=SUBJ, inversionInd=trueclassCode=ACT, moodCode=INTcode=PINSTRUCT

typeCode=SUBJ, inversionInd=trueclassCode=ACT, moodCode=INTCode=FINSTRUCT

typeCode=COMPclassCode=SBADM, moodCode=INT

0..1

0..n

0..1

0..1

0 /1

0..1

DIS entryRelationship

typeCode=REFRsubstanceAdministration classCode=SBADM moodCode=INT

typeCode=REFRsubstanceAdministration classCode=SBADM moodCode=INT

typeCode=REFRobservationclassCode=OBS moodCode=EVN

CP: Dispensing without prescription: replace «Must not be present» by «Must be present and null flavored if a MTP entryRelationship

is present»

CP: NEW entryRelationship

V3 - 2015-02-06

PRE

MTP

PAC

PRE Items

Dosage

typeCode=REFR, inversionInd=falseclassCode=ACT, moodCode=EVN

typeCode=REFR, inversionInd=falseOrganizerclassCode=CLUSTER, moodCode=EVN

typeCode=COMPclassCode=SBADM, moodCode=INT

0 / 1..n

0 / 1

0..n

0 / 1

0 /1

0..1

PADV entryRelationship

typeCode=REFRsubstanceAdministration classCode=SBADM moodCode=INT

typeCode=REFRsubstanceAdministration classCode=SBADM moodCode=INT

typeCode=REFRsupplyclassCode=SPLY moodCode=EVN

CP: NEW entryRelationship

PADVChange DIS

CP: PADV on a MTP: «Must be present and null flavored if PADV refers to a MTP »