{
"description": "**Concept**\\r\\nA medication agreement is a prescriber’s proposal for a patient to use medication. An agreement to discontinue the use of medication is also a medication agreement.\\r\\n**Purpose**\\r\\nThe goal of the medication agreement is to provide insight into the agreements reached between the prescriber and the patient on the use of medication.\\r\\n\\r\\n**Instructions**\\r\\n**MedicationAgreementAdditionalInformation:**\\r\\nWhen choosing a medicine, you can deviate from what is expected or from what the standard is. For example, when the hospital uses a different formulary than the community pharmacy. For reasons of efficiency, for example, one gastric acid inhibitor has been chosen in the hospital: pantoprazole.\\r\\nUpon admission, a patient with omeprazole is converted to pantoprazole for the duration of the stay. When discharged, the patient goes back to omeprazole.\\r\\nIt is clear that something can go wrong here and that the patient takes both omeprazole and pantoprazole when there is no intervention. In the hospital's medication agreement for pantoprazole a remark can be made about the deviation so that it is clear that pantoprazole is the substitute for omeprazole or that it should be used in addition to omeprazole.\\r\\nAnother example are the half strengths. The hospital sometimes stocks tablets with half the strength of the normal trade preparation (own production). Where\\n the patient enters the hospital on 25 mg chlortalidone, half a tablet once a day, he receives 12.5 mg intramural chlortalidone, one tablet once a day. Then the nursing does not have to break tablets in this case. Here there is a risk that the patient will use the 25 mg again at home, but then a whole tablet at a time in stead of half a tablet. By means of an explanation in the medication agreement (Additional information) of the last chlortalidone 25 mg, it can be indicated whether this has been a intended increase.",
"_filename": "LogicalModel-HdBe-MedicationAgreement.json",
"package_name": "healthdata.be.r4.cbb",
"date": "2022-07-07T15:04:03.2592055+00:00",
"derivation": "specialization",
"publisher": "Healthdata.be (Sciensano)",
"fhirVersion": "4.0.1",
"name": "HdBeMedicationAgreement",
"abstract": true,
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
"type": "https://fhir.healthdata.be/StructureDefinition/LogicalModel/MedicationAgreement",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "HdBe MedicationAgreement",
"_description": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "**Concept**\r\nEen medicatieafspraak is het voorstel van een voorschrijver tot gebruik van medicatie door een patiënt. \r\nOok de afspraak om het medicatiegebruik te staken is een medicatieafspraak. \r\n**Purpose**\r\nHet doel van de medicatieafspraak is inzicht te geven in de afspraken die zijn gemaakt tussen voorschrijver en patiënt over het gebruik van medicatie.\r\n**Example Instances**\r\n\r\n**Instructions**\r\n**MedicatieafspraakAanvullendeInformatie:**\r\nBij het kiezen van een geneesmiddel kan er worden afgeweken van wat er verwacht wordt of van wat de standaard is. Bijvoorbeeld wanneer het ziekenhuis een ander formularium hanteert dan de openbare apotheek. Uit efficiencyoverwegingen is in het ziekenhuis bijvoorbeeld gekozen voor één maagzuurremmer: pantoprazol. \r\nBij opname wordt een patiënt met omeprazol omgezet naar pantoprazol voor de duur van het verblijf. Bij ontslag gaat de patiënt weer terug naar omeprazol.\r\nHet is duidelijk dat hier nog weleens wat mis kan gaan en dat de patiënt zowel omeprazol als pantoprazol slikt als er niet ingegrepen wordt. In de medicatieafspraak van het ziekenhuis voor pantoprazol kan een opmerking worden gemaakt over de afwijking zodat duidelijk is dat pantoprazol de vervanger is van omeprazol of juist naast omeprazol moet worden gebruikt.\r\nAnder voorbeeld zijn de halve sterktes. Het ziekenhuis heeft soms de beschikking over tabletten met de halve sterkte van het\n normale handelspreparaat (eigen productie). Waar de patiënt het ziekenhuis ingaat met chlortalidon 25 mg, een maal daags een halve tablet krijgt hij intramuraal chlortalidon 12,5 mg, eenmaal daags één tablet. Dan hoeft de verpleging in dit geval geen tabletten te breken. Hier bestaat het risico dat de patiënt bij thuiskomst weer de 25 mg gaat gebruiken, maar dan een hele tablet per keer. Door een toelichting in de medicatieafspraak (Aanvullende informatie) van de laatste chlortalidon 25 mg kan worden aangegeven of dit een bewuste verhoging is geweest."
} ]
} ]
},
"package_version": "0.9.0-alpha",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/resource-effectivePeriod",
"valuePeriod": {
"start": "2020-09-01T00:00:00+02:00"
}
} ],
"status": "draft",
"language": "en-US",
"id": "2b82eaeb-c907-4b93-a0ba-fa909e721290",
"kind": "logical",
"_name": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "HdBe-Medicatieafspraak"
} ]
} ]
},
"url": "https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-MedicationAgreement",
"version": null,
"differential": {
"element": [ {
"id": "MedicationAgreement",
"max": "*",
"min": 0,
"path": "MedicationAgreement",
"short": "MedicationAgreement",
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Medicatieafspraak"
} ]
} ]
},
"definition": "Root concept of the MedicationAgreement information model. This root concept contains all data elements of the MedicationAgreement information model.",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Rootconcept van de bouwsteen Medicatieafspraak. Dit rootconcept bevat alle gegevenselementen van de bouwsteen Medicatieafspraak."
} ]
} ]
}
}, {
"path": "MedicationAgreement.Prescriber",
"min": 0,
"definition": "The health professional that entered the medication agreement with the patient.",
"short": "Prescriber",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "De zorgverlener die de medicatieafspraak met de patiënt heeft vastgelegd."
} ]
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-HealthProfessional" ]
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Voorschrijver"
} ]
} ]
},
"max": "1",
"id": "MedicationAgreement.Prescriber"
}, {
"path": "MedicationAgreement.PrescriptionReason",
"min": 0,
"definition": "The medical reason for the prescription or for use of the medication. This can be used to enter a medical indication which was the direct cause for prescription or for use of the medication in question. \r\n\r\nIt can concern every type of problem (or condition) of the patient, almost all diagnoses, complaints or symptoms.",
"short": "PrescriptionReason",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "De medische reden voor het voorschrijven of gebruik van de medicatie. Hiermee kan een medische indicatie worden doorgegeven die de directe aanleiding vormde voor het voorschrijven of het gebruik van de betreffende medicatie.\r\n\r\nHet kan gaan om ieder type probleem (of conditie) van de patiënt, vrijwel steeds een diagnose, een klacht of een symptoom."
} ]
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-Problem" ]
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "RedenVanVoorschrijven"
} ]
} ]
},
"max": "1",
"id": "MedicationAgreement.PrescriptionReason"
}, {
"path": "MedicationAgreement.AgreedMedicine",
"min": 1,
"definition": "The medicine agreed upon to be used.",
"short": "AgreedMedicine",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Het afgesproken te gebruiken geneesmiddel."
} ]
} ]
},
"type": [ {
"code": "Reference",
"targetProfile": [ "https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-PharmaceuticalProduct" ]
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Afgesprokengeneesmiddel"
} ]
} ]
},
"max": "1",
"id": "MedicationAgreement.AgreedMedicine"
}, {
"path": "MedicationAgreement.InstructionsForUse",
"min": 0,
"definition": "Instructions for the use of the medication, e.g. dose and route of administration.",
"short": "InstructionsForUse",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Aanwijzingen voor het gebruik van de medicatie, bijvoorbeeld dosering en toedieningsweg."
} ]
} ]
},
"type": [ {
"code": "Dosage",
"profile": [ "https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-InstructionsForUse" ]
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Gebruiksinstructie"
} ]
} ]
},
"max": "1",
"id": "MedicationAgreement.InstructionsForUse"
}, {
"path": "MedicationAgreement.MedicationAgreementDateTime",
"min": 1,
"definition": "The time at which the agreement was made. \r\nAppointment date + time are required (order of the appointments must be clear in cases with multiple appointments on one day)",
"short": "MedicationAgreementDateTime",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Het tijdstip waarop de afspraak gemaakt is.\r\nAfspraakdatum + tijd verplicht meegeven (er moet volgordelijkheid van de afspraken kunnen worden afgeleid bij meerdere medicatieafspraken op één dag)"
} ]
} ]
},
"type": [ {
"code": "dateTime"
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "MedicatieafspraakDatumTijd"
} ]
} ]
},
"max": "1",
"id": "MedicationAgreement.MedicationAgreementDateTime"
}, {
"path": "MedicationAgreement.PeriodOfUse",
"min": 0,
"definition": "Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original medication agreement. The end date indicates from when the medication is to be discontinued. \r\n\r\n**Duration:** The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. \r\n\r\n**End date:** The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date. \r\n\r\nWith medication for an indefinite period only a start date is indicated.",
"short": "PeriodOfUse",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "**Ingangsdatum**: Dit is het tijdstip waarop de afspraak ingaat (of is ingegaan of zal ingaan). Dit betreft het tijdstip waarop de in deze afspraak vastgelegde gebruiksinstructie ingaat. In geval van een afspraak om te stoppen betreft dit de ingangsdatum van de originele medicatieafspraak. De einddatum geeft aan vanaf wanneer de medicatie gestaakt moet worden.\r\n\r\n**Gebruiksduur**: De beoogde gebruiksduur. Bijvoorbeeld 5 dagen of 8 weken. Het is niet toegestaan om de gebruiksduur in maanden aan te geven, omdat verschillende maanden een variable duur in dagen hebben. \r\n\r\n**Einddatum**: Het tijdstip waarop de gebruiksperiode eindigt (of geëindigd is of zal eindigen). In het geval van een afspraak om het gebruik te staken betreft dit het tijdstip waarop de medicatie gestaakt moet worden. Om verwarring te voorkomen tussen 'tot' en 'tot en met' is het meegeven van de tijd altijd verplicht bij einddatum. \r\nBij medicatie voor onbepaalde duur wordt er alleen een ingangsdatum aangegeven."
} ]
} ]
},
"type": [ {
"code": "Range",
"profile": [ "https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-TimeInterval" ]
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Gebruiksperiode"
} ]
} ]
},
"max": "1",
"id": "MedicationAgreement.PeriodOfUse"
}, {
"path": "MedicationAgreement.MedicationAgreementStopType",
"min": 0,
"definition": "Stop type, the manner in which this medication is discontinued (temporary or definitive).",
"short": "MedicationAgreementStopType",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Stop type, de manier waarop gestopt wordt met deze medicatie (tijdelijk of definitief)."
} ]
} ]
},
"type": [ {
"code": "CodeableConcept"
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "MedicatieafspraakStopType"
} ]
} ]
},
"binding": {
"strength": "required",
"valueSet": "https://fhir.healthdata.be/ValueSet/MedicationStopType",
"description": "MedicationAgreementStopType codes"
},
"max": "1",
"id": "MedicationAgreement.MedicationAgreementStopType"
}, {
"path": "MedicationAgreement.ReasonMedicationAgreement",
"min": 0,
"definition": "Reason for this agreement. This can be the reason to start, change or stop the medication treatment.",
"short": "ReasonMedicationAgreement",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Reden voor het maken van deze medicatieafspraak. Dit kan de reden zijn om de medicatie te starten, te wijzigen of te stoppen."
} ]
} ]
},
"type": [ {
"code": "CodeableConcept"
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "RedenMedicatieafspraak"
} ]
} ]
},
"binding": {
"strength": "required",
"valueSet": "https://fhir.healthdata.be/ValueSet/MedicationReason",
"description": "ReasonMedicationAgreement codes"
},
"max": "1",
"id": "MedicationAgreement.ReasonMedicationAgreement"
}, {
"path": "MedicationAgreement.MedicationAgreementAdditionalInformation",
"min": 0,
"definition": "Additional information includes details on the structure of the agreement made that are relevant for pharmacovigilance and fulfillment by the pharmacist. This can be used e.g. to indicate that there was a conscious decision to deviate from the norm or that the agreement is to be structured in a certain way.\r\nSee also the Instructions section for more information about use of the element.",
"short": "MedicationAgreementAdditionalInformation",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Aanvullende informatie bevat een lijst van bijzonderheden over de gemaakte afspraak die van belang zijn voor de medicatiebewaking en invulling door de apotheker. Hiermee kan bijvoorbeeld worden aangegeven dat er bewust is afgeweken van wat gebruikelijk is of dat de afspraak op een bepaalde manier moet worden ingevuld. \r\nZie ook de sectie Instructions voor meer informatie over het gebruik."
} ]
} ]
},
"type": [ {
"code": "CodeableConcept"
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "MedicatieafspraakAanvullendeInformatie"
} ]
} ]
},
"binding": {
"strength": "required",
"valueSet": "https://fhir.healthdata.be/ValueSet/MedicationAgreementAdditionalInformation",
"description": "MedicationAgreementAdditionalInformation codes"
},
"max": "*",
"id": "MedicationAgreement.MedicationAgreementAdditionalInformation"
}, {
"path": "MedicationAgreement.Comment",
"min": 0,
"definition": "Comments regarding to the medication agreement. For example: in consultation with the medical specialist.",
"short": "Comment",
"_definition": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Opmerkingen met betrekking tot de medicatieafspraak. Bijvoorbeeld: in overleg met de specialist."
} ]
} ]
},
"type": [ {
"code": "string"
} ],
"_short": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [ {
"url": "lang",
"valueCode": "nl-NL"
}, {
"url": "content",
"valueMarkdown": "Toelichting"
} ]
} ]
},
"max": "1",
"id": "MedicationAgreement.Comment"
} ]
},
"contact": [ {
"name": "Service portal – healthdata.be",
"telecom": [ {
"use": "work",
"value": "https://sciensano.service-now.com/sp",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Element"
}