We have had a number of requests from partners to revise the Medication data type, and this post describes our current thoughts in this area. We would like to have your feedback on whether this meets your needs and works well for your scenarios. We are also interested in whether the descriptions provide sufficient information to understand what each field stores. Finally, if there are specific vocabularies that you want to use for codable values in these types, please add a comment with those as well.
There are currently two types related to medication in HealthVault - there is the Medication type and the Daily Medication Usage type.
We are proposing breaking medication into three types:
The Medication type is used to store information that answers the question "What medication is the record owner taking, and why?" For example, a person might be taking 75mg of aspirin daily to help prevent heart disease, 20mg of a statin drug twice a day to reduce cholesterol, and a One-A-Day Men's Health Formula multivitamin. This type is intended to support information entered directly by a person, or from a clinical system.
The Medication Prescription type is used to store information about a specific prescription, and is the analog what you get when you pick up a prescription from a pharmacy (ie the medication and some of the information on the instruction sheet).
While Medication and Medication Prescription are intended to be related (using related items) if they both come from an electronic system, they contain sufficient information to stand alone. They therefore both contain information about the specific medication, and the dose/strength/frequency of the medication.
The Medication Fill type stores information about the act of filling the prescription. It will always be related to a specific prescription.
In addition to these three types, the Daily Medication Usage type will be used to track the administration of the medication. That type is not described in this post.
Medication:
Some of the existing fields are moved to the Medication Fill type, and fields such as dose & dose unit are replaced with a field named "dose", which is of the "general measurement" type (see below for more information on general measurement).
| Element |
Type |
Description |
| Name |
string |
Patient-understandable name for the medication |
| Code |
Codable value |
Code/codes for the medication. Vocabs include RxNorm, NDC |
| Date-discontinued |
Approx-date |
Date the patient stopped taking the medicine |
| Date-started |
Approx-date |
Date the patient started taking the medication |
| Prescribed |
Codable value |
Whether the medication is prescribed, self-prescribed, etc. |
| Indication |
String |
Why the patient is taking medication |
| Dose |
General measurement |
Patient-understandable dose plus structured value and unit.
Examples: 1 table, 50ml |
| Strength |
General measurement |
Patient-understandable strength plus structured value and units.
Examples: 25mg, 15mg/ml |
| Frequency |
General measurement |
Patient-understandable frequency plus structured value and units
Example: Once a day |
| Route |
Codable value |
The route of the medication. Vocab=medication-routes. |
| PrescribedBy |
Person |
The physician who prescribed this medication Person |
Medication Prescription:
Contains the relevant information for a prescription. The information here is focused on the patient's view of the prescription, not the pharmacy's or the physician's view.
| Element |
Type |
Description |
| Name |
string |
Patient-understandable name for the medication |
| Code |
Codable value |
Code/codes for the medication. Vocabs include RxNorm, NDC |
| Date-prescribed |
Approx-date |
Date the medication was prescribed |
| Amount-prescribed |
General measurement |
The amount prescribed |
| Prescribed |
Codable value |
Whether the medication is prescribed, self-prescribed, etc. |
| Dose |
General measurement |
Patient-understandable dose plus structured value and unit.
Examples: 1 table, 50ml |
| Strength |
General measurement |
Patient-understandable strength plus structured value and units.
Examples: 25mg, 15mg/ml |
| Frequency |
General measurement |
Patient-understandable frequency plus structured value and units
Example: Once a day |
| Route |
Codable value |
The route of the medication. Vocab=medication-routes. |
| Substitution |
Codable value |
Whether the medication should be dispensed as written or whether substitution is allowed. |
| Duration |
General measurement |
Patient-understandable duration plus structured value and units |
| Refills |
Non-negative integer |
Original number of refills |
| Days-Supply |
Non-negative integer |
Number of days supply |
| Prescription duration |
Duration-value |
The duration of the prescription |
| Instructions |
String |
Instructions that go along with the prescription |
| Prescription Number |
String |
Prescription Number |
| PrescribedBy |
Person |
The physician who prescribed this medication |
Mediation Fill
Records the act of filling or refilling a prescription.
| Element |
Type |
Description |
| Name |
string |
Patient-understandable name for the medication |
| Date-filled |
Approx-date |
Date of this fill |
| Refills-left |
Non-negative integer |
The number of future refills that are allowed. |
| Days-Supply |
Non-negative integer |
Number of days supply |
| Pharmacy |
Organization |
The pharmacy that filled the prescription |
| Prescription Number |
String |
Prescription Number |
General Measurement
The general measurement type is somewhat analagous to the codable value type. It contains a "display" field, which contains a user-readable value, and also one or more value & unit pairs, where the value is a double and the unit is expressed as a codable value.
A dose of 200 mg would be stored as follows:
display: "200 mg"
value: 200
units: mg, coded from the measurement-units vocabulary
