HealthVault Data Types : Medication

Type Preview: Medication (update)

ericgu — Fri, 27 Jun 2008 00:54:00 GMT

We’ve gotten some good feedback on our proposed data type design, and we have a new one to run by you. If at all possible, we’d like to centralize feedback around these blog posts so that we only have to go to one place and so that everybody can read all the feedback (yes, that’s a hint for those who sent us feedback by email).

The first bit of feedback was “do you really need both Medication and Medication Prescription?” After a bit of discussion, we’ve decided that we’re going to remove the Medication Prescription type and instead put the prescription-specific information into an optional prescription element on the Medication type.

We also had some feedback about being able to support more complex dosage schemes than what can be expressed using dose/strength/frequency/route. We considered doing this during the design, but after a bit of discussion came to the conclusion that doing so would add a significant amount of complexity to the type without a significant benefit in our highest-priority scenarios. We therefore decided not to add that support to the coded part of the type, though it can be specified in the prescription instructions element.

Here is our revised design for Medication. Medication Fill is also listed but is unchanged from our previous proposal. Required elements are in bold.

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
Dose	General measurement	Patient-understandable dose plus structured value and unit. Examples: 1 tablet, 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.
Indication	String	Why the patient is taking medication
Date-started	Approx-date	Date the patient started taking the medication
Date-discontinued	Approx-date	Date the patient stopped taking the medication
Prescribed	Codable value	Whether the medication is prescribed, self-prescribed, etc.
Prescription	Prescription	Details of a prescribed medication.

Prescription

This is a sub-type that contains information that is specific to the prescription

Element	Type	Description
PrescribedBy	Person	The physician who prescribed this medication
Date-prescribed	Approx-date	Date the medication was prescribed
Amount-prescribed	General measurement	The amount prescribed
Substitution	Codable value	Whether the medication should be dispensed as written or whether substitution is allowed.
Refills	Non-negative integer	Original number of refills
Days-Supply	Non-negative integer	Number of days supply
Prescription expiration	date	The date when the prescription expires
Instructions	String	Instructions that go along with the prescription
Prescription Number	String	Prescription Number

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

Type Preview: Medication

ericgu — Mon, 12 May 2008 23:25:00 GMT

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:

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

A dose of 200 mg would be stored as follows:

display: "200 mg"
value: 200
units: mg, coded from the measurement-units vocabulary

Request for Interest: Updates to the Medication data type

timsell — Tue, 01 Apr 2008 01:09:00 GMT

Medication data in HealthVault is currently represented by a single data type that includes both medication prescription information and medication fulfillment information. When considering the roles involved with these two very distinct actions, the result has potential to become an overly complex data type. Planned updates for this data type include splitting it into multiple smaller data types to match the roles involved as well as several updates to existing fields and the introduction of new fields to further the HealthVault platform support of medication scenarios.

If your application would find utility in such updates, please reply to this post (preferred) or use the "contact me" link to send an email if you wish your feedback to be private. Please express your interest in working with us on this data type by Monday, April 7, 2008.