M6.1. Medication - Discontinuation of Repeat Authorisation

The following table describes the use of medication statements and related classes to convey information about a specific decision to discontinue a medication that was previously authorised for repeat prescribing. Use of this construct is not necessary where the act of discontinuation is not explicitly recorded in the sending system.

Whether or not the discontinuation is recorded explicitly the statusCode of any expired or cancelled authorisation should be "complete" indicating an old authorisation that is no longer active.

MedicationStatement

A statement that represents an explicit decision to discontinue an authorised repeat prescription.

[1..1] classCode (CS){ Fixed="SBADM " }

[1..1] moodCode (CS) {CNE:EVN}

Indicates that this is an actual act of discontinuation.

[1..1] id (II)

An instance identifier of this statement represented as using the Identifier Global flavour of the II data type.

[1..1] statusCode (CS) {CNE:EhrMedicationState}

Indicates whether the medication is active (applies to a current authorisation record) complete (applies to a now expired authorisation), obsolete (replaced) or nullified (deleted).

[1..1] availabilityTime (TS)

The date and time of recording the discontinuation.

[0..0] pertinentInformation (MedicationStatement/pertinentInformation)

Dosage is not applicable to a discontinuation.

[1..1] consumable (MedicationStatement/consumable)

Include this to identify the nature of the product.

[1..1] typeCode (CS){ Fixed="CSM " }

[1..1] manufacturedProduct (ManufacturedProduct)

Details of the medicinal product prescribed.

  • May include, drugs, nutritional supplements, devices used to administer drugs, dressing, appliances, diagnostic reagents, etc.

[1..1] classCode (CS){ Fixed="MANU " }

 Indicates that this is a manufactured product.

[1..1] manufacturedMaterial (Material)

Information about the material or substance that forms the medicinal product.

[1..1] Material

The details of a medicinal product.

[1..1] classCode (CS){ Fixed="MMAT " }

Indicates that this is an manufactured material.

[1..1] determinerCode (CS){CNE:KIND}

Indicates that this represents a kind of material.

[1..1] code (CE)

The code representing the nature of the product as one of the following:

  • virtual medicinal product
  • virtual medicinal product pack
  • actual medicinal product
  • actual medicinal product pack.

If the native coding scheme for medicinal product is the Read Codes then the appropriate code is represented using the Coded with Original Text flavour of the data type CE. Otherwise the Coded Translated flavour should be used with the medicinal product represented in the coding system used  in the sending system with a translation to an appropriate (possibly more generalised) Read Code.

Note

  • The source of these codes should eventually be an agreed UK medicinal product dictionary.

[0..*] participant (EhrStatement/participant)

If someone other than the EhrComposition/author of the containing EhrComposition was responsible for the discontinuation this is indicated here.

[1..1] typeCode (CS) {CNE:PRF}

Indicates that the related agent performed the act of discontinuation.

[1..1] time (TS)

The date and time of discontinuation.

[1..1] AgentRef (AgentRef)

A reference to the person responsible for discontinuation..

[1..1] classCode (CS){ Fixed="AGNT " }

Indicates that this is a reference to a related agent.

[1..1] id (II)

The unique instance identifier of the referenced role as specified in the role directory.

  • If a message contains several Folders, the referenced role directory is in the same Folder as the component that refers to it.

[0..3] component (MedicationStatement/component)

Relationship to details of the product to be supplied or actually supplied and/or administered.

  • Includes details of repeat prescription authorisations.

[1..1] typeCode (CS){ Fixed="COMP " }

Indicates that this is the supply details for a related to a medication statement (substance administration).

[1..1] Discontinue (EhrSupply)

Represents a record of a discontinuation or a previously authorised or issued prescription.

[1..1] classCode (CS){ Fixed="SPLY" }

[1..1] moodCode (CS){ Fixed="RQO" }

[1..1] id (II)

An identifier of the discontinuation.

[1..1] code (CD) {CWE:EhrDiscontinueReason}

A code representing the reason for discontinuation. If the native coding scheme for medicinal product is the Read Codes then the appropriate code is represented using the Coded with Original Text flavour of the data type CD. Otherwise the Coded Translated flavour should be used with the medicinal product represented in the coding system used  in the sending system with a translation to an appropriate (possibly more generalised) Read Code.

[1..1] statusCode (CS) {CNE:EhrSupplyState}

If the discontinuation record is valid (i.e. believed to be accurate) the status is "complete".

The other possible values ("obsolete" and "nullified") are only used if the record was subsequently corrected or deleted due an error.

[1..1] availabilityTime (TS)

The date and time that the discontinuation was recorded.

[0..1] pertinentInformation (EhrSupply/pertinentInformation)

[1..1] typeCode (CS){ Fixed="PERT " }

[1..1] pertinentSupplyAnnotation (SupplyAnnotation)

Details of the annotation.

[1..1] classCode (CS){ Fixed="OBS " }

Indicates that this is an Observation.

[1..1] moodCode (CS){ Fixed="EVN " }

Indicates that this is an actual event.

[1..1] text (ED)

A textual note that was sent from the prescriber to the dispenser as part of the prescription.

Note

  • This is not the place for recording dosage instructions.

[0..1] performer (EhrSupply/performer)

Include this only if the agent discontinuing the authorisation is not the EhrComposition/author of the containing EhrComposition.

[1..1] typeCode (CS){ Fixed="PRF " }

[1..1] AgentRef (AgentRef)

Refers to the person (or other agent) responsible for this discontinuation..

[1..1] classCode (CS){ Fixed="AGNT " }

Indicates that this is a reference to a related agent.

[1..1] id (II)

The unique instance identifier of the referenced role as specified in the role directory.

  • If a message contains several Folders, the referenced role directory is in the same Folder as the component that refers to it.

[0..0] consumable  (EhrSupply/consumable)

This should not be used in association with a discontinuation action.

[0..1] reversalOf (Discontinue/reversalOf)

Refers to a previous medication statement that contains the authorisation, discontinued by this statement.

[1..1] typeCode (CS){ Fixed="REV " }

[1..1] MedicationRef (MedicationRef) 

A reference to a previously recorded MedicationStatement statement that contains the authorisation, discontinued by this statement.

[1..1] classCode (CS){ Fixed="SBADM " }

Indicates that the referenced class is based on the Substance Administration class.

[1..1] moodCode (CS){CNE:x_MedicationMood}

Indicates whether this is an intention (INT), recommendation (RMD), order (ORD) or an actual event (EVN). The value used here should be the same as the moodCode of the MedicationStatement being referenced.

[1..1] id (II)

Refers to the id of the referenced medication statement.