mp:V2.0.0 Ontwerp medicatieproces 9 ENG - Bewerkingsoverzicht

Michiel Pos: /* Modification of someone else's medicatieafspraak */

2022-04-20T10:47:32Z

Modification of someone else's medicatieafspraak

← Oudere versie		Versie van 20 apr 2022 10:47
Regel 1.171:		Regel 1.171:

	===Modification of someone else's medicatieafspraak ===		===Modification of someone else's medicatieafspraak ===
	A patient takes 40 mg Lisinopril once a day because of hypertension. This medicatieafspraak was previously made by the GP with the patient. The patient is admitted to the ~~enters~~ A&E department because of a fall due to dizziness. The specialist notices hypotension and decides to reduce the dose of Lisinopril to 20 mg once a day. The specialist then stops the current medicatieafspraak and starts the new medicatieafspraak with a lower dose. With this he changes the medicationafspraak with the patient. The specialist informs the original prescriber (the general practitioner) about this with a stop medicatieafspraak and the new medicatieafspraak.		A patient takes 40 mg Lisinopril once a day because of hypertension. This medicatieafspraak was previously made by the GP with the patient. The patient is admitted to the A&E department because of a fall due to dizziness. The specialist notices hypotension and decides to reduce the dose of Lisinopril to 20 mg once a day. The specialist then stops the current medicatieafspraak and starts the new medicatieafspraak with a lower dose. With this he changes the medicationafspraak with the patient. The specialist informs the original prescriber (the general practitioner) about this with a stop medicatieafspraak and the new medicatieafspraak.
	The prescriber of the original medicatieafspraak adjusts the stop date in the original medicatieafspraak. If desired, this can also be automated by the information system. This prevents the second care provider no longer having to provide data over time because the delivery period has expired (including no stop MA) while the care provider of the original medication appointment continues to provide this incorrectly (without a stop date).		The prescriber of the original medicatieafspraak adjusts the stop date in the original medicatieafspraak. If desired, this can also be automated by the information system. This prevents the second care provider no longer having to provide data over time because the delivery period has expired (including no stop MA) while the care provider of the original medication appointment continues to provide this incorrectly (without a stop date).
	<br>		<br>
	[[Bestand:ENG_Modification of someone else's medicatieafspraak.PNG\|800px]]		[[Bestand:ENG_Modification of someone else's medicatieafspraak.PNG\|800px]]
	<br>		<br>

	===Setting up a variable dosing regimen (WDS) ===		===Setting up a variable dosing regimen (WDS) ===
	The prescriber prescribes anticoagulants and states in the MA that the medication is used as recorded by the schedule of the thrombosis service (‘gebruik volgens schema trombosedienst). The prescriber sends a VV to the pharmacist and the patient is registered with the thrombosis service. In order to bridge the period until thrombosis care can take over, the prescriber creates a WDS for the first period. After registration, the thrombosis service creates a dosing regimen that overwrites or succeeds the previous regimen. From this moment on, the thrombosis service takes over creating the dosing regimen from the original prescriber.		The prescriber prescribes anticoagulants and states in the MA that the medication is used as recorded by the schedule of the thrombosis service (‘gebruik volgens schema trombosedienst). The prescriber sends a VV to the pharmacist and the patient is registered with the thrombosis service. In order to bridge the period until thrombosis care can take over, the prescriber creates a WDS for the first period. After registration, the thrombosis service creates a dosing regimen that overwrites or succeeds the previous regimen. From this moment on, the thrombosis service takes over creating the dosing regimen from the original prescriber.

Titia van Malestein: /* Attachment: Document history */

2022-04-14T08:08:53Z

Attachment: Document history

← Oudere versie		Versie van 14 apr 2022 08:08
Regel 2.905:		Regel 2.905:
	\| style="background-color: white;vertical-align:top;"\| 08 April 2022		\| style="background-color: white;vertical-align:top;"\| 08 April 2022
	\| style="background-color: white;vertical-align:top;"\| broken internal links FO corrected [https://bits.nictiz.nl/browse/MP-607 BITS MP-607]		\| style="background-color: white;vertical-align:top;"\| broken internal links FO corrected [https://bits.nictiz.nl/browse/MP-607 BITS MP-607]
			\|-
			\| style="background-color: white;vertical-align:top;"\| 9 2.0.0
			\| style="background-color: white;vertical-align:top;"\| 14 April 2022
			\| style="background-color: white;vertical-align:top;"\| Changed images of uce case 4.1.38, 4.1.39 and 4.1.40, they showed GDS instead of WDS [https://bits.nictiz.nl/browse/MP-534 BITS MP-534]
	\|}		\|}

Marijke van Geijn: /* Attachment: Document history */

2022-04-08T09:01:49Z

Attachment: Document history

← Oudere versie		Versie van 8 apr 2022 09:01
Regel 2.900:		Regel 2.900:
	\| style="background-color: white;vertical-align:top;"\| 9 2.0.0		\| style="background-color: white;vertical-align:top;"\| 9 2.0.0
	\| style="background-color: white;vertical-align:top;"\| 05 April 2022		\| style="background-color: white;vertical-align:top;"\| 05 April 2022
	\| style="background-color: white;vertical-align:top;"\| all changes see: *[https://informatiestandaarden.nictiz.nl/wiki/mp:V2.0.0_releasenotes Releasenotes]		\| style="background-color: white;vertical-align:top;"\| all changes see: *[https://informatiestandaarden.nictiz.nl/wiki/mp:V2.0.0_releasenotes Releasenotes]
			\|-
			\| style="background-color: white;vertical-align:top;"\| 9 2.0.0
			\| style="background-color: white;vertical-align:top;"\| 08 April 2022
			\| style="background-color: white;vertical-align:top;"\| broken internal links FO corrected [https://bits.nictiz.nl/browse/MP-607 BITS MP-607]
	\|}		\|}

Marijke van Geijn: /* Qualification scripts */

2022-04-08T08:58:48Z

Qualification scripts

← Oudere versie		Versie van 8 apr 2022 08:58
Regel 2.785:		Regel 2.785:

	==Qualification scripts==		==Qualification scripts==
	[[mp:~~Vdraft~~ Kwalificatie\|Qualification scripts]]		[[mp:Vcurrent Kwalificatie\|Qualification scripts]]

	=Attachment: Document history=		=Attachment: Document history=

Marijke van Geijn: /* Examples dosages */

2022-04-08T08:57:42Z

Examples dosages

← Oudere versie		Versie van 8 apr 2022 08:57
Regel 2.409:		Regel 2.409:

	==Examples dosages==		==Examples dosages==
	See [[mp:V9.~~1 Voorbeelden doseringen~~\|examples dosages 9.1.0]] (both functional and technical effect in HL7v3 CDA and in FHIR)		See [[mp:V9.2.0.0_Voorbeelden_doseringen\|examples dosages 9 2.0.0]] (both functional and technical effect in HL7v3 CDA and in FHIR)

	==Medicatiegebruik: use indicator, according to agreement indicator, stop type, period of use and dosing instructions==		==Medicatiegebruik: use indicator, according to agreement indicator, stop type, period of use and dosing instructions==

Marijke van Geijn: /* Building block instantiations */

2022-04-08T08:54:50Z

Building block instantiations

← Oudere versie		Versie van 8 apr 2022 08:54
Regel 1.677:		Regel 1.677:

	==Building block instantiations==		==Building block instantiations==
	This section describes which instantiations of the building blocks belong to the medication overview. This concerns 'own' and 'other people's' building blocks ([[#~~GP observation service~~ (HAP)\|section 3.1]]) and then only the latest, relevant instantiations of this ~~([[#Thrombosis service\|section 3.2]])~~.		This section describes which instantiations of the building blocks belong to the medication overview. This concerns 'own' and 'other people's' building blocks ([[#After Hours General Practice clinics (HAP)\|section 3.1]]) and then only the latest, relevant instantiations of this.

	===Own and other people===		===Own and other people===

Marijke van Geijn: /* Discontinuing medication in a GDS */

2022-04-08T08:51:01Z

Discontinuing medication in a GDS

← Oudere versie		Versie van 8 apr 2022 08:51
Regel 1.343:		Regel 1.343:

	===Discontinuing medication in a GDS===		===Discontinuing medication in a GDS===
	When medication is discontinued, the prescriber creates a discontinuation-medicatieafspraak. In accordance with the process, the pharmacist is informed about this stop-MA and can adjust the medicatieverstrekking accordingly. The pharmacist will create a staken toedieningsafspraak . See [[#Discontinuing medication\|paragraphs 2.2.5.3]] and [[#Discontinuing ~~a toedieningsafspraak~~\|2.3.6.3]].		When medication is discontinued, the prescriber creates a discontinuation-medicatieafspraak. In accordance with the process, the pharmacist is informed about this stop-MA and can adjust the medicatieverstrekking accordingly. The pharmacist will create a staken toedieningsafspraak . See [[#Discontinuing medication\|paragraphs 2.2.5.3]] and [[#Discontinuing an administration agreement\|2.3.6.3]].

	===GDS supplier supplies other commercial product===		===GDS supplier supplies other commercial product===

Marijke van Geijn: /* Inadvertently ‘outstanding’ medication or 'orphans' */

2022-04-08T08:48:54Z

Inadvertently ‘outstanding’ medication or 'orphans'

← Oudere versie		Versie van 8 apr 2022 08:48
Regel 1.110:		Regel 1.110:

	===Inadvertently ‘outstanding’ medication or 'orphans'===		===Inadvertently ‘outstanding’ medication or 'orphans'===
	In a transitional situation and in a situation where not every XIS is connected, medicatieafspraken for the same treatment may exist that have been created by different information systems under different medicamenteuze behandelings. These medicatieafspraken should ideally be combined in a single medicamenteuze behandeling. This particularly applies to medication with an open end date, as this medication may have been discontinued under a different medicamenteuze behandeling. The medicatieafspraak therefore remains open, resulting in continued medicatieverstrekking. This is a so-called ‘orphan’ (a building block that has been registered, but in which, at a certain point, the health professional no longer has an active role. However, his information system continues to provide the building block, even if it has already been discontinued elsewhere). For medication with an end date, this problem will solve itself. Therefore, it is not necessary to take any action. When medication verification or medication assessment reveals that the medication is inappropriately still ‘open’, a stop-MA is created under the same medicamenteuze behandeling. The original prescriber is actively informed about this stop-MA and enters an end date for the medicatieafspraak in his own information system. Depending on the supplier and the client’s wishes, setting this end date can be done automatically or through an intervention of the prescriber. See also [[#Discontinuation of medication by third parties\|paragraph 4.1.26]] and [[#Modification of someone else's medicatieafspraak\|paragraph 4.1.40]].		In a transitional situation and in a situation where not every XIS is connected, medicatieafspraken for the same treatment may exist that have been created by different information systems under different medicamenteuze behandelings. These medicatieafspraken should ideally be combined in a single medicamenteuze behandeling. This particularly applies to medication with an open end date, as this medication may have been discontinued under a different medicamenteuze behandeling. The medicatieafspraak therefore remains open, resulting in continued medicatieverstrekking. This is a so-called ‘orphan’ (a building block that has been registered, but in which, at a certain point, the health professional no longer has an active role. However, his information system continues to provide the building block, even if it has already been discontinued elsewhere). For medication with an end date, this problem will solve itself. Therefore, it is not necessary to take any action. When medication verification or medication assessment reveals that the medication is inappropriately still ‘open’, a stop-MA is created under the same medicamenteuze behandeling. The original prescriber is actively informed about this stop-MA and enters an end date for the medicatieafspraak in his own information system. Depending on the supplier and the client’s wishes, setting this end date can be done automatically or through an intervention of the prescriber. See also [[#Discontinuation of medication by third parties\|paragraph 4.1.24]] and [[#Modification of someone else's medicatieafspraak\|paragraph 4.1.37]].
	<br>		<br>
	<br>		<br>

Marijke van Geijn: /* Creating a medicatieafspraak after the fact */

2022-04-08T08:47:42Z

Creating a medicatieafspraak after the fact

← Oudere versie		Versie van 8 apr 2022 08:47
Regel 1.098:		Regel 1.098:

	===Creating a medicatieafspraak after the fact===		===Creating a medicatieafspraak after the fact===
	In emergency situations, for example, it may happen that the medicatieafspraak is only created after the medication has been dispensed or administered. This may lead to conflicting medicatieafspraken. This means that one or more medicatieafspraken must be discontinued in order to prevent the occurrence of parallel medicatieafspraken. The only exception for parallel medicatieafspraken is described in [[#Medicamenteuze behandeling\|paragraph 1.3.3]].		In emergency situations, for example, it may happen that the medicatieafspraak is only created after the medication has been dispensed or administered. This may lead to conflicting medicatieafspraken. This means that one or more medicatieafspraken must be discontinued in order to prevent the occurrence of parallel medicatieafspraken. The only exception for parallel medicatieafspraken is described in [[#'Medicamenteuze behandeling'\|paragraph 1.3.3]].

	===Single medication use===		===Single medication use===

Marijke van Geijn: /* Two PRKs in a single medicamenteuze behandeling */

2022-04-08T08:47:00Z

Two PRKs in a single medicamenteuze behandeling

← Oudere versie		Versie van 8 apr 2022 08:47
Regel 1.092:		Regel 1.092:

	===Two PRKs in a single medicamenteuze behandeling===		===Two PRKs in a single medicamenteuze behandeling===
	In certain circumstances, the pharmacy is allowed to select a different PRK for the toedieningsafspraak than is indicated in the medicatieafspraak made by a prescriber. If for instance a failure of the prescriber’s information system would result in only the communication of the toedieningsafspraak, a subsequent prescriber will only have this toedieningsafspraak with the new PRK. The next prescriber will then probably assume that this PRK is also the PRK of the medicatieafspraak. A modification of the medicatieafspraak will then also result in a stop-MA (without referring to the original MA) and a new medicatieafspraak on the basis of this PRK. This means that there are now two medicatieafspraken with different PRKs under the same medicamenteuze behandeling. These two medicatieafspraken continue to exist. After any information system failure, (the information system of) the prescriber must check whether there have been changes and implement them, if necessary (see also [[#Discontinuation of medication by third parties\|paragraph 4.1.26]]).		In certain circumstances, the pharmacy is allowed to select a different PRK for the toedieningsafspraak than is indicated in the medicatieafspraak made by a prescriber. If for instance a failure of the prescriber’s information system would result in only the communication of the toedieningsafspraak, a subsequent prescriber will only have this toedieningsafspraak with the new PRK. The next prescriber will then probably assume that this PRK is also the PRK of the medicatieafspraak. A modification of the medicatieafspraak will then also result in a stop-MA (without referring to the original MA) and a new medicatieafspraak on the basis of this PRK. This means that there are now two medicatieafspraken with different PRKs under the same medicamenteuze behandeling. These two medicatieafspraken continue to exist. After any information system failure, (the information system of) the prescriber must check whether there have been changes and implement them, if necessary (see also [[#Discontinuation of medication by third parties\|paragraph 4.1.24]]).
	<br>		<br>
	[[Bestand:ENG_Voorschrijven_Twee PRKs onder een medicamenteuze behandeling.png\|800px]]		[[Bestand:ENG_Voorschrijven_Twee PRKs onder een medicamenteuze behandeling.png\|800px]]

← Oudere versie		Versie van 8 apr 2022 09:01
Regel 2.900:		Regel 2.900:
	\| style="background-color: white;vertical-align:top;"\| 9 2.0.0		\| style="background-color: white;vertical-align:top;"\| 9 2.0.0
	\| style="background-color: white;vertical-align:top;"\| 05 April 2022		\| style="background-color: white;vertical-align:top;"\| 05 April 2022
	\| style="background-color: white;vertical-align:top;"\| all changes see: *[https://informatiestandaarden.nictiz.nl/wiki/mp:V2.0.0_releasenotes Releasenotes]		\| style="background-color: white;vertical-align:top;"\| all changes see: *[https://informatiestandaarden.nictiz.nl/wiki/mp:V2.0.0_releasenotes Releasenotes]
			\|-
			\| style="background-color: white;vertical-align:top;"\| 9 2.0.0
			\| style="background-color: white;vertical-align:top;"\| 08 April 2022
			\| style="background-color: white;vertical-align:top;"\| broken internal links FO corrected [https://bits.nictiz.nl/browse/MP-607 BITS MP-607]
	\|}		\|}