Med Relative Dose IV Drug

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Approval Status

  • Approval Status: Pending
  • Example Task Force: 2/15/2018
  • SDWG:

C-CDA 2.1 Example:

  • 2.16.840.1.113883.10.20.22.2.1:2014-06-09
  • 2.16.840.1.113883.10.20.22.2.1.1:2014-06-09
  • 2.16.840.1.113883.10.20.22.4.16:2014-06-09
  • 2.16.840.1.113883.10.20.22.4.23:2014-06-09
  • 2.16.840.1.113883.10.20.22.4.119

Reference to full CDA sample:

  • Medications in empty CCD

Validation location

Comments

This example illustrates an example of a medication order with the following characteristics:

  • an IV drug with a relative dose quantity that is based on weight,

  • a drug vehicle used for preparation,

  • and indications for the medication.

This example was created to address the following Use Case: An oncologist is ordering a drug as part of a chemotherapy regimen. Chemotherapy regimens consist of orders could be administered weeks or months in advance. Moreover their preparation is based on the patient's weight at the time of administration. Because of these constraints, the C-CDA medications section needs to be represented in a way that reflects this.

Additional Notes and Assumptions: * the /entry/substanceAdministration/effectiveTime/@value is meant to be set at a future date relative to the date of the encounter. The date of the encounter would have been represented in a separate section outside of this example.

Custodian

  • May Terry (GitHub: mayterry88)

Keywords

  • medication, chemo, IV, realtive dosing

Permalink

 

Example: download example view on GitHub

<section>
    <templateId root="2.16.840.1.113883.10.20.22.2.1.1"/>
    <templateId root="2.16.840.1.113883.10.20.22.2.1.1" extension="2014-06-09"/>
    <!-- Medication Section (entries required) -->
    <code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of Medication Use"/>
    <title>MEDICATIONS</title>
    <text>
        <table border="1" width="100%">
            <thead>
                <tr>
                    <th>Medication</th>
                    <th>Instructions</th>
                    <th>Dosage</th>
                    <th>Effective Date(s)</th>
                    <th>Status</th>
                </tr>
            </thead>
            <tbody>
                <tr ID="Medication_1">
                    <td>
                        <content ID="MedicationName_1">4 ML bevacizumab 25 MG/ML Injection</content>
                    </td>
                    <td/>
                    <td>
                        <content>5 mg/kg</content>
                    </td>
                    <td>2018-02-15</td>  <!-- one time administration on Day 1 -->
                    <td>Active</td>
                </tr>
            </tbody>
        </table>
    </text>
    <entry typeCode="DRIV">
        <substanceAdministration classCode="SBADM" moodCode="INT">
            <!-- ** Medication Activity (V2) ** -->
            <templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/>
            <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
            <id root="6c844c75-aa34-411c-b7bd-5e4a9f206e29"/>
            <text>
                <!-- This reference refers to medication information in unstructured portion of section-->
                <reference value="#Medication_1"/>
            </text>
            <statusCode code="active" />  <!-- the medication order is currently active -->
            <!-- for this regimen, bevacizumab will only be administered once, on Day 1, 
		as an example scheduled for a future date relative to the date of the encounter.  -->
            <effectiveTime value = "20180215" />
            <routeCode code="C38276"
                codeSystem="2.16.840.1.113883.3.26.1.1"
                codeSystemName="NCI Thesaurus"
                displayName="INTRAVENOUS"/>
            <!-- an absolute dose quantity is unknown at the time the order is placed because 
                 the drug is prepared based on the weight at the time of administration. -->
            <!-- unit of measure taken from UCUM: http://download.hl7.de/documents/ucum/ucumdata.html -->
            <doseQuantity value="5" unit="mg/kg" />
            <consumable>
                <manufacturedProduct classCode="MANU">
                    <!-- ** Medication information ** -->
                    <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
                    <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
                    <id root="2a620155-9d11-439e-92b3-5d9815ff3cc2"/>
                    <manufacturedMaterial>
                        <code code="1657066"
                            displayName="4 ML bevacizumab 25 MG/ML Injection"
                            codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm">
                            <originalText>
                                <reference value="#MedicationName_1"/>
                            </originalText>
                        </code>
                    </manufacturedMaterial>
                </manufacturedProduct>
            </consumable>
            <participant typeCode="CSM">
                <participantRole classCode="MANU">
                    <templateId root="2.16.840.1.113883.10.20.22.4.24"/>
                    <code code="412307009" displayName="drug vehicle"
                        codeSystem="2.16.840.1.113883.6.96"/>
                    <playingEntity classCode="MMAT">
                        <!-- bevacizumab is prepared with a compatible solution for continuous infusion. 
	                         In this example, we use normal saline for preparation. 
	                    -->
                        <code code="1807639" displayName="1000 ML Sodium Chloride 9 MG/ML Injection"
                            codeSystem="2.16.840.1.113883.6.88"
                            codeSystemName="RxNorm"/>
                        <name>Sodium Chloride 0.9%</name>
                    </playingEntity>
                </participantRole>
            </participant> 
            <entryRelationship typeCode="RSON">
                <observation classCode="OBS" moodCode="EVN">
                    <!-- ** Indication ** -->
                    <templateId root="2.16.840.1.113883.10.20.22.4.19"
                        extension="2014-06-09"/>
                    <!-- This ID may link to the problem ID entry in the problem list, if it already exists. -->
                    <id root="e63166c7-6482-4a44-83a1-37ccdbdd532b"/>
                    <code code="75321-0"
                        codeSystem="2.16.840.1.113883.6.1"
                        codeSystemName="LOINC"
                        displayName="Clinical finding"/>
                    <statusCode code="completed"/>
                    <value xsi:type="CD"
                        code="363406005"
                        displayName="Malignant neoplasm of colon"
                        codeSystem="2.16.840.1.113883.6.96"/>
                </observation>
            </entryRelationship>
        </substanceAdministration>
    </entry>
</section>
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