DECOR Information for Project: CDA-CH-EMED eMedication (cdachemed-)

Project Information

CDA-CH-EMED defines the documents for the exchange of medication information in the context of the EPR (electronic patient record) in Switzerland. The documents
are based on the IHE Pharmacy Technical Framework modelled and specialized in the Building Block Repository CH-PHARM. Base for this modelling was the report from IPAG eMedikation, 7.6.2017 and the work of IPAG/eHealth Suisse.

The following documents have been defined (in parenthesis the amount of medications that are described):

Additional project information

Properties
Prefix: cdachemed-Default language: en-US
Publication location Project overview
http://ehealthsuisse.art-decor.org/ Project index
Disclaimer
The content of this publication has been carefully prepared and reviewed. However, eHealth Suisse does not guarantee the accuracy, completeness or quality of the information provided, or that it is up-to-date. Liability claims against eHealth Suisse in respect of material or immaterial damage caused by the use or non-use of the information offered or by inaccurate or incomplete information are in principle ruled out provided that there is no provable culpable intent or gross negligence on the institute’s part.
List of Authors
  • Administrator
  • Oliver Egger
  • Dr. Kai Heitmann
  • Johannes Gnaegi
  • Michaela Ziegler
  • Quentin Ligier
  • Tony Schaller
  • Pero Grgic
  • Annatina Foppa
  • Patrick Jolo

Version Info

Date By Description
2023‑01‑25 15:12:18 Pjolo
There have been changes to the following 2 issues since the last intermediate version or release.
  • Issue 32 "Leaking test" with status "Open". Last event (2022-08-17T15:19:55):
    All rules in the same context are leaking.
  • Issue 33 "Definition of must support" with status "Open". Last event (2022-09-08T10:08:58):
    Finding:

    hl7:manufactureMaterial.code has a description 

    R Must support. The element SHALL be present and describes the code of the medication package (GTIN) or the drug classification (WHO ATC). The @nullFlavor "NA" for magistral preparations is currently disallowed.

    it is nowhere defined (or I can't find it) what the meaning of must support is for the CDA CH EMED specification. For the CH-EMED specification the meaning of must support is defined here:

    http://fhir.ch/ig/ch-emed/index.html#mustsupport

    MustSupport

    For all elements listed in the minimum data set in the 

    IPAG report the corresponding FHIR elements ‘mustSupport’ flag have been set to true. ‘MustSupport’ flags are currently only defined for the Medication Card document.

    Meaning of the Flag MustSupport for this Implementation Guide

    The flag 

    mustSupport follows the IHE use of R2 as defined in Appendix Z. It demands that the content creator must support these elements if they are known. If the sending application has data for the element, it is required to populate the element with a non-empty value. If the value is not known, the element may be omitted. A receiving application may ignore the information conveyed by the element. A receiving application shall not raise an error solely due to the presence or absence of the element.


    Suggestion:

    Define the meaning of must-support, harmonize it with CH-EMED.

    Further explanation:

    Raised as an issue in the current ballot for CDA-CH EMED.
2022‑07‑05 09:45:14 Patrick Jolo Official Release: 220705
Release: 1.0.2

There have been changes to the following 9 issues since the last intermediate version or release.
  • Issue 19 "Usage of @contextConductionInd" with status "Closed". Last event (2022-02-21T11:23:43):
  • Issue 24 "CP-PHARM-144: ContextConduction" with status "Closed". Last event (2022-02-22T14:51:24):
    reviewed and closed
  • Issue 25 "Missing linked templates/value sets" with status "Closed". Last event (2022-02-22T14:34:44):
    reviewed and closed.
  • Issue 26 "Missing author definition" with status "Closed". Last event (2022-02-24T08:07:41):
    reviewed and closed
  • Issue 27 "informationRecipient" with status "Open". Last event (2022-02-21T15:58:09):
  • Issue 28 "Custodian" with status "Open". Last event (2022-06-09T17:00:55):
    Put another way, are there use-cases where someone from organization A is creating CDA-CH-EMED documents in behalf of organization B?
    (The custodian is described as: The organization in whose name this CDA document has been created).

    If not, then the custodian and the author organization are the same, so we should provide the information only once and decide which of these two we use.
  • Issue 29 "Explicit must support" with status "Open". Last event (2021-12-09T10:23:48):
    We should make it clear what should be supported and what can be ignored, as is done in CH-EMED.

    The only way I say is by adding it to the description, but I'm not sure we can edit all templates (by example those imported from CDA-CH).
  • Issue 30 "Section titles" with status "Open". Last event (2022-06-29T20:50:35):
    PRE and PADV sections do not have required titles, contrary to MTP, DIS, PML and PMLC sections. Others have them either as description or as Schematron assertions.

    1. Describe required titles for PRE and PADV sections.
    2. Uniformize the display (description + Schematron assertions?)
  • Issue 31 "Missing classCode" with status "Closed". Last event (2022-07-04T13:46:48):
    Checked and closed
2022‑03‑02 11:06:30 Patrick Jolo
Release: 1.0.1

There have been no changes to issues since the last intermediate version or release.
Change status to active
2022‑03‑01 14:53:26 Patrick Jolo
Release: 1.0

There have been changes to the following 7 issues since the last intermediate version or release.
  • Issue 19 "Usage of @contextConductionInd" with status "Closed". Last event (2022-02-21T11:23:43):
  • Issue 24 "CP-PHARM-144: ContextConduction" with status "Closed". Last event (2022-02-22T14:51:24):
    reviewed and closed
  • Issue 25 "Missing linked templates/value sets" with status "Closed". Last event (2022-02-22T14:34:44):
    reviewed and closed.
  • Issue 26 "Missing author definition" with status "Closed". Last event (2022-02-24T08:07:41):
    reviewed and closed
  • Issue 27 "informationRecipient" with status "Open". Last event (2022-02-21T15:58:09):
  • Issue 28 "Custodian" with status "Open". Last event (2021-12-09T09:29:11):
    Is there a practical difference between the custodian and the author organization (author/assignedAuthor/representedOrganization)? Which one should be use to convey the 

    If both information are the same, we should mark one of them as not supported. The custodian is mandatory in HL7 specs but we still can use a null flavor on it.
  • Issue 29 "Explicit must support" with status "Open". Last event (2021-12-09T10:23:48):
    We should make it clear what should be supported and what can be ignored, as is done in CH-EMED.

    The only way I say is by adding it to the description, but I'm not sure we can edit all templates (by example those imported from CDA-CH).
2021‑06‑23 09:00:58 Dr. Kai Heitmann Official Release: 0.98
Release for the Projectathon, taking place in September 2021

There have been changes to the following 4 issues since the last intermediate version or release.
  • Issue 20 "Issues in 'Original Representation Section - coded'" with status "Closed". Last event (2021-05-25T13:31:49):
    decision on point 4: no actions to be taken.
    other points fixed.
    ticket will be closed
  • Issue 21 "change display name of document type" with status "Closed". Last event (2021-05-21T17:21:52):
    yes, you are right. I will therefore close the issue.
    annex 3 will be fixed, yes, but release time is still unclear.
  • Issue 22 "Missing linked templates" with status "Closed". Last event (2021-05-21T16:55:29):
    thanks
  • Issue 23 "Original Representation Section - not mandatory" with status "Closed". Last event (2021-06-08T11:11:08):
2021‑06‑22 16:40:54 Patrick Jolo Official Release: 0.98

Release for the Projectathon, taking place in September 2021

There have been changes to the following 4 issues since the last intermediate version or release.

  • Issue 20 "Issues in 'Original Representation Section - coded'" with status "Closed". Last event (2021-05-25T13:31:49):
    decision on point 4: no actions to be taken.
    other points fixed.
    ticket will be closed
  • Issue 21 "change display name of document type" with status "Closed". Last event (2021-05-21T17:21:52):
    yes, you are right. I will therefore close the issue.
    annex 3 will be fixed, yes, but release time is still unclear.
  • Issue 22 "Missing linked templates" with status "Closed". Last event (2021-05-21T16:55:29):
    thanks
  • Issue 23 "Original Representation Section - not mandatory" with status "Closed". Last event (2021-06-08T11:11:08):
2021‑02‑22 20:00:28 Annatina Foppa Official Release: 0.97 (22.02.2021)
Release for the eMedication test event, taking place in March 2021.

Main changes:
- added original representation as requirement for all eMed documents
- changed document type according to current annex 3 (old types were deprecated)
- added value set UnitsOfPresentation 2.16.756.5.30.1.1.11.83 to set the dosequantity
- added value set ActivePharmaceuticalIngredient 2.16.756.5.30.1.1.11.82
- issues solved, see below
- issues of ch-pharm solved, release of ch-pharm 0.97

There have been changes to the following 10 issues since the last intermediate version or release.
  • Issue 1 "EprDocumentTypeCode not valid anymore" with status "Closed". Last event (2021-02-11T10:55:38):
    changed template according to eMedication Architecture Specification, Table 19.
  • Issue 2 "EprDocumentTypeCode translation, displayName wrong" with status "Closed". Last event (2021-02-16T08:35:46):
    changed 
    IHEPharmacyMedicationList 
    1.3.6.1.4.1.19376.1.9.1.1.5
    accordingly; applying the instructions of IHE PML, page 19 https://www.ihe.net/uploadedFiles/Documents/Pharmacy/IHE_Pharmacy_Suppl_PML.pdf#page=19 . Issue solved
  • Issue 3 "EprDocumentTypeCode not valid anymore" with status "Closed". Last event (2021-02-11T11:01:46):
    changed according to eMed Architecture Specs

    < translation   code =" 761938008 "   codeSystem =" 2.16.840.1.113883.6.96 "   codeSystemName =" SNOMED CT "   displayName =" Medicinal prescription record (record artifact) " / >

  • Issue 4 "EprDocumentTypeCode not valid anymore" with status "Closed". Last event (2021-02-11T11:00:13):
    Changed according to eMedication Architecture Specs

      < translation   code =" 419891008 "   codeSystem =" 2.16.840.1.113883.6.96 "   codeSystemName =" SNOMED CT "   displayName =" Record artifact (record artifact) " / >
  • Issue 5 "EprDocumentTypeCode not valid anymore" with status "Closed". Last event (2021-02-11T10:57:29):
    Changed according to eMedication Architecture Specs

      < translation   code =" 419891008 "   codeSystem =" 2.16.840.1.113883.6.96 "   codeSystemName =" SNOMED CT "   displayName =" Record artifact (record artifact) " / >
  • Issue 15 "Validity of document probably missing" with status "Cancelled". Last event (2021-02-15T16:23:44):
    After discussion with Stéphane, it doesn't really make sense to have a document validity in an MTP document. The PRE section should not apply in the MTP specification (hence the "not applicable"), so this issue can be closed.
  • Issue 16 "Missing referenced template 1.3.6.1.4.1.19376.1.5.3.1.4.4.1" with status "Closed". Last event (2021-02-11T11:26:28):
    Linked from CH-PHARM  into CDE-CH-EMED Entry Level templates. Thanks for pointing this out
  • Issue 17 "Undefined template links" with status "Closed". Last event (2021-02-11T11:37:31):
    Both templates are defined in HL7CHCDA, linked them from there to eMed-templates
  • Issue 18 "Undefined template link: 2.16.756.5.30.1.1.10.9.27" with status "Closed". Last event (2021-02-12T10:34:22):
    template has been imported
  • Issue 19 "Usage of @contextConductionInd" with status "Open". Last event (2021-02-16T09:15:46):
    The usage of the @contextConductionInd attribute is undocumented and unclear but required.
    Stéphane is submitting a change proposal to IHE PHARM, forbidding its usage.
2020‑07‑29 16:49:22 Oliver Egger Official Release: 0.96.1 (29.7.2020)
There have been changes to the following 4 issues since the last intermediate version or release.
  • Issue 11 "Missing linked template Validation Step" with status "Closed". Last event (2020-05-14T11:14:56):
    That was it, thanks!
  • Issue 12 "Wrong namespace for numerator and denominator tags" with status "Closed". Last event (2020-07-29T14:08:46):
    now all pharm numerator/denominator should have been fixed by Tony/Oliver
  • Issue 13 "Wrong example for Dispense Item Entry" with status "Closed". Last event (2020-06-08T10:51:58):
  • Issue 14 "Missing referenced templates" with status "Closed". Last event (2020-07-29T13:45:57):
2020‑05‑08 14:19:04 Oliver Egger Official Release: 0.96 (08.05.2020)
Release: 0.96 (08.05.2020)
Changelog for update from 0.95.3:
  • ch-pcc and IHE PCC added as dependent projects
  • SubstanceAdministration: routeCode has CE data type (was CD)
  • manufacturedMaterial.pharm: asContent not declared as a list
  • IHEPrescriptionItemEntryContentModule, Prescription Item Entry Content Module repeatNumber, routeCode order fixed
  • Adjustments Documed Code Translations to Appendix 3 (Prescription changed, Dispensation, Treatment Plan and Medication Comment currently no typeCode
  • Medication Card document and Medication Prescription document Original Representation Section added for original representation
  • update to IHE PHARM 2020 (Validation Step Template for IHE PRE)
  • SNOMED CT coding for substances instead of ATC
  • Art-Decor Issue 1 "EprDocumentTypeCode not valid anymore" with status "Open". Last event (2019-10-15T11:26:08):
    Finding:

      <!-- Mapping to the Swiss EPR XDS.b metadata according to the Value-Set
    EprDocumentTypeCode (201704.1-beta; 2.16.756.5.30.1.127.3.10.1.27) -->
      < translation code =" 275670009 " codeSystem =" 2.16.840.1.113883.6.96 " codeSystemName =" SNOMED CT " displayName =" Medication Dispensation " / >

    Medication Dispensation with SNOMED CT code 275670009 is not in the 201907.0-stable ValueSet anymore.

    Suggestion:
    Discuss with eHealth Suisse.

    Further explanation:

    -

  • Art-Decor Issue 2 "EprDocumentTypeCode translation, displayName wrong" with status "Open". Last event (2019-10-15T11:40:53):
    Finding:

    displayName of translation fixed to Medication summary, but should be  Medication summary document

    Suggestion:

    IHE PML specifies expliciltly 'Table 6.3.1.D.5-1' SHALL be 56445-0, LOINC, “Medication summary” 

    Further explanation:

    -

  • Art-Decor Issue 3 "EprDocumentTypeCode not valid anymore" with status "Open". Last event (2019-10-15T11:43:12):
    Finding:

      <!-- Mapping to the Swiss EPR XDS.b metadata according to the Value-Set
    EprDocumentTypeCode (201704.1-beta; 2.16.756.5.30.1.127.3.10.1.27) -->
      < translation code =" 440545006 " codeSystem =" 2.16.840.1.113883.6.96 " codeSystemName =" SNOMED CT " displayName =" Drug prescription " / >

    Medication Prescription with SNOMED CT code 440545006 is not in the 201907.0-stable ValueSet anymore.

    Suggestion:

    Change to 761938008 Medical Prescription record (record artifact)? Discuss with eHealth Suisse


    -

    Further explanation:

    -

  • Art-Decor Issue 4 "EprDocumentTypeCode not valid anymore" with status "Open". Last event (2019-10-15T11:44:50):
    Finding:

      <!-- Mapping to the Swiss EPR XDS.b metadata according to the Value-Set
    EprDocumentTypeCode (201704.1-beta; 2.16.756.5.30.1.127.3.10.1.27) -->
      < translation code =" 761931002 " codeSystem =" 2.16.840.1.113883.6.96 " codeSystemName =" SNOMED CT " displayName =" Medication Treatment Plan " / >

    Medication Treatment Plan with SNOMED CT code  761931002  is not in the 201907.0-stable ValueSet anymore.

    Suggestion:

    Discuss with eHealth Suisse.

    Further explanation:

    -

  • Art-Decor Issue 5 "EprDocumentTypeCode not valid anymore" with status "Open". Last event (2019-10-15T11:45:55):
    Finding:

       < translation   code =" 1221000195109 "   codeSystem =" 2.16.840.1.113883.6.96 "   codeSystemName =" SNOMED CT "   displayName =" Medication Comment " / >

    Medication Comment with SNOMED CT code  1221000195109  is not in the 201907.0-stable ValueSet anymore.

    Suggestion:

    Discuss with eHealth Suisse.

    Further explanation:

    -
2020‑02‑06 16:57:17 Oliver Egger Official Release: 0.96.1 (06.02.2020)
Changelog for update from 0.95.3:
  • ch-pcc and IHE PCC added as dependent projects
  • SubstanceAdministration: routeCode has CE data type (was CD)
  • manufacturedMaterial.pharm: asContent not declared as a list
  • IHEPrescriptionItemEntryContentModule, Prescription Item Entry Content Module repeatNumber, routeCode order fixed
  • Adjustments Documed Code Translations to Appendix 3 (Prescription changed, Dispensation, Treatment Plan and Medication Comment currently no typeCode
  • Medication Card document and Medication Prescription document Original Representation Section added for original representation
  • update to IHE PHARM 2020 (Validation Step Template for IHE PRE)
  • SNOMED CT coding for substances instead of ATC
  • Art-Decor Issue 1 "EprDocumentTypeCode not valid anymore" with status "Open". Last event (2019-10-15T11:26:08):
    Finding:

      <!-- Mapping to the Swiss EPR XDS.b metadata according to the Value-Set
    EprDocumentTypeCode (201704.1-beta; 2.16.756.5.30.1.127.3.10.1.27) -->
      <translation code="275670009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Medication Dispensation"/>

    Medication Dispensation with SNOMED CT code 275670009 is not in the 201907.0-stable ValueSet anymore.

    Suggestion:
    Discuss with eHealth Suisse.

    Further explanation:

    -

  • Art-Decor Issue 2 "EprDocumentTypeCode translation, displayName wrong" with status "Open". Last event (2019-10-15T11:40:53):
    Finding:

    displayName of translation fixed to Medication summary, but should be Medication summary document

    Suggestion:

    IHE PML specifies expliciltly 'Table 6.3.1.D.5-1' SHALL be 56445-0, LOINC, “Medication summary” 

    Further explanation:

    -

  • Art-Decor Issue 3 "EprDocumentTypeCode not valid anymore" with status "Open". Last event (2019-10-15T11:43:12):
    Finding:

      <!-- Mapping to the Swiss EPR XDS.b metadata according to the Value-Set
    EprDocumentTypeCode (201704.1-beta; 2.16.756.5.30.1.127.3.10.1.27) -->
      <translation code="440545006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Drug prescription"/>

    Medication Prescription with SNOMED CT code 440545006 is not in the 201907.0-stable ValueSet anymore.

    Suggestion:

    Change to 761938008 Medical Prescription record (record artifact)? Discuss with eHealth Suisse


    -

    Further explanation:

    -

  • Art-Decor Issue 4 "EprDocumentTypeCode not valid anymore" with status "Open". Last event (2019-10-15T11:44:50):
    Finding:

      <!-- Mapping to the Swiss EPR XDS.b metadata according to the Value-Set
    EprDocumentTypeCode (201704.1-beta; 2.16.756.5.30.1.127.3.10.1.27) -->
      <translation code="761931002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Medication Treatment Plan"/>

    Medication Treatment Plan with SNOMED CT code 761931002 is not in the 201907.0-stable ValueSet anymore.

    Suggestion:

    Discuss with eHealth Suisse.

    Further explanation:

    -

  • Art-Decor Issue 5 "EprDocumentTypeCode not valid anymore" with status "Open". Last event (2019-10-15T11:45:55):
    Finding:

      <translation code="1221000195109" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Medication Comment"/>

    Medication Comment with SNOMED CT code 1221000195109 is not in the 201907.0-stable ValueSet anymore.

    Suggestion:

    Discuss with eHealth Suisse.

    Further explanation:

    -
2018‑05‑08 09:03:51 Johannes Gnaegi Official Release: 0.95.3 (08.05.2018)
There have been no changes to issues since the last intermediate version or release. Formal release to include formal changes to CDA-CH.
2018‑05‑03 17:03:51 Oliver Egger Official Release: 0.95.2 (30.04.2018)
labeled pre-publication review
2018‑04‑29 08:51:05 Oliver Egger Official Release: 0.95.1
ajdusted samples
2018‑04‑26 20:40:35 Oliver Egger Official Release: 0.95.0
  • update to IHE Pharmacy Framework 2017
  • EDQM valusets
  • integration of feedback for hearing of ordonnance of appendix 4

Data sets, codes, OIDs and Rules: this information is used for rendering and validation purposes.