IHE Pharmacy Medication Overview, published by Integrating the Healthcare Enterprise (IHE). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/pharm-meow/tree/r4-rr and changes regularly. See the Directory of published versions
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PHARM yyy

This section corresponds to transaction [PHARM-y] of the IHE Pharmacy Technical Framework. Transaction [PHARM-y] is used by the Medication Overview Creator and Medication Overview Repository actors.

1:33.y.1 Scope

The Submit Medication Overview transaction is used by a Medication Overview Creator to submit a Medication Overview - the set of medication treatment lines summarizing the patient's medication - to a Medication Overview Repository. It is a push interaction: the Creator provides the medication information to be stored and made available for later retrieval.

1:33.y.2 Actor Roles

Actor	Role
Medication Overview Creator	Assembles the Medication Overview and submits it to the Medication Overview Repository.
Medication Overview Repository	Receives, validates and stores the submitted Medication Overview.

1:33.y.3 Referenced Standards

FHIR R4 — HL7 FHIR Release 4.0.1

1:33.y.4 Interaction Diagram

@startuml
skinparam backgroundColor transparent
skinparam sequenceMessageAlign center
hide footbox

participant "Medication Overview\nCreator" as Cr
participant "Medication Overview\nRepository" as R

Cr -> R : Submit Medication Overview\n(MedicationOverview Bundle)
activate R
R --> Cr : Acknowledgement
deactivate R
@enduml

1:33.y.4.1 Submit Medication Overview Message

The Medication Overview Creator sends a Medication Overview Bundle document to the Medication Overview Repository. The Bundle contains the Composition and the medication treatment lines for a single patient.

1:33.y.4.2 Acknowledgement

The Medication Overview Repository returns an acknowledgement indicating whether the submission was accepted.

1:33.y.5 Expected Actions

The Medication Overview Repository shall store the submitted Medication Overview so that it can subsequently be retrieved through the Get Medication Overview [PHARM-x] transaction.

1:33.y.6 Workflow Examples

The following scenarios illustrate how medication treatment lines are produced before being summarized into a Medication Overview.

Begin treatment with line

This is a normal case, where the medication line is the trigger for prescriptions.

1. Psychiatrist decides that patient should initiate treatment for depression, indicating bupropion. They create a treatment line for that patient. No prescription is necessarily authorized yet.
   • At this moment, querying a patient's current medications should return this line, with status "????"
2. After checking contraindications, psychiatrist decides to treat the patient with fluoxetine instead. The prescription is finally issued for 1 box of 30 tablets.
   • At this moment, querying a patient's current medications should return this line, with status "????"
3. When medication is dispensed, the medication line is not updated but the medication may be added to the link.

Treatments from prescriptions

This is the other normal case, where the medication line is derived from existing prescriptions.

1. Patient visits the GP who issues a prescription.
2. From the prescription, a medication line is created (or updated if one already exists).