MyHealth@Eu Electronic Prescription and Dispense
0.1.0 - draft 150

MyHealth@Eu Electronic Prescription and Dispense - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Mapping to Profiles

### Mappings from MyHealth@EU / EHDS models to FHIR profiles

MyHealth@EU logical models refine the EHDS logical information models provided by the Xt-EHR project. These models add obligation levels (Mandatory, Required, Optional) to the EHDS base elements.
Please read more about the models on the Prescription and Medication Models Overview page.

The mappings below show how the logical model elements explicitly defined in the MyHealth@EU models are realised in the FHIR R4 profiles of this guide.

#### Medication Prescription

The MyHealthEuPrescription model refines EHDSMedicationPrescription. The prescription maps primarily to MedicationRequestMyHealthEuEpd. The prescribed medication is represented using MedicationMyHealthEuEpd.

EHDS Medication Prescription allows multiple prescribed items on one prescription. In such cases, the prescription identifier may be represented using `MedicationRequest.groupIdentifier`, and one `MedicationRequest` instance represents each prescribed item.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
header.identifier | MedicationRequest.identifier; MedicationRequest.groupIdentifier | Use `groupIdentifier` when several prescribed items belong to the same prescription.
header.author[x] | MedicationRequest.requester | Reference to PractitionerRoleMyHealthCore.
header.date | MedicationRequest.authoredOn |
prescriptionItem | MedicationRequest | One MedicationRequest represents one prescribed item.
prescriptionItem.identifier | MedicationRequest.identifier |
prescriptionItem.validityPeriod | MedicationRequest.dispenseRequest.validityPeriod |
prescriptionItem.substitution | MedicationRequest.substitution |
prescriptionItem.dosageInstructions | MedicationRequest.dosageInstruction | Constrained by the dosage mappings below.
prescriptionItem.note | MedicationRequest.note |
prescriptionItem.medication | MedicationRequest.medication[x] | Reference to MedicationMyHealthEuEpd.
prescriptionItem.quantityPrescribed | MedicationRequest.dispenseRequest.extension:prescribedQuantity |
prescriptionItem.treatmentPeriod | MedicationRequest.extension:effectiveDosePeriod | R5 preadoption extension.
prescriptionItem.renderedDosageInstruction | MedicationRequest.extension:renderedDosageInstruction | R5 preadoption extension.

#### Medication

The MyHealthEuMedication model refines EHDSMedication. It maps to MedicationMyHealthEuEpd.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
identifyingCode[x] | Medication.code; Medication.identifier |
productName | Medication.extension:productName |
classification | Medication.extension:classification |
marketingAuthorisationHolder | Medication.manufacturer | Reference to OrganizationMyHealthCore where available.
item | Medication | FHIR R4 Medication represents both the medicinal product and its package/item details.
item.ingredient | Medication.ingredient |
item.ingredient.isActive | Medication.ingredient.isActive |
item.ingredient.substance | Medication.ingredient.itemCodeableConcept; Medication.ingredient.itemReference |
item.ingredient.strengthInfo | Medication.ingredient.strength |
item.ingredient.strengthInfo.strength | Medication.ingredient.strengthRatio |
item.doseForm | Medication.form |
item.containedQuantity | Medication.extension:sizeOfItem |
item.amount | Medication.amount |
item.packageType | Medication.extension:packageType |

#### Dosaging

The MyHealthEuDosaging model refines EHDSDosage. It maps to the `MedicationRequest.dosageInstruction` and `MedicationDispense.dosageInstruction` elements.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
dosageDetails | Dosage |
dosageDetails.note | Dosage.text; Dosage.patientInstruction | Used for free-text instructions to the patient or dispenser.
dosageDetails.doseAndRate | Dosage.doseAndRate |
dosageDetails.repeat.frequency | Dosage.timing.repeat.frequency; Dosage.timing.repeat.frequencyMax; Dosage.timing.repeat.period; Dosage.timing.repeat.periodUnit |
dosageDetails.repeat.eventTime | Dosage.timing.repeat.when; Dosage.timing.repeat.offset; Dosage.timing.repeat.timeOfDay |
dosageDetails.repeat.bounds.duration | Dosage.timing.repeat.boundsDuration |
dosageDetails.routeOfAdministration | Dosage.route |

#### Medication Dispense

The MyHealthEuMedicationDispense model refines EHDSMedicationDispense. It maps to MedicationDispenseMyHealthEuEpd. The dispensed medication is represented using MedicationMyHealthEuEpd.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
header.identifier | MedicationDispense.identifier |
header.date | MedicationDispense.whenHandedOver | May also be represented as the recorded event time where supported by the implementation context.
relatedRequest | MedicationDispense.authorizingPrescription | Reference to MedicationRequestMyHealthEuEpd.
medication | MedicationDispense.medicationReference | Reference to MedicationMyHealthEuEpd.
dispensedQuantity | MedicationDispense.quantity |
timeOfDispensation | MedicationDispense.whenHandedOver |
substitutionOccurred | MedicationDispense.substitution.wasSubstituted |
dosageInstructions | MedicationDispense.dosageInstruction | Constrained by the dosage mappings above.
renderedDosageInstruction | MedicationDispense.extension:renderedDosageInstruction | R5 preadoption extension.

#### Supporting models mapped in MyHealth@EU Core

Several referenced EHDS models are implemented through the MyHealth@EU Core IG. The mappings below cover only the elements explicitly defined in the MyHealth@EU models.

##### Patient

The MyHealthEuPatient model refines EHDSPatient.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
identifier | Patient.identifier |
name | Patient.name | Constrained to MyHealthEuHumanName.
dateOfBirth | Patient.birthDate |
administrativeGender | Patient.gender |

##### Human Name

The MyHealthEuHumanName model refines EHDSHumanName.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
family | HumanName.family |
given | HumanName.given |

##### Address

The MyHealthEuAddress model refines EHDSAddress.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
street | Address.line.extension:streetName | iso21090-ADXP-streetName extension.
houseNumber | Address.line.extension:houseNumber | iso21090-ADXP-houseNumber extension.
city | Address.city |
postalCode | Address.postalCode |
country | Address.country |

##### Telecom

The MyHealthEuTelecom model refines EHDSTelecom.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
type | ContactPoint.system |
value | ContactPoint.value |

##### Health Professional

The MyHealthEuHealthProfessional model refines EHDSHealthProfessional.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
identifier | Practitioner.identifier; PractitionerRole.identifier |
name | Practitioner.name | Constrained to MyHealthEuHumanName.
address | Practitioner.address | Constrained to MyHealthEuAddress.
telecom | Practitioner.telecom | Constrained to MyHealthEuTelecom.
professionalRole | PractitionerRole |
professionalRole.role | PractitionerRole.code |
professionalRole.organisation | PractitionerRole.organization | Reference to OrganizationMyHealthCore.
professionalRole.specialty | PractitionerRole.specialty |

##### Organisation

The MyHealthEuOrganisation model refines EHDSOrganisation.

Logical model element | FHIR Path (R4) | Comment
--- | --- | ---
identifier | Organization.identifier |
name | Organization.name |
address | Organization.address | Constrained to MyHealthEuAddress.