ARCHETYPE Medication summary (openEHR-EHR-EVALUATION.medication_summary.v1)

ARCHETYPE IDopenEHR-EHR-EVALUATION.medication_summary.v1
ConceptMedication summary
DescriptionSummary or persistent information about the use of a single medication or group of medications, especially where the pattern of use or cumulative dosage needs to be monitored.
UseUse to record summary information about the use of a single medication or group or class of medications, especially where the pattern of use or cumulative dosage needs to be monitored. This archetype has been designed to represent an overview of the use of medication only in specific situations where it adds value to the health record, such as where the cumulative dose of the medication has significant toxic effects or long term use has adverse health impacts. A single instance of the archetype will be used to capture one or more episodes of use, so that a pattern of use can be identified and/or a cumulative dose can be calculated. Examples of use include: - monitoring of the cumulative dose of doxorubicin or methotrexate taken over a lifetime. - monitoring the duration of high dose bisphosphanates. - monitoring the use of an experimental medication in a trial. Use a new instance of this archetype to record details about each medication or group or class of medications. Triggers for closing one episode and commencing a new one will largely reflect local data collection preferences and clinical priorities, including if the individual: - stops using the medication for a significant period of time (which will likely be locally defined). - significantly changes their amount or pattern of use. - changes in the route by which the medication was administered.
MisuseNot to be used to represent a 'Medication list' - use COMPOSITION.medication_list for this purpose. In addition, not to be used to represent a medication within a 'Medication list' - use either an INSTRUCTION.medication_order or ACTION.medication for this purpose. Not to be used for recording an order for a medication to be administered or consumed - use INSTRUCTION.medication_order for this purpose. Not to be used for documenting the actual administration or consumption of a medication - use ACTION.medication for this purpose. Not to be used for recording the status of use or screening question/answer pairs regarding the medication - use OBSERVATION.medication_screening for this purpose. Not to be used to record an observation about the use of a medication - use OBSERVATION.medication_statement for this purpose.
PurposeTo record summary or persistent information about the use of a single medication or group or class of medications, especially where the pattern of use or cumulative dosage needs to be monitored.
References
Copyright© openEHR Foundation
AuthorsAuthor name: Heather Leslie
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2015-12-08
Other Details LanguageAuthor name: Heather Leslie
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2015-12-08
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=openEHR Foundation, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=50B8849AB9B274AB2D8E0456FA33FF85, build_uid=0c00cb63-d882-4789-83b5-9e27946b84d8, revision=1.0.1}
Keywordsdrug, lifelong, medication, self-medicate, medicine, history, lifetime, cumulative, dose, use, administration, consumption
Lifecyclepublished
UID24f51bf9-bcc2-47e6-b035-e03d63fc6a1f
Language useden
Citeable Identifier1013.1.2825
Revision Number1.0.1
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Summary or persistent information about the use of a single medication or group of medications, especially where the pattern of use or cumulative dosage needs to be monitored., archetypeConceptComment=null, otherContributors=Dag Aarhus, Vestre Viken HF, Norway
Ulrich Andersen, Denmark
Ole Andreas Bjordal, Webmed, Norway
Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor)
Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor)
Terje Bektesevic Holmlund, UiT Norges arktiske universitet, Norway
SB Bhattacharyya, Bhattacharyyas Clinical Records Research & Informatics LLP, India
Colin Brown, NHS Scotland SCIMP, United Kingdom
Laila Bruun, Oslo universitetssykehus HF, Norway
Greg Burch, Tiny Medical Apps, United Kingdom
Fatemeh Chalabianloo, Helse Bergen, Norway
Grant Forrest, Lunaria Ltd, United Kingdom
James Goddard, NHS Wales Informatics Service, United Kingdom
Heather Grain, Llewelyn Grain Informatics, Australia
Anca Heyd, DIPS ASA, Norway
Joost Holslag, Nedap, Netherlands
Evelyn Hovenga, EJSH Consulting, Australia
Mikkel Johan Gaup Grønmo, Regional forvaltning EPJ, Helse Nord, Norway (Nasjonal IKT redaktør)
Nils Kolstrup, Skansen Legekontor og Nasjonalt Senter for samhandling og telemedisin, Norway
Kanika Kuwelker, Helse Vest IKT, Norway (Nasjonal IKT redaktør)
Jörgen Kuylenstierna, eWeave AB, Sweden
Tomi Laptoš, Marand, Slovenia
Liv Laugen, Oslo universitetssykehus, Norway (Nasjonal IKT redaktør)
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
Pramil Liyanage, Ministry of Health, Sri Lanka
Colin Macfarlane, Elsevier, United Kingdom
James McClay, University of Nebraska Medical Center, United States
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor)
Lars Morgan Karlsen, Nordlandssykehuset Bodø, Norway
Svenne Naumann, Finnmarkssykehuset, Norway
Bjørn Næss, DIPS ASA, Norway
Ana Pereira, CINTESIS, CUF-Porto, Portugal
Natalia Strauch, Medizinische Hochschule Hannover, Germany
Norwegian Review Summary, Norwegian Public Hospitals, Norway
Rowan Thomas, St. Vincent's Hospital Melbourne, Australia
Anders Thurin, VGR, Sweden
Pencho Tonchev, Medical University- Pleven, Bulgaria
John Tore Valand, Helse Bergen, Norway (openEHR Editor)
Marit Alice Venheim, Helse Vest IKT, Norway
Thomas Wilson, Finnmarkssykehuset HF Klinikk Hammerfest, Norway
Michael Zampaglione, Australia, originalLanguage=en, translators=German: Ramona Wellmann, Alina Rehberg, Natalia Strauch, Medizinische Hochschule Hannover, wellmann.ramona@mh-hannover.de, rehberg.alina@mh-hannover.de, Strauch.Natalia@mh-hannover.de
Norwegian Bokmål: Gro-Hilde Ulriksen, John Tore Valand, Liv Laugen, Vebjørn Arntzen, Norwegian centre for e-health research, Helse Bergen, ​Oslo University Hospital, Norway, john.tore.valand@helse-bergen.no, liv.laugen@ous-hf.no, varntzen@ous-hf.no, john.tore.valand@helse-vest-ikt.no
Portuguese (Brazil): Adriana Kitajima, Débora Farage, Fernanda Maia, Laíse Figueiredo, Marivan Abrahão, Core Consulting, contato@coreconsulting.com.br, Hospital Alemão Oswaldo Cruz (HAOC)
, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={identities=[], events=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=2, text=Medication name, description=Name of medication or group of medications., comment=The medication name can be represented as a generic substance, trade name or a group or class of medications. Coding of 'Medication name' with a terminology capable of triggering decision support is strongly recommended where possible. Free text entry should only be used if there is no appropriate terminology available. For example: 'Adriamycin'; 'doxorubicin' or 'anthracyclines'; 'Fosamax', 'alendronate' or 'bisphosphanates'., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0007], code=at0007, itemType=ELEMENT, level=2, text=Clinical description, description=Narrative description about the overall use of the medication., comment=For example: "Used between 1996 and 2001 against osteoporosis. Ceased after five years of use to minimise risk of adverse effects.", uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028], code=at0028, itemType=ELEMENT, level=2, text=Clinical indication, description=The overall clinical indication for the use of the medication., comment=Coding with an external terminology is preferred, where possible. For example: 'Osteoporosis'., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0009], code=at0009, itemType=ELEMENT, level=2, text=Onset of use, description=The date when the medication was first administered., comment=Can be a partial date, for example, only a year., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008], code=at0008, itemType=CLUSTER, level=2, text=Episode, description=Details about use of the medication during a specified period of time., comment=Triggers for closing one episode and commencing a new one can include: - a change in dose; - or a significant change in the pattern of use, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0011], code=at0011, itemType=ELEMENT, level=3, text=Episode onset, description=The date of the first administration of the medication for this episode., comment=Can be a partial date, for example, only a year., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0018], code=at0018, itemType=ELEMENT, level=3, text=Episode indication, description=The clinical indication for the use of the medication during this episode, particularly if this is more specific or differs from the 'Clinical indication', or there is no clinical indication that applies for all episodes., comment=This element and the root level 'Clinical indication' element can potentially be in conflict with each other. In those situations, this element takes precedence over 'Clinical indication' for this episode. Coding with an external terminology is preferred, where possible. For example: 'Cancer therapy' or 'rheumatoid arthritis for osteoporosis'., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0020], code=at0020, itemType=ELEMENT, level=3, text=Therapeutic intent, description=The therapeutic intent for use of the medication during this episode., comment=Coding with an external terminology, where possible. For example: pain relief; palliative or curative; short term course or life-long antibiotics., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0014], code=at0014, itemType=ELEMENT, level=3, text=Description, description=Narrative description about the use of the medication during this episode., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0016], code=at0016, itemType=ELEMENT, level=3, text=Episode amount, description=Cumulative dose of the medication used in this episode., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Quantity
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0029], code=at0029, itemType=SLOT, level=3, text=Additional details, description=Additional details about medication use during this episode., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.dosage.v1 and specialisations or
openEHR-EHR-CLUSTER.dosage.v2 and specialisations or
openEHR-EHR-CLUSTER.medication.v1 and specialisations or
openEHR-EHR-CLUSTER.medication.v2 and specialisations or
openEHR-EHR-CLUSTER.therapeutic_direction.v1, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0012], code=at0012, itemType=ELEMENT, level=3, text=Episode cessation, description=The date of the last administration of the medication for this episode., comment=Can be a partial date, for example, only a year., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0031], code=at0031, itemType=ELEMENT, level=3, text=Episode duration, description=The duration of the use of the medication in this episode., comment=If 'Episode onset' and 'Episode cessation' are used in systems, this data element may be calculated, or alternatively, be considered redundant in this scenario., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=Allowed values: years, months, days, hours
>=0 hours
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0013], code=at0013, itemType=ELEMENT, level=3, text=Episode reason for cessation, description=The reason why use of the medication was stopped., comment=Coding with an external terminology is preferred, where possible. For example: sub-optimal control of diabetes; adverse reaction; or high cost., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0032], code=at0032, itemType=ELEMENT, level=3, text=Route, description=The route by which the ordered item was, administed during this episode., comment=For example: 'oral', 'intravenous', or 'topical'. Coding of the route with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0008]/items[at0022], code=at0022, itemType=ELEMENT, level=3, text=Therapeutic response, description=The observed response to the treatment with this medication during this episode., comment=Coding with an external terminology is preferred, where possible. For example: UTI resolved, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0015], code=at0015, itemType=ELEMENT, level=2, text=Cumulative dose, description=Total amount of the medication used over the lifetime of the individual., comment=For example: monitoring of the cumulative dose of doxorubicin. May be manually calculated or derived via the EHR from multiple sources. , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_QUANTITY, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0010], code=at0010, itemType=ELEMENT, level=2, text=Cessation of use, description=The date when the medication was last administered., comment=Can be a partial date, for example, only a year., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0030], code=at0030, itemType=ELEMENT, level=2, text=Reason for cessation, description=The reason why all use of the medication was stopped., comment=Coding with an external terminology is preferred, where possible. For example: sub-optimal control of diabetes; adverse reaction; or high cost., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0027], code=at0027, itemType=ELEMENT, level=2, text=Cumulative duration, description=The sum of the duration of all episodes., comment=May be manually calculated or derived via the EHR from multiple sources., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=>=0 seconds
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All not explicitly excluded archetypes, extendedValues=null]], state=[], capabilities=[], other_participations=[], content=[], context=[], relationships=[], source=[], target=[], activities=[], description=[], ism_transition=[], contacts=[], provider=[], items=[], credentials=[]}, topLevelItems={data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001], code=at0001, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0005], code=at0005, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0005]/items[at0006], code=at0006, itemType=ELEMENT, level=2, text=Last updated, description=The date this medication summary was last updated., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0005]/items[at0019], code=at0019, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models or formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
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