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Detectedissue-example.json

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Patient, Practitioner

Raw JSON (canonical form + also see JSON Format Specification)

Drug-drug interaction between prescription and medication statement

{
  "resourceType": "DetectedIssue",
  "id": "ddi",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      <p><b>Severity: High</b> - Risk of internal bleeding</p>\n      <p>Those who take acetaminophen along with the widely used blood-thinning drug warfarin may face the risk of serious internal bleeding. People on warfarin who take acetaminophen for at least seven days in a row should be closely watched for bleeding.</p>\n      <ul>\n        <li><a href=\"MedicationStatement/tylenol\">500 mg Acetaminophen tablet 1/day, PRN since 2010</a></li>\n        <li><a href=\"MedicationRequest/warfarin\">Warfarin 1 MG TAB prescribed Jan. 5, 2014</a></li>\n      </ul>\n      <p>Mitigation: Jan 5, 2014 by Dr. Adam Careful: </p>\n      <p>Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring</p>\n    </div>"
  },
  "status": "final",
  "code": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "DRG",
        "display": "Drug Interaction Alert"
      }
    ]
  },
  "severity": "high",
  "identifiedDateTime": "2014-01-05",
  "author": {
    "reference": "Device/software"
  },
  "implicated": [
    {
      "reference": "MedicationStatement/example001",
      "display": "500 mg Acetaminophen tablet 1/day, PRN since 2010"
    },
    {
      "reference": "MedicationRequest/medrx0331",
      "display": "Warfarin 1 MG TAB prescribed Jan. 15, 2015"
    }
  ],
  "detail": "Risk of internal bleeding.  Those who take acetaminophen along with the widely used blood-thinning drug warfarin may face the risk of serious internal bleeding. People on warfarin who take acetaminophen for at least seven days in a row should be closely watched for bleeding.",
  "mitigation": [
    {
      "action": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
            "code": "13",
            "display": "Stopped Concurrent Therapy"
          }
        ],
        "text": "Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring"
      },
      "date": "2014-01-05",
      "author": {
        "reference": "Practitioner/example",
        "display": "Dr. Adam Careful"
      }
    }
  ]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.