HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG
0.1.0 - ci-build
HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG, published by New Zealand Medicines Formulary LP. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7NZ/nzf/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org.nz/fhir/ig/formulary/ImplementationGuide/hl7.org.nz.fhir.ig.formulary | Version: 0.1.0 | |||
| Draft as of 2023-03-16 | Computable Name: NZFormularyIG | |||
This IG is to support retrieving formulary and medication information in New Zealand. This is part of a project by the NZULM/NZ Formulary to provide the information we produce and collate in a standards-based form. As an organisation we want to make it as easy as possible to retrieve the medication information that you require in a timely manner.
The key resource for this implementation is the Medication resource. For those that are familiar with the New Zealand Medicines Terminology (NZMT) we will provide a medication resource for the key types of medications in the NZMT. These are:
The standard Medication resource provides the key information needed for integration however we have defined several extensions to allow for the addition of specific NZULM/Formulary information. The following table describes these extensions and shows which extensions apply to which medication type.
| Extension | Description | MP | TP | MPUU | TPUU | MPP | TPP | CTPP |
|---|---|---|---|---|---|---|---|---|
| Type | Type of NZMT reference (e.g. CTPP, MPUU) etc. | Yes | Yes | Yes | Yes | Yes | Yes | |
| Cautionary and Advisory Labels (CALs) | List of all Cautionary and Advisory labels associated with the medication | Yes | Yes | Yes | Yes | Yes | ||
| ATC | The Anatomical Therapeutic Chemical Classification code(s) | Yes | Yes | Yes | Yes | Yes | Yes | |
| Unapproved | True if the medication has not been approved by Medsafe and can be prescribed under section 29 | Yes | ||||||
| Legal Classification | Medsafe legal classification | Yes | Yes | Yes | ||||
| Medsafe Status | Medsafe product status | Yes | ||||||
| Prescribe by Brand | Whether the medication should be prescribed by brand or not | Yes | ||||||
| Funding | NZ specific funding information provided by PHARMAC | Yes | ||||||
| Funding rules | The rules and constraints around funding for the given medicine provided by PHARMAC | Yes | ||||||
| PHARMAC Supply Information | PHARMAC provided information detailing medication supply issues | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Links | Links to associated resources, such as monographs, datasheets and patient information leaflets | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
The medication resources will also link to several documents (using the link extension). To facilitate this, we use DocumentReference resources.
We provide document references for the following data:
| Data | Description |
|---|---|
| Adult monographs | A reference to all adult monographs - this allows for integrating systems to determine which monograph(s) to link to for a given medication |
| Child monographs | A reference to all children monographs - this allows for integrating systems to determine which monograph(s) to link to for a given medication |
| Patient information leaflets | A link to all patient information leaflets - these contain a number of extensions to provide extra information about the PIL (see mapping tab) |
| Medsafe Datasheets | A reference to all medsafe datasheet URLs |
| Medsafe CMIs | A reference to all medsafe CMI URLs |
All medications will have a nzmt code. Where applicable one or more Pharmacodes® will be added to a CTPP. Where applicable one or more GTIN codes will added to a CTPP or a TPUU
Subsidy information is added to Containered Trade Product Packs where applicable. The funding information is derived from both the PHARMAC community schedule as well as the HML.
There are two extensions added that store this information. The first is nzf-funding. This stores the general information around funding for a specific product, including some of the community schedule details (price etc.) - see extension details To cater for the existence of multiple schedules this extension can be added to a product multiple times, once per schedule. This allows vendors to see both the current schedule information as well as an upcoming schedule. To determine which set of information to use the 'scheduleDate' field can be used. The second extension is nzf-funding-rule. This extension once again has a schedule date so vendors can determine which schedule they would like to look at. The purpose of this extension is to provide the PHARMAC funding rules that apply to the given product. Most of the data here comes from the ps_rule table (in the NZMT releases) however a number of attribute rules are also added. These are:
| Name | Condition | Rule Type | Rule value | Rule text |
| Sole Subsidised Supply | When a CTPP associated with a ps_brand entry has the sole_supply flag set | SoleSupply | Sole Subsidised Supply | |
| Principal Sole Supply | When a CTPP associated with a ps_brand entry has the pss flag set | PrincipalSoleSupply | Principal Sole Supply | |
| Cost Brand Source | When a CTPP associated with ps_pack entry has cost brand source = 1 | CostBrandSource | CBS | |
| Original Pack | When a CTPP associated with ps_pack entry has originalPack = 1 | OriginalPack | Original Pack | |
| Hospital Supply Status | When a CTPP associated with a ps_brand entry has the hss set | HospitalSupplyStatus | Hospital Supply Status | |
| Safety: Uncompounded | ps_formulary.safety = Uncompounded | Safety | Uncompounded | Safety cap required |
| Safety: Compounded | ps_formulary.safety = compounded | Safety | Compounded | Safety cap required for extemporaneously compounded oral liquid preparations |
| Statim | ps_formulary.statim = Must | Statim | Must | Statim: Three months or six months, as applicable, dispensed all-at-once. |
| Statim | ps_formulary.statim = Must | Statim | Must | Statim: Three months or six months, as applicable, dispensed all-at-once. |
As we stated we want this to be as useful as possible so please get in touch if you have any feedback.
Each medication can have one or more optional related medication extensions. These allow navigation through the NZMT concept hierarchy.
The following table shows the related medications for each concept
| Concept | Related medications |
| CTPP | MP TPP |
| MPP | MP MPUU (1 or more) |
| MPUU | MP MPP (1 or more) |
| TPP | MP TP TPUU (1 or more) MPP |
| TPUU | MP TP TPP (1 or more) MPUU |