Medication Scheme Implementation Guide
1.0.0 - trial-use
Medication Scheme Implementation Guide
1.0.0 - trial-use
Medication Scheme Implementation Guide, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-medication-scheme/ and changes regularly. See the Directory of published versions
| Official URL: https://fhir.ee/OperationDefinition/Task-reimbursements | Version: 1.0.0 | |||
| Standards status: Trial-use | Maturity Level: 1 | Computable Name: Reimbursements | ||
The reimbursement operation is used to get possible reimbursement for given Medication.
URL: [base]/Task/$reimbursements
| Use | Name | Scope | Cardinality | Type | Binding | Documentation |
| IN | input | 1..1 | Task | Task input containing Medication and MedicationStatement as contained resources | ||
| OUT | return | 1..1 | Task | Found reimbursements |
URL: POST [base]/Task/$reimbursements
This is NOT an idempotent operation.
Näidis-sisend olukorras, kus andmeid ei ole veel salvestatud ja soovitakse pärida võimalikke soodustusi.
Kasutatud on ravimit ja eeldatud, et patsiendile pannakse diagnoos E11-E11 või E14-E14.
Patsiendi viide on veel vigane.
Näidispäring salvestamata ravimiskeemi reaga
{
"resourceType": "Parameters",
"parameter": [
{
"name": "input",
"resource": {
"resourceType": "Task",
"contained": [
{
"resourceType": "Medication",
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-medication-epc"
]
},
"id": "input-medication",
"extension": [
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-medicinal-product-classification",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/atc",
"code": "A10AE54",
"display": "glargiin-insuliin + liksisenatiid"
}
]
}
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-size-of-item",
"valueQuantity": {
"value": 3,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "ML"
}
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-medicinal-product-name",
"valueString": "SULIQUA"
}
],
"identifier": [
{
"system": "http://ravimiregister.ee/pakendid",
"value": "1737042"
}
],
"doseForm": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/ravimvormid",
"code": "1461",
"display": "süstelahus pen-süstlis"
}
]
},
"totalVolume": {
"value": 12
},
"ingredient": [
{
"item": {
"concept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/toimeained",
"code": "12560",
"display": "glargiin-insuliin"
}
]
}
},
"isActive": true,
"strengthRatio": {
"numerator": {
"value": 100,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "ÜHIK"
},
"denominator": {
"value": 1,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "TK"
}
}
},
{
"item": {
"concept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/toimeained",
"code": "13527",
"display": "liksisenatiid"
}
]
}
},
"isActive": true,
"strengthRatio": {
"numerator": {
"value": 33,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "MCG"
},
"denominator": {
"value": 1,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "ML"
}
}
}
]
},
{
"resourceType": "MedicationStatement",
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-medication-statement"
]
},
"id": "input-statement",
"extension": [
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-substitution-allowed",
"extension": [
{
"url": "substitutionAllowed",
"valueBoolean": true
},
{
"url": "substitutionAllowedReason",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/ravimi-asendamatuse-pohjus",
"code": "KP08",
"display": "Patsiendil on diagnoositud kaasuv psüühika- või käitumishäire"
}
]
}
}
]
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-total-prescribed-amount",
"valueInteger": 15
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-prescription-validity-time",
"valueDateTime": "2024-08-27T03:00:00+03:00"
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-medication-left",
"valueInteger": 5
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-prescription-authorization",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-volituse-liik",
"code": "V",
"display": "volitatud"
}
]
}
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-prescription-intent",
"valueCode": "order"
}
],
"status": "recorded",
"category": [
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/ravikuuri-tyyp",
"code": "p",
"display": "pidev"
}
],
"text": "pidev"
},
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/statement-origin-category",
"code": "123",
"display": "ei ole patsiendi ytluse põhjal"
}
]
},
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-liik",
"code": "1",
"display": "tavaretsept"
}
],
"text": "tavaretsept"
},
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-kordsus",
"code": "3",
"display": "3-kordne"
}
],
"text": "3-kordne"
}
],
"medication": {
"reference": {
"reference": "#input-medication"
}
},
"subject": {
"reference": "Patient/pat1MatiMeri"
},
"informationSource": [
{
"reference": "#PractitionerRole-N11243",
"display": "Firstname Lastname"
}
],
"effectivePeriod": {
"start": "2024-02-27"
},
"reason": [
{
"concept": {
"coding": [
{
"system": "http://fhir.ee/CodeSystem/rhk-10",
"code": "E11.3",
"display": "Insuliinisõltumatu suhkurtõbi silmatüsistusega"
}
]
}
}
],
"dosage": [
{
"patientInstruction": "süstida kõhunaha alla",
"timing": {
"repeat": {
"frequency": 3,
"period": 1,
"periodUnit": "d",
"timeOfDay": [
"09:00:00",
"15:00:00",
"20:00:00"
]
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 12,
"system": "https://fhir.ee/CodeSystem/retsept-annustamise-yhik",
"code": "TY"
}
}
]
}
]
},
{
"resourceType": "PractitionerRole",
"id": "PractitionerRole-N11243",
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-practitioner-role"
]
},
"active": true,
"practitioner": {
"identifier": {
"system": "https://fhir.ee/sid/pro/est/pho",
"value": "N11243"
},
"display": "Firstname Lastname"
},
"organization": {
"identifier": {
"system": "https://fhir.ee/sid/org/est/br",
"value": "11242172"
},
"display": "Aktsiaselts Ida-Tallinna Keskhaigla"
},
"code": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/practitioner-role",
"code": "doctor",
"display": "Doctor"
}
]
}
],
"specialty": [
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/ee-medre-specialty",
"code": "E130",
"display": "E130-display"
}
]
}
],
"contact": [
{
"telecom": [
{
"system": "email",
"value": "test@example.com"
},
{
"system": "phone",
"value": "37256789012"
}
]
}
]
}
],
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-reinbursement-task"
]
},
"implicitRules": "http://hl7.org/fhir/reference",
"status": "requested",
"intent": "proposal",
"priority": "routine",
"focus": {
"reference": "#input-statement"
}
}
}
]
}
Näidis-väljund olukorras, kus on saadetud Ravimiskeemi rida, mida ei ole veel maha salvestatud:
Näidisvastus salvestamata ravimiskeemi reaga
{
"resourceType": "Task",
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-reinbursement-task"
]
},
"implicitRules": "http://hl7.org/fhir/reference",
"contained": [
{
"resourceType": "Medication",
"id": "input-medication",
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-medication-epc"
]
},
"extension": [
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-medicinal-product-classification",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/atc",
"code": "A10AE54",
"display": "glargiin-insuliin + liksisenatiid"
}
]
}
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-size-of-item",
"valueQuantity": {
"value": 3,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "ML"
}
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-medicinal-product-name",
"valueString": "SULIQUA"
}
],
"identifier": [
{
"system": "http://ravimiregister.ee/pakendid",
"value": "1737042"
}
],
"doseForm": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/ravimvormid",
"code": "1461",
"display": "süstelahus pen-süstlis"
}
]
},
"totalVolume": {
"value": 12
},
"ingredient": [
{
"item": {
"concept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/toimeained",
"code": "12560",
"display": "glargiin-insuliin"
}
]
}
},
"isActive": true,
"strengthRatio": {
"numerator": {
"value": 100,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "ÜHIK"
},
"denominator": {
"value": 1,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "TK"
}
}
},
{
"item": {
"concept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/toimeained",
"code": "13527",
"display": "liksisenatiid"
}
]
}
},
"isActive": true,
"strengthRatio": {
"numerator": {
"value": 33,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "MCG"
},
"denominator": {
"value": 1,
"system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
"code": "ML"
}
}
}
]
},
{
"resourceType": "MedicationStatement",
"id": "input-statement",
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-medication-statement"
]
},
"extension": [
{
"extension": [
{
"url": "substitutionAllowed",
"valueBoolean": true
},
{
"url": "substitutionAllowedReason",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/ravimi-asendamatuse-pohjus",
"code": "KP08",
"display": "Patsiendil on diagnoositud kaasuv psüühika- või käitumishäire"
}
]
}
}
],
"url": "https://fhir.ee/StructureDefinition/ee-tis-substitution-allowed"
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-total-prescribed-amount",
"valueInteger": 15
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-prescription-validity-time",
"valueDateTime": "2024-08-27T03:00:00+03:00"
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-medication-left",
"valueInteger": 5
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-prescription-authorization",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-volituse-liik",
"code": "V",
"display": "volitatud"
}
]
}
},
{
"url": "https://fhir.ee/StructureDefinition/ee-tis-prescription-intent",
"valueCode": "order"
}
],
"status": "recorded",
"category": [
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/ravikuuri-tyyp",
"code": "p",
"display": "pidev"
}
],
"text": "pidev"
},
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/statement-origin-category",
"code": "123",
"display": "ei ole patsiendi ytluse põhjal"
}
]
},
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-liik",
"code": "1",
"display": "tavaretsept"
}
],
"text": "tavaretsept"
},
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-kordsus",
"code": "3",
"display": "3-kordne"
}
],
"text": "3-kordne"
}
],
"medication": {
"reference": {
"reference": "#input-medication"
}
},
"subject": {
"reference": "Patient/pat1MatiMeri"
},
"effectivePeriod": {
"start": "2024-02-27"
},
"reason": [
{
"concept": {
"coding": [
{
"system": "http://fhir.ee/CodeSystem/rhk-10",
"code": "E11.3",
"display": "Insuliinisõltumatu suhkurtõbi silmatüsistusega"
}
]
}
}
],
"dosage": [
{
"patientInstruction": "süstida kõhunaha alla",
"timing": {
"repeat": {
"frequency": 3,
"period": 1,
"periodUnit": "d",
"timeOfDay": [
"09:00:00",
"15:00:00",
"20:00:00"
]
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 12,
"system": "https://fhir.ee/CodeSystem/retsept-annustamise-yhik",
"code": "TY"
}
}
]
}
]
},
{
"resourceType": "PractitionerRole",
"id": "PractitionerRole-N11243",
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-practitioner-role"
]
},
"active": true,
"practitioner": {
"identifier": {
"system": "https://fhir.ee/sid/pro/est/pho",
"value": "N11243"
},
"display": "Firstname Lastname"
},
"organization": {
"identifier": {
"system": "https://fhir.ee/sid/org/est/br",
"value": "11242172"
},
"display": "Aktsiaselts Ida-Tallinna Keskhaigla"
},
"code": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/practitioner-role",
"code": "doctor",
"display": "Doctor"
}
]
}
],
"specialty": [
{
"coding": [
{
"system": "https://fhir.ee/CodeSystem/ee-medre-specialty",
"code": "E130",
"display": "E130-display"
}
]
}
],
"contact": [
{
"telecom": [
{
"system": "email",
"value": "test@example.com"
},
{
"system": "phone",
"value": "37256789012"
}
]
}
]
},
{
"resourceType": "Parameters",
"id": "output-params",
"meta": {
"profile": [
"https://fhir.ee/StructureDefinition/ee-tis-reimbursement-task-response-parameters"
]
},
"parameter": [
{
"name": "insuranceParameter",
"valueBoolean": true
},
{
"name": "insuranceEUParameter",
"valueBoolean": false
},
{
"name": "oldAgePensionParameter",
"valueBoolean": false
},
{
"name": "incapacityForWorkPensionParameter",
"valueBoolean": false
},
{
"name": "reimbursementRateParameter",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-soodustuse-maar",
"code": "75",
"display": "75%"
}
],
"text": "II tüüpi diabeedi raviks kombinatsioonis metformiiniga rasvumusega patsientidele (KMI>=35kg/m2), kellel suukaudsed diabeediravimid (metformiin, sulfonüüluurea preparaat, PPAR agonist, DPP-4 inhibiitor) maksimaalsetes talutavates annustes ei ole andnu"
}
},
{
"name": "reimbursementRateParameter",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-soodustuse-maar",
"code": "50",
"display": "50%"
}
],
"text": "II tüüpi diabeedi raviks kombinatsioonis metformiiniga juhul kui ravi suukaudsete diabeediravimitega ei ole efektiivne või on vastunäidustatud"
}
},
{
"name": "reimbursementRateParameter",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.ee/CodeSystem/retsepti-soodustuse-maar",
"code": "0",
"display": "0%"
}
]
}
}
]
}
],
"status": "requested",
"intent": "proposal",
"priority": "routine",
"focus": {
"reference": "#input-statement"
},
"output": [
{
"valueReference": {
"reference": "#output-params"
}
}
]
}