Fast Healthcare Interoperability Resources (FHIR®) Representation of Medication Data Derived from German Procedure Classification Codes (OPS) Using Identification of Medicinal Products (IDMP) Compliant Terminology

Abstract

Electronic documentation of medication data is one of the biggest challenges associated with digital clinical documentation. Despite its importance, it has not been consistently implemented in German university hospitals. In this paper we describe the approach of the German Medical Informatics Initiative (MII) towards the modelling of a medication core dataset using FHIR® profiles and standard-compliant terminologies. The FHIR profiles for Medication and MedicationStatement were adapted to the core dataset of the MIl. The terminologies to be used were selected based on the criteria of the ISO-standard for the Identification of Medicinal Products (IDMP). For a first use case with a minimal medication dataset, the entries in the medication chapter of the German Procedure Classification (OPS codes) were analyzed and mapped to IDMP-compliant medication terminology. OPS data are available at all German hospitals as they are mandatory for reimbursement purposes. Reimbursement-relevant encounter data containing OPS medication procedures were used to create a FHIR representation based on the FHIR profiles MedicationStatement and Medication. This minimal solution includes – besides the details on patient and start-/end-dates – the active ingredients identified by the IDMP-compliant codes and – if specified in the OPS code – the route of administration and the range of the amount of substance administered to the patient, using the appropriate unit of measurement code. With FHIR, the medication data can be represented in the data integration centers of the MII to provide a standardized format for data analysis across the MII sites.

Surgical Care in Specialist Ophthalmology Departments: Structure and Impact of the COVID-19 Pandemic

“…The sample was drawn from the benchmarking program of the Professional Association of German Anaesthetists (BDA), the Professional Association of German Surgeons (BDC) and the Association for Operating Theatre Management (VOPM), in which more than 320 hospitals nationwide have participated since 2008.The service providers of different care levels transmit their operating theatre process data, which includes surgery-related information such as the operation and procedure code (OPS) [18] and this was used to evaluate the process data in a standardised manner, thus enabling a direct comparison with other healthcare providers [19].…”

Fast Healthcare Interoperability Resources (FHIR) for Interoperability in Health Research: Systematic Review

“…Of the 49 studies, the majority were conducted in Germany (47%, n=23) [12,26,[28][29][30][31]34,35,[40][41][42][45][46][47]52,53,[56][57][58]60,62,63,69], the United States (27%, n=13) [22,25,36,44,[48][49][50]61,[64][65][66]68,70], and Australia (6%, n=3) [1,43,67]. The remaining studies were performed in Austria (2%, n=1) [32], Canada (2%, n=1) [24], France (2%, n=1) [51], Greece (2%, n=1) [59], Japan (2%, n=1) [27], Pakistan (2%, n=1) [38], Spain (2%, n=1) [55], Switzerland (2%, n=1) [39], Taiwan (2%, n=1) [23], and the United Kingdom (2%, n=1)…”

“…In terms of medical specialty, most (55%, 27/49) of the studies [24,[27][28][29][30][31][32]34,[36][37][38][39][40][41][42]44,46,48,49,53,56,[60][61][62][63]67,70] were using a generic approach-implementable in any kind of specialty (Table 2). Of the remaining studies, 16% (8/49) use cases focused on infectious disease [1,22,23,26,45,47,50,59], whereas 12% (6/49) focused on oncology [25,55,57,58,65,66] and 8% (4/49) on genomics [43,52,68,69].…”

“…Among the 49 studies, 37% (n=18) did not report on or use additional standards or terminologies [12,22-24,27,28,30-32, 38,39,48,50,55,57,64,66,69]. SNOMED CT [1,25,26,35,37,43,[45][46][47]51,55,56,65,70] and LOINC [25,26,35,37,42-45, 47,49,51,55,56,58,61,65,68,70] were reported to be used by 29% (n=14) and 37% (n=18) of the studies, respectively; 18% (n=9) of the studies used International Classification of Diseases 10th Revision [25,26,35,37,49,51,58,65,68] and 12% (n=6) used OMOP CDM [26,29,35,47,52,60]; and 43% (n=21) of the studies used additional standards which were categorized under "Other" (Table 1) [26,34-37,40,42,43,45-47,49,51,56,58-60, 62,63,67,70]. The implemented FHIR resources by each study are listed in Table 2; 5 (10%) studies did not precisely list their FHIR resources used [36,38,56,64,69].…”