Standardized Medication Profile

The communication of health information, including medications, is critical to ensuring safe and effective transitions from one health care setting to another. Medication errors, poor communication and poor coordination between providers, along with the rising incidence of preventable adverse events and hospital readmissions, have drawn national attention to the importance of the timely transfer of medication information between post-acute care (PAC) providers, including Long-term Care Hospitals(LTCH), Inpatient Rehabilitation Facilities (IRF), Skilled Nursing Facilities (SNF), Home Health Agencies (HHA) and other settings.

About 40% of patients discharged from acute care receive PAC services (McCarthy, 2021) and in 2018 Medicare fee-for-service spending on PAC expenditures was $58.6 billion (MedPAC, 2020). However, little is known about the transfer of health information, such as medications, during transitions of care, including the types of medication information transferred or the mode(s) of transfer used.

As patients move through the healthcare system there is a need for a consistent, standardized approach to exchanging with other care team members and payers the medications and medication related information for the patient as they move from mode to mode during transitions of care (ToC).

Introduction

The use case will:

  • Identify and define the components of an interoperable medication and medication related information exchange for clinicians, patients, payers and caregivers to use for the exchange of essential medication information during transitions of care (ToC) to and from hospitals, ambulatory, and long-term & post-acute care (LTPAC) settings.
  • Develop a FHIR Implementation Guide focused on the US jurisdiction (may be portable to other jurisdictions but outside the scope of this project) for a Standardized Medication Profile (SMP) group of profiles. The profiles in the SMP IG will use and extend (as necessary) US Core profiles and provide mechanisms for the exchange of essential medication and medication related information. The work will also align with and use the Post-Acute Care Interoperability (PACIO) Project implementation Guides. The resulting Implementation Guide will be verified with a connectathon track prior to submission for a Standard for Trial Use (STU) ballot and publication.

Building on the work done for the Patient Medication List Guidance and PACIO projects, this implementation guide will formalize the FHIR representation. The intent is to perform a joint ballot with NCPDP.

Background

The NCPDP WG14/WG10 Standardized Medication Profile Task Group completed an analysis of data fields and transactions available in the current NCPDP SCRIPT and Specialized standards (as defined by the IMPACT Act) and documented existing data fields that meet patient and medication profile attributes and specific gaps.

In September 2019, an HL7 Project Scope Statement was initiated to create a White Paper that would identify and define components of an interoperable medication profile. Harmonizing NCPDP and HL7 standards and projects related to the medication related information pertinent to Post-Acute Care gaps. Resulting in:

Resources