Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.
Table of Contents

Purpose

...

Page Properties

Link

https://ehealthmisapi1.docs.apiary.io/#reference/public.-reimbursement/medication-request-requests/prequalify-medication-request-request

Посилання на Apiary або Swagger

Resource

/api/medication_request_requests/prequalify

Посилання на ресурс, наприклад: /api/persons/create

Scope

medication_request_request:write

Scope для доступу

Components

ePrescription

Зазначається перелік бізнес компонентів, які використовують цей метод, наприклад: ePrescription

Microservices

API paragraph not found

Перелік мікросервісів, які використовує метод API, наприклад: Auth, ABAC

Protocol type

REST

Тип протоколу, який використовується запитом, наприклад: SOAP | REST

Request type

POST

Тип запиту API, наприклад: GET, POST, PATCH…

Sync/Async

Sync

Метод є синхронним чи асинхронним?

Public/Private/Internal

Public

...

  1. Check ended_at >= started_at

    1. in case of error - return 422 error “Ended date must be >= Started date!“

  2. Validate started_at >= created_at, but not greater than (created_at + MEDICATION_REQUEST_REQUEST_EXTENDED_LIMIT_STARTED_AT_DAYS)

    1. if invalid - return 422 error  (message: "The start date should be equal to or greater than the creation date, but the difference between them should be not exceed {{MEDICATION_REQUEST_REQUEST_EXTENDED_LIMIT_STARTED_AT_DAYS}} day(s).")

  3. Validate started_at >= current_date()

    1. if invalid - return 422 error  (message: "Started date must be >= current date!")

  4. Check created_at >= (current date - MEDICATION_REQUEST_REQUEST_DELAY_INPUT)

    1. in case of error - return 422 “Create date must be >= Current date - MRR delay input!”

...

  1. Check compatibility of innm with medication list for the program

    1. if data is not found:

      1. add to response: status = INVALID

      2. add to response: rejection_reason = "Innm not on the list of approved innms for program {program_name}"

Expand
titleSQL script example
Code Block
SELECT m0.id, m2.id, m2.package_qty, m2.package_min_qty, m3.id, m3.name
FROM medications AS m0
         INNER JOIN ingredients AS i1 ON i1.medication_child_id = {$.medication_id}
         INNER JOIN medications AS m2 ON i1.parent_id = m2.id
         INNER JOIN medical_programs AS m3 ON m3.id = {$.medical_program_id}
         INNER JOIN program_medications AS p4 ON (m3.id = p4.medical_program_id) AND (p4.medication_id = m2.id)
WHERE (i1.is_primary = TRUE)
  AND (m0.id = {$.medication_id})
  AND (m0.type = 'INNM_DOSAGE')
  AND (m0.is_active = TRUE)
  AND (m2.is_active = TRUE)
  AND (m3.medication_request_allowed = TRUE)
  AND (p4.is_active = TRUE)
  AND (p4.medication_request_allowed = TRUE)

2. Check if there is at list one record of Brand with requested primary container volume

a. if not exist - return 404 error (message: "Not found any appropriate medication with such container parameters")

3. Check if there is at list one record medication_qty <= max_request_dosage or (max_request_dosage is null)

a. if not exist - return 404 error (message: "Not found any appropriate medication complying with max_request_dosage limit")

4. Check compliance of medication quantity: remainder of the division (medication_qty/package_min_qty) is equal to 0

...

innm_dosge, $medical_program_id, $person_id and max(end_date). In case there is found Medication Request with ended_at>=current_date then next one  can be done in:

  1. if (ended_at - started_at + 1) >= MEDICATION_REQUEST_REQUEST_STANDARD_DURATION chart param then
    created_at at from prequalify request should be greater then (ended at - MEDICATION_REQUEST_MAX_RENEW_DAY) of the found MR

    1. in case of error return 422 error ('It's to early to create new medication request for such innm_dosage and medical_program_id')

  2. if (ended_at - started_at + 1) < MEDICATION_REQUEST_REQUEST_STANDARD_DURATION chart DURATION chart param then
    created_at from prequalify request should be greater then (ended at - MEDICATION_REQUEST_MIN_RENEW_DAY) of the found MR

    1. in case of error return 422 error ('It's to early to create new medication request for such innm_dosage and medical_program_id')

...

Validate employee_id as described on Create Medication request Request. Except on Prequalify method a declaration has not checked for the employee.

6. Check Care plan and Activity

...

  1. If medication request has program with MEDICATION_REQUEST_MAX_PERIOD_DAY in medical program setting:

    1. Check that medication request period (ended_at - started_at + 1) less than or equal to medical program setting MEDICATION_REQUEST_MAX_PERIOD_DAY parameter

      1. in case of error - return 200 with status = INVALID and rejection_reason = “Period length exceeds allowed value for the medical program“ 

  2. If medication request has program without MEDICATION_REQUEST_MAX_PERIOD_DAY in medical program setting:

    1. Check that medication request period (ended_at - started_at + 1) less than or equal to MEDICATION_REQUEST_MAX_PERIOD_DAY parameter from charts

      1. in case of error - return 200 with status = INVALID and rejection_reason = “Period length exceeds default maximum value“

...

  1. Validate "context" is an active (not entered-in-error) entity from corresponding dictionary, that belongs to the current patient

    1. Validate there is an entity in collection $.data.context.identifier.type.coding[0].code with id == $.data.context.identifier.value that belongs to the current patient

      1.  in case of error - return 200 with status = INVALID and rejection_reason = “Entity not found“

    2. encounter diagnosis is not empty in $.encounter.diagnosis

      1. in case of error return 422 ("Encounter without diagnosis can not be referenced")

    3. Validate context.identifier.type.coding[0].code = encounter

      1. in case of error return 422 ("value is not allowed in enum")

    4. encounter diagnosis is not empty in $.encounter.diagnosis

      1. in case of error return 422 ("Encounter without diagnosis can not be referenced")

9. Check person

It is needed to check if person has allowed verification status to get medication.

...

It is needed to check if medical program can be provided by pharmacies.

  1. If the medical program has no setting skip_contract_provision_verify or it is equal to false/null:

    1. If medical program has funding_source = LOCAL:

      1. Check there is exists any active medical program provision with msp_legal_entity_id equal to employee's legal entity

        1. in case of error - return 200 with status = INVALID and rejection_reason = "Medical program is not provided for legal entity specified in the medication request"

...