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Технічний опис бізнес-процесу виписування рецепту в ЕСОЗ (загальний процес для усіх рецептурних ЛЗ, в т.ч. і тих, які підлягають реімбурсації)

Configuration parameters

Description of the configuration parameters that are used when processing a request in the system

Dictionaries

Provides a list of links to dictionaries that are available in Confluence

Input parameters

ATTRIBUTES - see on Apiary

Request structure

See on API-specification (посилання на сторінку з API-специфікацією)

Description of the REST API request structure, example

{
  "medication_request_request": {
    "person_id": "585044f5-1272-4bca-8d41-8440eefe7d26",
    "employee_id": "d290f1ee-6c54-4b01-90e6-d701748f0851",
    "division_id": "881d6dee-dd3d-43f3-8983-922354c0e6ce",
    "created_at": "2017-08-17",
    "started_at": "2017-08-17",
    "ended_at": "2017-09-16",
    "medication_id": "1349a693-4db1-4a3f-9ac6-8c2f9e541982",
    "medication_qty": 10.34,
    "intent": "plan",
    "category": "community",
    "based_on": [
      {
        "identifier": {
          "type": {
            "coding": [
              {
                "system": "eHealth/resources",
                "code": "care_plan"
              }
            ]
          },
          "value": "9183a36b-4d45-4244-9339-63d81cd08d9c"
        }
      },
      {
        "identifier": {
          "type": {
            "coding": [
              {
                "system": "eHealth/resources",
                "code": "activity"
              }
            ]
          },
          "value": "9183a36b-4d45-4244-9339-63d81cd08d9c"
        }
      }
    ],
    "context": {
      "identifier": {
        "type": {
          "coding": [
            {
              "system": "eHealth/resources",
              "code": "encounter"
            }
          ]
        },
        "value": "9183a36b-4d45-4244-9339-63d81cd08d9c"
      }
    },
    "dosage_instruction": [
      {
        "sequence": 1,
        "text": "0.25mg PO every 6-12 hours as needed for menses from Jan 15-20, 2015.  Do not exceed more than 4mg per day",
        "additional_instruction": [
          {
            "coding": [
              {
                "system": "eHealth/SNOMED/additional_dosage_instructions",
                "code": "311504000"
              }
            ]
          }
        ],
        "patient_instruction": "0.25mg PO every 6-12 hours as needed for menses from Jan 15-20, 2015.  Do not exceed more than 4mg per day",
        "timing": {
          "event": [
            "2017-04-20T19:14:13Z"
          ],
          "repeat": {
            "bounds_duration": {
              "value": 10,
              "unit": "days",
              "system": "eHealth/ucum/units",
              "code": "d"
            },
            "count": 2,
            "count_max": 4,
            "duration": 4,
            "duration_max": 6,
            "duration_unit": "d",
            "frequency": 1,
            "frequency_max": 2,
            "period": 4,
            "period_max": 6,
            "period_unit": "d",
            "day_of_week": [
              "mon"
            ],
            "time_of_day": [
              "2017-04-20T19:14:13Z"
            ],
            "when": [
              "WAKE"
            ],
            "offset": 4
          },
          "code": {
            "coding": [
              {
                "system": "TIMING_ABBREVIATIONS",
                "code": "patient"
              }
            ]
          }
        },
        "as_needed_boolean": true,
        "site": {
          "coding": [
            {
              "system": "eHealth/SNOMED/anatomical_structure_administration_site_codes",
              "code": "344001"
            }
          ]
        },
        "route": {
          "coding": [
            {
              "system": "eHealth/SNOMED/route_codes",
              "code": "46713006"
            }
          ]
        },
        "method": {
          "coding": [
            {
              "system": "eHealth/SNOMED/administration_methods",
              "code": "419747000"
            }
          ]
        },
        "dose_and_rate": {
          "type": {
            "coding": [
              {
                "system": "eHealth/dose_and_rate",
                "code": "'ordered'"
              }
            ]
          },
          "dose_range": {
            "low": {
              "value": 0,
              "unit": "mg",
              "system": "eHealth/ucum/units",
              "code": "mg"
            },
            "high": {
              "value": 0,
              "unit": "mg",
              "system": "eHealth/ucum/units",
              "code": "mg"
            }
          },
          "rate_ratio": {
            "numerator": {
              "value": 0,
              "unit": "mg",
              "system": "eHealth/ucum/units",
              "code": "mg"
            },
            "denominator": {
              "value": 0,
              "unit": "mg",
              "system": "eHealth/ucum/units",
              "code": "mg"
            }
          }
        },
        "max_dose_per_period": {
          "numerator": {
            "value": 0,
            "unit": "mg",
            "system": "eHealth/ucum/units",
            "code": "mg"
          },
          "denominator": {
            "value": 0,
            "unit": "mg",
            "system": "eHealth/ucum/units",
            "code": "mg"
          }
        },
        "max_dose_per_administration": {
          "value": 0,
          "unit": "mg",
          "system": "eHealth/ucum/units",
          "code": "mg"
        },
        "max_dose_per_lifetime": {
          "value": 0,
          "unit": "mg",
          "system": "eHealth/ucum/units",
          "code": "mg"
        }
      }
    ],
    "priority": "routine",
    "prior_prescription": {
      "identifier": {
        "type": {
          "coding": [
            {
              "system": "eHealth/resources",
              "code": "medication_request"
            }
          ]
        },
        "value": "9183a36b-4d45-4244-9339-63d81cd08d9c"
      }
    },
    "container_dosage": {
      "system": "MEDICATION_UNIT",
      "code": "ML",
      "value": 4
    }
  },
  "programs": [
    {
      "id": "59781de0-2e64-4359-b716-bcc05a32c10f"
    }
  ]
}Headers

...

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!”

...

There is a list of medications (medications.type = BRAND OR medications.type = INNM_DOSAGE)  which can be used for the program. It must be check whether there is at least one available medication (with `medication_request_allowed` == TRUE)  for the Innm for the particular program 

...

2. Check if there is at list one record of Brand with requested primary container volume in case when found medications is not medications.type = INNM_DOSAGE:

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

...

4. Check max allowed quantity for the treatment period. If there in a list of medications is at list one record with medications.type = INNM_DOSAGE do p.4.2 and skip p.4.1
   4.1. in case when found medications is medications.type = BRAND:

• Get non-null max_daily_dosage from all filtered above program medications

• Define max value among max_daily_dosage as highest_max_daily_dosage

• Get package_min_qty from all related brands, connected to found program medications

• Define min value among package_min_qty as lowest_package_min_qty

...

i. in case of error - return 422 “The amount of medications in medication request is not complying with max_daily_dosage and treatment period limit”.

4.2. in case when found medications is medications.type = INNM_DOSAGE:

• Get non-null max_daily_dosage from all filtered above program medications

• Define max value among max_daily_dosage as highest_max_daily_dosage

a. Validate: ((highest_max_daily_dosage × (ended_at - started_at+1)) - medication_qty) >= 0

i. in case of error - return 422 “The amount of medications in medication request is not complying with max_daily_dosage and treatment period limit”

5. Check compliance of medication quantity in case when found medications is not medications.type = INNM_DOSAGE: remainder of the division (medication_qty/package_min_qty) is equal to 0

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1. if found and medical program setting skip_mnn_in_treatment_period skip_treatment_period= false (absent):

   1. add to response: status = INVALID

   2. add to response: rejection_reason = "It can be only 1 active / completed medication request request or medication request per one innm for the same patient at the same period of time!"

2. Fetch Medication Request by $

...

1. if (ended_at - started_at + 1) >= MEDICATION_REQUEST_REQUEST_STANDARD_DURATION chart param then
   created_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 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 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 MEDICATIONsetting MEDICATION_REQUEST_MAX_PERIOD_DAY request_max_period_dayparameter

      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 MEDICATION_REQUEST_MAX_PERIOD_DAY request_max_period_dayin medical program setting:

   1. Check that medication request period (ended_at - started_at + 1) less than or equal to MEDICATIONto MEDICATION_REQUEST_MAX_PERIOD_DAY 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“lt maximum value“

8. Check context

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.

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Declaration should always be validated for each program. Validate skip_medication_request_employee_declaration_verify skip_request_employee_declaration_verify and skip_medication_request_legal_entity_declaration_verify skip_request_legal_entity_declaration_verify  parameters at medical program settings as described at Create Medication request Request if there are some exclusions.

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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"

Processing

A list of processes related to receiving, changing or transmitting data according to the logic defined in the REST API

Response structure examples

Collect array for all programs in payload with status for each (VALID or INVALID) and rejection_reason.

See on API-specification (посилання на сторінку з API-специфікацією)

Description of the REST API response structure, example

{
  "meta": {
    "code": 200,
    "url": "https://example.com/resource",
    "type": "object",
    "request_id": "req-adasdoijasdojsda"
  },
  "data": [
    {
      "program_id": "59781de0-2e64-4359-b716-bcc05a32c10f",
      "program_name": "Програма \"Доступні ліки\"",
      "status": "INVALID",
      "rejection_reason": "Innm not on the list of approved innms for program 'DOSTUPNI LIKI' !"
    }
  ]
}

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Post-processing processes

Description of actions performed on data after processing

Technical modules where the method is used

List of pages describing technical modules where the method is used

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