Four-eyes principle

How can the four-eyes principle be represented in FHIR e.g. in medicationrequest?

Should there be any additional field that would indicate the person verified the order and should it be in standard because at the moment I don’t see such field?

At present, it hasn’t been identified as something that is widely implemented - and thus is not part of core. Submitting a change request to capture “reviewer” at least as an extension seems reasonable. Another alternative is to use Provenance (which would allow you to capture not only ‘who’, but when, from where, how and other metadata).


the four-eyes is a human process thing. I am not sure it would be persisted in interoperability model.
I like Lloyds suggestion for Provenance, but it would seem more a AuditEvent as it is not actually changing the MedicationRequest.

Provinence is what I expect, auditevent would be too technical and loosely related to objects, there is a clear dependence on provinence on the medicalrequest and servicerequest which suits me very well and I have the option to extend it with a signature in the future.