Recurring Tasks in a CarePlan

1

I struggle with the correct setup of a CarePlan. I would like to specify that medication A has to be taken every day before breakfast for example.

To do so, I would specify an ActivityDefinition in order to capture the timing information and a Task that instantiates the ActivityDefinition and is part of the CarePlan.

Once the medication has been given, a corresponding MedicationAdministration should be created and linked to this task. This allows me to track the adherence to the care plan as well as to use the MedicationAdministration for other purposes.

Now the problems:

  • Is there a preferred or proven way to deal with open-ended care plans? The care plan has no end date in my case and will remain valid until a change of condition requires a change to the care plan. Creating a new task for every day in the background seems to be a bad idea as it would require a change to the CarePlan itself. Reusing the same task leaves me to wonder what the status of the taks should be?
  • How should I link the created MedicationAdministration to the task in the CarePlan? I want to avoid using MedicationRequests if possible, as it makes the whole model overly complicated.

Thank you for your thoughts on this and Happy Easter.

2
  • Define the task once, and specify that it repeats everyday using CarePlan.activity.detail.scheduledTiming
  • MedicationAdministration.basedOn links an administration to the plan that prompted it
3

I agree with what Grahame said. Additionally, there is also the option of using CarePlan.activity.outcome (which could get renamed to performed per https://jira.hl7.org/browse/FHIR-26064) to reference the MedicationAdministration.

4

Thank you for your replies. I did some testing and figured out it will be easier to link from the medication administration or observation (implemented this one at the same time) to the care plan.

Now there is a basedOn property for an observation but not for the medication administration. Am I missing something? The only way I see right now is to create a medication request and link from the administration to the request and then to the care plan.

This is a bit more complicated than I hoped as the information to be included in the request is already given in the care plan in my case.

Any suggestions?

5

It’s odd that MedicationAdministration can’t link to CarePlan. For prescription meds, it makes sense for the link to be through MedicationRequest, but for over the counter meds, tying them to a CarePlan is perfectly reasonable. Can you submit a change request? (In the meantime, you’ll either need to link through MedicationRequest or use an extension.)

6

Thank you, we’ll see how we can solve this issue. In the meantime, I’ve created the change request. Please feel free to add a comment if there are any formal errors: https://jira.hl7.org/browse/FHIR-26995