• Medication
• Medication, Active
• Medication, Administered
• Medication, Dispensed
• Medication, Order
• Medication, Discharge
• Immunization, Order

7.16.0 Medication

QDM defines Medication as clinical drugs or chemical substances intended for use in the medical diagnosis, cure, treatment, or prevention of disease. Medications are defined as direct referenced values or value sets containing values derived from code systems such as RxNorm. QDM defines five contexts for Medication, each of which is listed below referencing the US-Core or FHIR resource which provides the expected context:

7.16.1 Medication, Active

This QDM context correlates with a medication on a patient’s active medication list and thus it maps to MedicationStatement. Note that MedicationStatement does not include reference to the QDM attributes route or frequency or recorder. These attributes may be important if the medication list is the only source of information about medication usage and quality measures or clinical decision support (CDS) expressions need to assess total daily dosage or cumulative dose over time. Ordered medications (MedicationRequest) or dispensed medications (MedicationDispense) or administered medications (MedicationAsminstration) represent alternative mechanisms to determine such information.

7.16.2 Medication, Administered

This QDM context correlates with a record of a patient consuming or otherwise being administered a medication. It references individual medication administration events and, therefore, may not reference frequency of administration. Note that a separate QDM and US-Core profile address Immunization, Administered.

7.16.3 Medication, Dispensed

This QDM context maps to the FHIR MedicationDispense resource, indicating information about medications that have been dispensed.

7.16.4 Medication, Order

This QDM context references the US-Core MedicationRequest resource with the MedicationRequest.intent = order and MedicationRequest.setting set to the setting most appropriate for the intended meaning of the quality measure or clinical decision support (CDS) expression.

7.16.5 Medication, Discharge

This QDM context specifically references the discharge medication list provided to a patient at the time of discharge from an inpatient setting. The list may include reference to new prescriptions sent to a pharmacy for dispensing and self-administration after discharge. It may also include over-the-counter medications and those medications already present in the patient’s home for which new prescriptions are not necessary.  The QDM Medication, Discharge concept is mapped to MedicationRequest as a request to the patient to take the medication with MedicationRequest.intent = plan and MedicationRequest.setting = discharge.

7.16.6 Immunization, Order

This QDM context references the US-Core MedicationRequest resource as there is no other FHIR resource to reference an order for an immunization. The mapping uses the US-Core MedicationRequest resource with the MedicationRequest.intent = order and MedicationRequest.setting set to the setting most appropriate for the intended meaning of the quality measure or clinical decision support (CDS) expression.