PrescribeIT® Change List

2.1.1 v3.0 Revision C Publication (2021-05-25)

Breaking Changes
- None
Substantive (potentially breaking) Changes
- None
Non-Substantive Changes
- In Deferred DownloadsRx Polling, updated comments by removing option for both identifiers to be specified.
- In PrescribeIT® Detected Issue - DUR, updated comments to clarify their usage.
- In PrescribeIT® Dispense, PrescribeIT® Prescription, PrescribeIT® New Prescription, and PrescribeIT® Renewal Prescription profiles, updated dose[x] to the correct Binding: PrescriptionDoseQuantityUnit (20190430) (extensible) to enforce the system + code pair.
- In PrescribeIT® Drug Range, updated Binding: PrescriptionDoseQuantityUnit (20190430) (extensible) to enforce the system + code pair.
- In Task p160-m - RX Renewal Create Request, clarified Task.input:daysSinceLastDispense comments.
- In Shared Health Address, updated various element examples and comments.
- In Shared Health Patient, updated birthDate element comments to reflect Deferred Query behaviour when a partial date is submitted.
- In Shared Health Locum Practitioner, removed 'registry' (PRN) since locums are not in the Provider Registry.
- In Shared Health SAML Practitioner, updated Practitioner.practitionerRole:practitionerOrg cardinality to make it mandatory to align with existing THX behaviour.
- In Shared Health Practitioner - Provider Registry, updated Practitioner.practitionerRole to allow for organization, role, and specialty in a TPR response.
- In Interaction Bundle - Organization Query and Interaction Bundle - Practitioner Query, updated Bundle.link:next comments to declare that it is not currently supported the the Provider Registry and updated telecom discrete search parameter examples.
- Split C3 - 201 p200 RX Dispense Notification and C4 - 201 p143 Cancel RX Remaining Fills Revoked examples into separate examples to align with Extension: Task Group Identifier Scenario 4) Bundle restricted to same task type only: There are cases when only tasks of the same type can be grouped together. This is true for the cancel request (e140), Dispense Notifications (p200), Cancel RX Dispense Notification (p210).
- Display the following extension urls on parent element to reflect what is already in the child element type:
  - List.text.status
  - OperationOutcome.issue.details.text.extension:details-translation.url
  - OperationOutcome.issue.extension:userText.value[x].extension:userText-translation.url
  - Communication.extension:topic.value[x].extension.url
  - Practitioner.practitionerRole:practitionerSpecialty.role.coding.display.extension:role-translation.url
  - Practitioner.practitionerRole:practitionerSpecialty.specialty.text.extension:specialty-translation.url
- Updated various diagrams (e.g. Task-e140, p141, p142, and p143) to align with their respective profile structure.

2.1.2 v3.0 Revision B Publication (2021-02-18)

Breaking Changes
- None
Substantive (potentially breaking) Changes
- None
Non-Substantive Changes
- In RequestToken API section, added both Prescriber Role and External Token attributes and clarified that the time returned in X-SHAREDHEALTH-EXCHANGE-SAML-EXPIRY header is in UTC.
- In Change List, added Backwards Compatability notes.
- Added E4 - 101 (from Medical Office Assistant) e161 Denied and e164 Under Review message sample.
- In Attachment Upload API section, added PUT request example.
- In all Tasks, updated Task.creator element with contextual comments. In the context of all EMR message this will be the PrescribeIT Prescriber that responsible for initiating or overseeing the clinical event in the message. In the context of all PMS message this is the PrescribeIT pharmacy that is responsible for initiating the message.
- Change title "Queries and Operations" to Formulary Queries and Deferred Rx Polling and updated introduction.
- In PrescribeIT® Dispense, PrescribeIT® Prescription, PrescribeIT® Prescription, and PrescribeIT® Prescription profiles, updated SIG Table spreadsheet to include new clinical examples re: timing.repeat.bounds[x]
- In PrescribeIT® Dispense, updated various MedicationDispense.authorizingPrescription comments.
- In Task p160-m - RX Renewal Create Request, clarified comments.
- In Task e161-m - RX Renewal Response - Denied and Task e164-m - RX Renewal Response - Under Review, removed Task.creator.reference comments and made Task.creator a choice between SAML Practitioner or Shared Health Practitioner profiles.
- In PrescribeIT® Prescription, updated MedicationOrder.priorPrescription comments related to Tasks e140 and e180 and updated MedicationOrder.prescriber comments.
- In 305 Clinician Communication - Practitioner to Organization, updated message sample to include Communication.sender:PR.extension:onBehalfOf element.
- In Interaction Bundle 101 - Execute tasks from physician office, added Conformance Rule stating that if a 101 is sent with multiple practitioners, the one containing SAML Practitioner must be first (after MessageHeader and Patient).
- In Shared Health Practitioner, Shared Health SAML Practitioner, and Shared Health Practitioner - Provider Registry, updated Practitioner.practitionerRole:practitionerSpecialty.role comments.
- In Stage 2 – Formal Conformance/Certification Testing, updated introduction.
- In Interaction Bundle - Batch Clear Message Queue Request , updated Bundle.entry.request.url comments.
- In Shared Health Patient, updated Patient.id comments and tagged extension PHN-version under Patient.identifier:jurisidictionalHealthNumber as it was in PrescribeIT2.0 Shared Health Patient.
- Updated all examples with DIN system (http://hl7.org/fhir/NamingSystem/ca-hc-din) and SNOMED system (https://fhir.infoway-inforoute.ca/CodeSystem/snomedctcaextension)
- In Shared Health - eRx Service Location and Shared Health Organization - Provider Registry, updated Organization.id comments.
- Added Formulary API section.
- In Error and Exception Handling Scenarios, updated Asynchronous Errors detected by Destination – Event Type 101, 201 or 401 comments that SDF will never send OperationOutcome errors in 999
- In Extension: Medication Order Protocol, marked as FUTURE USE ONLY.
- In PrescribeIT® Clinician Communication, there was a technical correction that should have no impact to vendors on the max cardinality of .Communication.extension:topic.value[x]:valueReference.extension element. The source file was always max cardinality of 1..1 but a publication issue caused this to display as 1..* in past releases. This has now been corrected to display as 1:1.
- In Shared Health Operation Outcome, there was a technical correction that should have no impact to vendors on the max cardinality of both OperationOutcome.issue.extension:referenceNum and OperationOutcome.issue.extension:userText elements. The source file was always max cardinality of 1..1 but a publication issue caused this to display as 1..* in past releases. This has now been corrected to display as 1:1.
- In Shared Health Artifacts, removed Provider Registry Search Parameters section because complete Query parameters are already found in Interaction Bundle - Organization Query and Interaction Bundle - Practitioner Query sections.
- In Interaction Bundle 101 - Execute tasks from physician office Bundle.entry element, removed note "A bundle may contain one or more e140 messages that were grouped together as of the same original prescription."

2.1.3 v3.0 Revision A Publication (2020-10-28)

Breaking Changes
- None
Substantive (potentially breaking) Changes
- Reverted Communication Topic Group official URL back to PrescribeIT®2.0 URL 'http://sharedhealth.exchange/fhir/StructureDefinition/ext-communication-topic-requisition' as seen in 305 Clinician Communication - Practitioner to Organization example.

This is the first publication for v3.0.

2.1.4 v3.0 Publication (2019-04-01)

There are some Substantive (potentially breaking) Changes changes that have been made between PrescribeIT®2.0 and PrescribeIT®3.0; however no vendor impact is expected as the conformance rules are already in place. The updates will formalize these rules and by doing so this allows for automated validation of these rules.

Message Version - it is expected that vendors who are currently on PrescribeIT®2.0 will be able to process PrescribeIT®3.0 messages. Vendor testing has been conducted to confirm that vendors will not experience any negative impact though this is formally considered to be a breaking change.

All other new data elements have been added as optional extensions. Vendor testing confirmed that these additional values will be ignored by the receiving applications.

Breaking Changes
- None
Substantive (potentially breaking) Changes
- Created Task p170-m - Pharmacist Adapt and its associated profiles, extensions, and example.
- Created Task p190-m - Pharmacist Prescribe and its associated profiles, extensions, and example.
- Created Interaction Bundle 902 - Jurisidictional RX Identifier Notification and its associated profiles, , extensions, and example.
- Created PrescribeIT® 3.0 Terminology pack with various Value Set updates, including to the following: Specification (added "PrescribeIT®3.0"), Task Type (added "p170" and "p190"), Issue Details (removed "ISS105"), Message Events (added "902"), and Practitioner Role (added "nurse").
- In Task e161-m - RX Renewal Response - Denied and Task e164-m - RX Renewal Response - Under Review, updated Task.creator type to reference Shared Health Practitioner and created Task.extension(recorder) to reference Shared Health Non-Clinician Practitioner in order to allow MOA’s or Non-PrescribeIT® Prescribers to send these responses.
- In Task e163-m - RX Renewal Response - Approved with Changes , changed Task.input(change) cardinality to 1..1 to formalize an existing Conformance Rule such that it may be automatically validated.
- In Task p141-m - Cancel RX Request Denied and Task p143-m - Cancel RX Remaining Fills Revoked, set Task.priority to a Code of "High'.
- In Task p143-m - Cancel RX Remaining Fills Revoked, added Task.extension(reason) Conformance Rule of limiting the text to no more than 240 characters due to vendor limitations.
- In Task p160-m - RX Renewal Create Request, set Task.input(instruction).valueString to Max Length of '1000'.
- In PrescribeIT® Clinician Communication, set Communication.recipient.reference to a cardinality of 1..1 and updated comments.
- In PrescribeIT® Dispense, set MedicationDispense.authorizingPrescription.reference to a cardinality of 0..1 and updated comments.
- In PrescribeIT® Dispense , PrescribeIT® Prescription, PrescribeIT® Prescription Adapt, PrescribeIT® Prescription - PMS, and PrescribeIT® Prescription Renew, enabled dosageInstruction.dose[x] to support PrescribeIT® Drug Range type and dosageInstruction.timing.repeat.bounds[x] to support HL7 Quantity and HL7 Period types.
- In PrescribeIT® Prescription, PrescribeIT® Prescription Adapt, PrescribeIT® Prescription - PMS, and PrescribeIT® Prescription Renew, set MedicationOrder.note from a maxLength of '5000' to '2500' as the previous length was deemed to be too high, and updated MedicationOrder.dosageInstruction.text and MedicationOrder.dosageInstruction.route comments for greater clarity.
- In PrescribeIT® Pharmacy-related Observation, clarified Observation.effectiveDateTime comment that for Height and Weight, this element must be included.
- In PrescribeIT® Formulary Operation Output, updated Parameters.parameter.part(unitCost) comments to indicate that this value must never be displayed to user.
- In Shared Health Practitioner, Shared Health SAML Practitioner, and Shared Health Practitioner - Provider Registry, added Practitioner.practitionerRole(practitionerSpecialty).role and updated Practitioner.communication comments. Also updated Practitioner Read Response example to reflect changes.
- In Shared Health Practitioner, Shared Health SAML Practitioner, and Shared Health Operation Outcome, marked Practitioner.practitionerRole.specialty.role.coding.display, Practitioner.practitionerRole.specialty.text, OperationOutcome.issue.userText, and OperationOutcome.issue.details.text as mustSupport in order to see these French translation elements on the Grid View.
- In Practitioner Search Parameters Group No 4 Practitioner Search By Discrete Fields, added 'role' parameter
- In Organization Search Parameters Group No 3 Organization Search Elastic and Practitioner Search Parameters Group No 5 Practitioner Search by Elastic, removed unsupported 'email' parameter.
- In Shared Health Bundle for Messages added "max1patient" constraint: no more than a single patient in the bundle, "groupIdsSame" constraint: all groupIdentifier values must all be the same within a message, and "tbdl-1" constraint: Full URL must end with resource id when present. These constraints were added such that it may be automatically validated.
- In all Tasks, limited Task.meta.security to a cardinality max of "0" for privacy reasons and such that it may be automatically validated.
- In Shared Health Quantity set Quantity.system to have a fixedUri of "http://unitsofmeasure.org" to formalize an existing Conformance Rule such that it may be automatically validated.
Non-Substantive Changes
- Updated FHIR validator to support PrescribeIT® 3.0 profiles.
- Updated PrescribeIT® and Shared Health examples to align with new profiles, invariants, and human Conformance Rules comments.
- In Shared Health Operation Outcome, updated OperationOutcome.issue.severity and OperationOutcome.issue.code bindings which has no impact to the "Code System URI / ID" and "Concept Codes".
- In Shared Health Patient, updated Patient.gender binding which has no impact to the "Code System URI / ID" and "Concept Codes".
- In Shared Health Practitioner, Shared Health SAML Practitioner, Shared Health Locum Practitioner, and Shared Health Practitioner - Provider Registry, updated Practitioner.identifier:registry.type and Practitioner.identifier:license.type bindings which has no impact to the "Code System URI / ID" and "Concept Codes".
- In PrescribeIT® Guide Tasks section, added an Excel spreadsheet providing Task Grouping rules.
- In both PrescribeIT® and Shared Health Implementation Guides, changed "Requisition identifier / Requisition ID" to "Group Identifier" in related comments and slicing names. Note: In Extension: Task Group Identifier Extension.url of http://hl7.org/fhir/StructureDefinition/extension-Task.groupIdentifier/ has not changed.>
- In Shared Health Locum Practitioner, changed Practitioner.identifier(License) to not use pattern slicing.
- In Shared Health Practitioner, updated various Practitioner.practitionerRole.specialty comments.
- In Shared Health Address, updated Address.country comments to allow for any format of 'Canada'.
- In PrescribeIT® Prescription, PrescribeIT® Prescription Adapt, PrescribeIT® Prescription - PMS, and PrescribeIT® Prescription Renew, updated MedicationOrder.priorPrescription comment to indicate that this element is not required, set MedicationOrder.dosageInstruction.additionalInstructions type to 'Shared Health CodeableConcept Text Required' and set timing.event as a supported but optional element.
- In Interaction Message Header 401 - Execute deferred tasks from prescriber office, updated MessageHeader.destination.endpoint comments to indicate that this will be the PrescribeIT® Switch URI.
- In Interaction Bundle - Practitioner Query, updated 'Elastic Search by Specialty' section to indicate that it will include matches on both the English and French description.
- In Interaction Bundle 901 - Message disposition notification, updated the introduction to include 2 potential scenarios.
- In Extension: Referenced Business identifier , changed 'Referenced Requisition identifier' name to 'Referenced Business identifier' to recognize that reference can be target prescription, dispense or task by business identifier rather than URL
- In Extension: Task DIS Notification, updated comments.
- In Resources, Identifiers, IDs, and References, added section on Logical versus Business Identifiers.
- In Polling for Messages, updated polling description paragraph.