PrescribeIT® Specification and Guide Version 5.0

2.1.1 v5.0 Publication (2021-05-20)

• Special Note

  • v5.0 of this specification has been superseded by v5.3. v5.3 is compatible but adds additional features for Quebec.
  • The version (Bundle.meta.tag:version) that is sent in the message will remain PrescribeIT5.0
• Breaking Changes
  • None
• Substantive (potentially breaking) Changes
  • In Prescription, Prescription Adapt, New Prescription, PMS Prescription, PMS Rx Dispense Prescription, Renewal Prescription profiles, made MedicationOrder.dateWritten element mandatory and updated MedicationOrder.dateWritten, MedicationOrder.dispenseRequest.validityPeriod.start and MedicationOrder.dispenseRequest.validityPeriod.end Conformance Rules. Also, added constraint over25dur-true: IF over25dur = TRUE, total number of detectedissue must be 25 and made MedicationOrder.extension:detectedIssue a max cardinality of 25 to enforce existing Conformance Rules.
  • Added PrescribeIT® PMS Rx Dispense Prescription profile that is referenced in Task p160.
  • In Task e161-m - RX Renewal Response - Denied, Task e162-m - RX Renewal Response - Approved, Task e163-m - RX Renewal Response - Approved with Changes and Task e164-m - RX Renewal Response - Under Review, added a Task Multiple Response boolean flag.
  • In Task e161-m - RX Renewal Response - Denied and Task e164-m - RX Renewal Response - Under Review, added a constraint creator-not-recorder to enforce existing Conformance Rule.
  • In Task e161-m - RX Renewal Response - Denied, added Extension: Task Drug Name and Extension: Task NewRx Reference.
  • In Task p160-m - RX Renewal Create Request, added Task Split Prescription and Task Split Prescription Reason boolean flags; increased Task:input max from 3 to 12 in order to include 4 Task.input:PMSinformationalRx and 5 Task.input:PMSrequestedRx; and added a few constraints enforcing Split Prescription business rules.
  • In Task p200-m - RX Dispense Notification and Task p210-m - RX Dispense Cancel Notification, added Task Split Prescription boolean flag, Task Split Prescription Reason, and Task.input:PMSrequestedRx. Added constraint p200-1: IF splitPrescriptionFlag = TRUE, splitPrescriptionReason must be specified.
  • In Group No 2 Organization Search - Discrete fields, added Address Book parameter to allow Search by Fax.
  • In Interaction Bundle 101 - Execute tasks from physician office, Interaction Bundle 201 - Execute tasks from pharmacy, and Interaction Bundle 401 - Execute deferred tasks from an EMR, updated MessageHeader.destination max cardinality to 1..1 (i.e. only sent to PrescribeIT® Switch) and to align with Interaction Bundle 101, 201, and 305.
  • In Interaction Bundle 401 - Execute deferred tasks from an EMR, updated max50tasks invariant such that a Bundle cannot have more than 50 tasks in one message.
  • In Interaction Bundle 902 - Jurisidictional RX Identifier Notification and Interaction Message Header 902 - Jurisidictional RX Identifier Notification, updated Bundle.entry to a max of 51 entries (1 MessageHeader + 50 MedicationOrder resources) and MessageHeader.data to a max of 50 references (50 MedicationOrder resources) in one message.
  • In Interaction Bundle - Organization Query and Shared Health API Summary, updated content with PR Bulk Search Organization information.
  • In Shared Health Patient, added constraint senderPatientIdentifier-branch-1: This must be an OID ending in .1 to enforce an existing Conformance Rule.
  • In Shared Health Locum Practitioner, added Extension: Practitioner Locum Indicator in order to disambiguate with Shared Health Practitioner (i.e. make the two profiles mutually exclusive).
  • In Shared Health SAML Practitioner, updated Practitioner.identifier:license cardinality to 1..1 to align with existing Conformance Rule.
  • In PrescribeIT® Prescriber Prescription Identifier, added a constraint EMR-id-branch-2: This must be an OID ending in .2 to enforce an existing Conformance Rule.
  • In Extension: Task Group Identifier, added constraint groupIdentifier-branch-3: This must be an OID ending in .3 to enforce an existing Conformance Rule.
  • In PrescribeIT® Dispense, added a constraint dispenseIdentifier-branch-4: This must be an OID ending in .4 to enforce an existing Conformance Rule.
  • In Clinician Communication added constraint 305-1: topic and topicGroup MUST not be populated together to align with existing Conformance Rule that Communication.extension(topic) and Communication.extension(topicGroup) must never be populated together, only one or the other extension can be populated depending on what needs to be referenced.
  • Updated all Interaction Bundle profiles and examples such that Bundle.meta.tag.code = "PrescribeIT5.0" or "Shared5.0"
  • Updated all Interaction MessageHeader.meta.profile cardinality to 1..1 to align with their respective one fixed value profile.
  • Updated all Interaction MedicationOrder.contained cardinality to 1..1 to align with the expectation that only one prescribable medication is associated with a MedicationOrder.
  • Updated A2 - 201 p200 RX Dispense Notification, A3 - 201 p210 RX Dispense Cancel Notification, E1 - 201 p160s Multiple RX Renewals, E3 - 101 e120 Renewal RX Fill, e161 RX Denied, e162 RX Approved, e163 RX Approved with Changes, and e164 RX Under Review, E3 - 101 e120 Renewal RX Fill, e162 RX Approved, and e163 RX Approved with Changes, and E4 - 101 (from MOA) e161 Denied and e164 Under Review examples with Backwards Compatibility changes.
  • Updated POLL2 - Multi-message all-pharmacy-tasks and POLL3 - Multi-page all-physician-tasks examples with 50 bundles.
  • Added 50 Deferred tasks bundle.
  • Added 5.0.3 Terminology Gateway file with changes to the following subsets:
    • actpharmacysupplytype|20210501
    • detectedissuecategory|20210501
    • detectedIssuemitigationaction|20210501
    • issuetype|20190415
    • prescriptioncancelreason|20210401
    • prescriptiondosequantityunit|20210308
    • prescriptionmedicinalproduct
    • prescriptionrenewalrejectreason|20210501
    • prescriptionrenewalreviewreason|20210501
    • prescriptionsplitreason|20210501
    • sharedissuedetails|20210501
    • sharedspecificationversion|20210501
• Non-Substantive Changes
  • In HL7 FHIR Tooling, updated FHIR Validator table to reflect new artifacts.
  • In PrescribeIT® Clinician Communication, updated Communication.status comments.
  • In PrescribeIT® Medication, updated Medication.code.coding.display comments.
  • In Extension: Medication Order Dispense First Fill Instructions, updated various comments and definitions.
  • In Interaction Bundle - Organization Query, made Bundle.meta.lastUpdated and in its related entry Shared Health Organization - Provider Registry, made Organization.meta.lastUpdated supported to reflect actual Provider Registry response implementation and stated that Bundle.link:next is currently not supported by the Provider Registry.
  • In PrescribeIT® Formulary Operation Output, update Parameters.parameter:product.part max cardinality from 9 to 8 to align with the max total of the child parts.
  • 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-e161, e162, e163, and e164) to align with their respective profile structure.