HL7 FHIR® Implementation Guide: NHSN Inpatient Medication COVID-19 Administration Reports, Release 1 - US Realm

DESCRIPTION

This IG supports electronic submission of line-level medication administration data to the National Healthcare Safety Network (NHSN). The project establishes an electronic submission standard that is vendor-neutral that leverages existing workflows and eliminates duplicate documentation. This IG details data elements that can be used to describe medications administered (name, formulation, route, dose, duration) to hospitalized patients (inpatients) diagnosed with COVID-19 as part of NHSN COVID-19 reporting pathways. All inpatient medication administration events should be reported irrespective of whether or not medication administration was linked to an adverse event.

ALTERNATIVE NAMES

HL7 FHIR® Implementation Guide: NHSN Inpatient Medication COVID-19 Administration Reports, Release 1 - US Realm may also go by the following names or acronyms:

BENEFITS

• Enables electronic medication administration (eMAR) records for accurately measuring in-hospital medication exposure, including identifying the exact medications patients have received, in what formulations, doses, and for what duration of time
• Reduces reliance on the medication list instead of medication administrations as a severe limitation in achieving accurate representation of medication exposure in U.S. healthcare data through FHIR resources

IMPLEMENTATIONS/CASE STUDIES

• Nebraska Medicine
• Emory University Hospital

DEVELOPMENT BACKGROUND

Medication data are integral to informing the quality, safety, and costs of U.S. healthcare, supporting federal, state, and local public health, and guiding clinical decision-making in patient care. In inpatient workflows, medication administration—as captured by electronic medication administration (eMAR) records—is considered the gold standard for accurately measuring in-hospital medication exposure, including identifying the exact medications patients have received, in what formulations, doses, and for what duration of time. The need for medication administration information has never been clearer as during the COVID-19 pandemic, where identification of the medications that acutely ill hospitalized patients with COVID-19 had received was integral to understanding clinical management of this new public health threat and directing public health resources, including scarce medications. The continued reliance on the medication list instead of medication administrations is a severe limitation in achieving accurate representation of medication exposure in U.S. healthcare data through FHIR resources.

The COVID-19 pandemic highlighted the importance of identifying the scope of medication use among hospitalized patients for new and emerging diseases during public health emergencies. Data sources for accurate, efficient, scalable reporting of medication exposure among patients hospitalized with suspected or confirmed COVID-19 were lacking throughout the pandemic. This NHSN COVID-19 Medication Administration FHIR implementation guide (IG) seeks to overcome some of the challenges of other time-, labor- and cost-intensive methods of quantifying and characterizing medication use, such as data based on administrative claims, by utilizing a vendor-neutral, interoperable standard for fully electronic patient-level queries of medication data among U.S. inpatient populations. It builds upon NHSN’s long-standing experience in healthcare surveillance, and hospital quality and benchmarking efforts for inpatient antibiotic use and expands upon data collected by federal health entities related to the impact of COVID-19 on hospital bed capacity, personal protective equipment, and other public health emergency resources.

RELATED DOCUMENTS

HL7 FHIR® Implementation Guide: NHSN Inpatient Medication COVID-19 Administration Reports, Release 1 - US Realm

STU DOCUMENTS

HL7 FHIR® Implementation Guide: NHSN Inpatient Medication COVID-19 Administration Reports, Release 1- US Realm See the standard at http://hl7.org/fhir/us/nhsn-med-admin/STU1.

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TOPIC

• Pharmacy

BALLOT TYPE

• STU

STATUS DATE

2021-10-12

RESPONSIBLE WORK GROUP

PRODUCT TYPE

• Implementation Guide

STAKEHOLDERS

• Clinical and Public Health Laboratories
• Clinical Decision Support Systems Vendors
• EHR, PHR Vendors
• Health Care IT Vendors
• Healthcare Institutions
• Payors
• Pharmaceutical Vendors
• Quality Reporting Agencies

FAMILY

• FHIR

CURRENT STATE

• Active

REALM

• US Realm