HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
1.1.0 - STU1 Release 1.1 - Standard for Trial-Use International flag

This page is part of the HRSA Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+ or uds-plus) FHIR IG (v1.1.0: STU1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: De-Identified UDS Plus MedicationRequest

Official URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-medicationrequest Version: 1.1.0
Standards status: Trial-use Maturity Level: 2 Computable Name: UDSPlusMedicationRequest

The UDS+ profile is based on the MedicationRequest resource and establishes the core elements, extensions, vocabularies and value sets for representing MedicationRequest for UDS+ program.

Introduction

This profile is used to represent de-identified MedicationRequest information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes MedicationRequest.authoredOn.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a MedicationRequest resource text element may contain information such as the MedicationRequest date, patient information. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Ids and References

The original MedicationRequest resource id should not be included in the De-identified MedicationRequest instance. Instead a new id should be created and provided as part of the FHIR resource. The Data Submitter should be capable of using the generated id to relink the data to the original MedicationRequest. All resource references to the MedicationRequest submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

  • subject
  • encounter

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

  • authoredOn

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from MedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* MedicationRequest De-Identified UDS Plus MedicationRequest
... id S 0..1 id The de-identified MedicationRequest identifier created by the health center to send data to UDS+ Data Receiver
... text 0..0
... contained 0..0
... intent S 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
... medication[x] S 1..1 CodeableConcept, Reference(Medication) Medication to be taken
... subject S 1..1 Reference(De-Identified UDS Plus Patient) Who or group medication request is for
.... display 0..0
... encounter S 0..1 Reference(De-Identified UDS Plus Encounter) Encounter created as part of encounter/admission/stay
.... display 0..0
... authoredOn SC 0..1 dateTime When request was initially authored
uds-plus-medreq-1: All dateTime data elements should be truncated to a year only for de-identified resources.
... requester S 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
.... display 0..0
... performer
.... display 0..0
... note 0..0
... dosageInstruction S 0..* Dosage How the medication should be taken
... dispenseRequest
.... validityPeriod C 0..1 Period Time period supply is authorized for
uds-plus-medreq-2: All Period.start data elements should be truncated to a year only for de-identified resources.
uds-plus-medreq-3: All Period.end data elements should be truncated to a year only for de-identified resources.

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
uds-plus-medreq-1errorMedicationRequest.authoredOnAll dateTime data elements should be truncated to a year only for de-identified resources.
: $this is dateTime implies $this.toString().length() = 4
uds-plus-medreq-2errorMedicationRequest.dispenseRequest.validityPeriodAll Period.start data elements should be truncated to a year only for de-identified resources.
: $this is Period and Period.start.exists() implies $this.start.toString().length() = 4
uds-plus-medreq-3errorMedicationRequest.dispenseRequest.validityPeriodAll Period.end data elements should be truncated to a year only for de-identified resources.
: $this is Period and Period.end.exists() implies $this.end.toString().length() = 4

 

Other representations of profile: CSV, Excel, Schematron