FormularyItem

Introduction

Scope and Usage

A FormularyItem is a product or service that is available through a program and includes the conditions and constraints of availability, e.g. amount limits, categorization, cost limits, and other requirements for use. This resource describes the program-specific information for a product or service. This information is specific to the inclusion of the item in the formulary and is not inherent to the item itself.

This diagram was created for the PDEX US Drug Formulary Implementation Guide but it shows where FormularyItem would fit in a drug context. If you abstract that to generic Insurance Plans to the left and to a set of resources that can be referenced to the right, that is the concept behind the FormularyItem resource.

StructureDefinition

Elements (Simplified)

• FormularyItem [0..*]: - Definition of a FormularyItem
• FormularyItem.identifier [0..*]: Identifier Business identifier for this formulary item
• FormularyItem.status [1..1]: code required:formularyitem-status active | entered-in-error | inactive
• FormularyItem.category [0..*]: CodeableConcept Categorization of this formulary item
• FormularyItem.context [0..1]: CodeableReference Owner of the formulary that this item was created for
• FormularyItem.subject [1..1]: CodeableReference Information that this item is about
• FormularyItem.author [0..1]: ContactDetail Creator or owner of the information about the item
• FormularyItem.cost [0..*]: BackboneElement The pricing of the underlying item
• FormularyItem.cost.effectiveDate [0..*]: Period The date range for which the cost is effective
• FormularyItem.cost.type [1..1]: CodeableConcept The category of the cost information
• FormularyItem.cost.source [0..1]: string The source or owner for the price information
• FormularyItem.cost.cost[x] [1..1]: Money, CodeableConcept example:medication-cost-category The price or category of the cost of the medication
• FormularyItem.specialPrecaution [0..*]: CodeableConcept Any precautions that affect the item
• FormularyItem.monitoringProgram [0..*]: BackboneElement Program under which a item is reviewed
• FormularyItem.monitoringProgram.type [0..1]: CodeableConcept Type of program under which the item is monitored
• FormularyItem.monitoringProgram.name [0..1]: string Name of the reviewing program
• FormularyItem.indicationGuideline [0..*]: BackboneElement Guidelines or protocols for administration of the medication for an indication
• FormularyItem.indicationGuideline.indication [0..*]: CodeableReference Indication for use that applies to the specific administration guideline
• FormularyItem.indicationGuideline.dosingGuideline [0..*]: BackboneElement Guidelines for dosage of the medication
• FormularyItem.indicationGuideline.dosingGuideline.treatmentIntent [0..1]: CodeableConcept Intention of the treatment
• FormularyItem.indicationGuideline.dosingGuideline.dosage [0..*]: BackboneElement Dosage for the medication for the specific guidelines
• FormularyItem.indicationGuideline.dosingGuideline.dosage.type [1..1]: CodeableConcept Category of dosage for a medication
• FormularyItem.indicationGuideline.dosingGuideline.dosage.dosage [1..*]: Dosage Dosage for the medication for the specific guidelines
• FormularyItem.indicationGuideline.dosingGuideline.administrationTreatment [0..1]: CodeableConcept Type of treatment the guideline applies to
• FormularyItem.indicationGuideline.dosingGuideline.patientCharacteristic [0..*]: BackboneElement Characteristics of the patient that are relevant to the administration guidelines
• FormularyItem.indicationGuideline.dosingGuideline.patientCharacteristic.type [1..1]: CodeableConcept Categorization of specific characteristic that is relevant to the administration guideline
• FormularyItem.indicationGuideline.dosingGuideline.patientCharacteristic.value[x] [0..1]: CodeableConcept, Quantity, Range The specific characteristic
• FormularyItem.associatedDocuments [0..*]: Reference(DocumentReference) Documents that provide more information about the item
• FormularyItem.characteristic [0..*]: BackboneElement Specifies descriptive properties of the item
• FormularyItem.characteristic.type [1..1]: CodeableConcept Code specifying the type of characteristic of item
• FormularyItem.characteristic.value[x] [1..1]: CodeableConcept, string, Quantity(SimpleQuantity), base64Binary, Attachment Description of the characteristic
• FormularyItem.availabilityStatus [0..1]: code required:formularyitem-status active | entered-in-error | inactive
• FormularyItem.availabilityPeriod [0..1]: Period Time period of the availability of the item
• FormularyItem.coverageInformation [0..*]: BackboneElement Specific coverage information about the item
• FormularyItem.coverageInformation.type [1..1]: CodeableConcept Code specifying the type of coverage information
• FormularyItem.coverageInformation.coverage [1..1]: Reference(Coverage) Description of the coverage
• FormularyItem.substitution [0..*]: BackboneElement Specifies if changes are allowed when dispensing a medication from a regulatory perspective
• FormularyItem.substitution.type [1..1]: CodeableConcept Specifies the type of substitution allowed
• FormularyItem.substitution.allowed [1..1]: boolean Specifies if regulation allows for changes in the medication when dispensing
• FormularyItem.schedule [0..*]: CodeableConcept Specifies the schedule of a medication in jurisdiction
• FormularyItem.maxDispense [0..1]: BackboneElement The maximum number of units of the medication that can be dispensed in a period
• FormularyItem.maxDispense.quantity [1..1]: Quantity(SimpleQuantity) The maximum number of units of the medication that can be dispensed
• FormularyItem.maxDispense.period [0..1]: Duration The period that applies to the maximum number of units
• FormularyItem.associatedItems [0..*]: BackboneElement Associated or related formulary items
• FormularyItem.associatedItems.type [1..1]: CodeableConcept Category of formulary item
• FormularyItem.associatedItems.reference [1..1]: Reference(FormularyItem) Associated items about the formulary item

Mappings

• FormularyItem Mappings — 6 mapping entries

Implementation Guide

implementationguide-FormularyItem-core.xml

<?xml version="1.0" encoding="UTF-8"?>

<ImplementationGuide xmlns="http://hl7.org/fhir">
  <id value="FormularyItem-core"/>
  <version value="0.1"/>
  <name value="FormularyItemHL7Extensions"/>
  <title value="Formulary Item  H L7  Extensions"/>
  <status value="draft"/>
  <date value="2015-02-19T00:00:00.000"/>
  <publisher value="Health Level Seven, Inc. - FHIR WG"/>
  <description value="Defines common extensions used with or related to the FormularyItem resource"/>
</ImplementationGuide>

Resource Packs

list-FormularyItem-packs.xml

<?xml version="1.0" encoding="UTF-8"?>

<List xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../publish/List.xsd">
  <id value="FormularyItem-packs"/>
  <status value="current"/>
  <mode value="working"/>
  <entry>
    <item>
      <reference value="ImplementationGuide/FormularyItem-core"/>
    </item>
  </entry>
</List>

Search Parameters

• identifier — token — Returns formulary items with this external identifier — FormularyItem.identifier

Full Search Parameters

Examples

• formularyitem-examples-header — formularyitem-examples-header
• formularyitemexample01 — formularyitemexample01 — Penicillin V (as penicillin V potassium) 25 mg/mL oral solution

Full Examples

Mapping Exceptions

formularyitem-fivews-mapping-exceptions.xml

Unmapped Elements

• FiveWs.what — Unknown
• FiveWs.recorded — Unknown
• FiveWs.author — Unknown
• FiveWs.cause — Unknown
• FiveWs.version — Unknown
• FiveWs.witness — Unknown
• FiveWs.class — Unknown
• FiveWs.where — Unknown
• FiveWs.context — Unknown
• FiveWs.init — Unknown
• FiveWs.why — Unknown
• FiveWs.source — Unknown
• FiveWs.who — Unknown
• FiveWs.grade — Unknown
• FiveWs.status — Unknown
• FiveWs.planned — Unknown
• FiveWs.done — Unknown
• FiveWs.subject — Unknown