Scope
This paragraph contains guidelines that were drawn up on the basis of the experiences acquired by care providers and patients during the pilot project. They were finalised during the ICT Work Group of 26/06/2013 and offered as additional guidelines. The Vitalink user group is authorized for the amendment of these guidelines. Amendments always have to be approved by the ICT Work Group.
RSW/RSB annotation
There are no strict visualisation guidelines for RSW and RSB. However, the Vitalink guidelines can be viewed as recommendations.
Display
The medication scheme must be offered to the patient in a well-organised and uniform manner in printed form or with the help of a viewer. Substantively the medication scheme should contain the same information for all software systems.
The readability of such a scheme is improved by ensuring that the horizontal rows are only displayed if they contain content. The columns with specific hours are printed dynamically depending on whether there is medication present at specific hours in the medication scheme. If more ingestion times are present than can be displayed in the standard lay-out, the information is displayed in a text field instead of in columns. Several remarks:
- Unambiguous identification of the patient (name, first name and NISS number) in the header;
- Time of last change and print in the header;
- Care provider that has last adapted the medication scheme in the header;
- Care provider that has printed the medication scheme in the header;
- Version number of the medication scheme;
- Information text to display in a footnote: “This is a medication scheme that is managed by your care team and is shared via Vitalink. More information can be found at www.vitalink.be/toelichtingms/.”
It is desirable to offer the medication scheme in an accessible textual version for low educated patients. Clear user instructions grouped by ingestion time with minimum interpretation by the patient can prevent mistakes with the ingestion of medication. These guidelines are out of scope of this paragraph.
The provision of administration schemes on a daily or weekly basis is desirable for nurses and, if necessary, for patients' viewers. These guidelines are also out of scope of this paragraph. They concern overview schemes, that in the first place are suitable for communication between care providers and with the patient.
Example
Description of guidelines
1. Uniform content
| No | Description | Comment |
| 1.1 | Header | |
| 1.1.1 | Unambiguous identification of the patient | Name, first name & NISS number |
| 1.1.2 | Date and hour of last change + identification of the care provider who changes the medication scheme | Date format = dd/mm/yyyy |
| 1.1.3 | Date and hour of print + identification of the care provider who prints the medication scheme (details of the pharmacy + owner) | Date format = dd/mm/yyyy |
| 1.2 | Sorting of medication lines within groups per CD-TEMPORALITY Obsolete medication (see M. Concept: Obsolete medication) is not displayed. | Sorting:
Translation of the codes, see M. Specific translation of supported Kmehr table codes. |
| 1.2.1 | Within the column the medication lines are sorted according to periodicity. | The sorting is defined in M. Specific translation of supported Kmehr table codes. The effect will be for example like this: Daily
Non-daily
|
| 1.2.1 | Columns (see 1.2) and periodic subdivisions (see 1.2.1) that are not entered in the medication scheme are not printed. | |
| 1.3 | Display of columns | |
| 1.3.1 | Fixed pattern of 16 columns | Column / description of the product: – Frequency – Start – End – Ingestion / unit – Morning – Breakfast (before, during and after) – Lunch (before, during and after) – Dinner (before, during and after) – Sleep. Refer to example. |
| 1.3.2 | Dynamic display of columns for specific times: ingestion times at specific hours are only displayed if they are filled in. | If more than 5 specific hours are used in a medication scheme, the 6th and following are printed as text in a line without columns. E.g. “3 om 16:00”. |
| 1.3.3 | Ingestion times (Code table CD DAYPERIOD) that cannot be assigned to a column, are displayed as text in a line without columns . | See M. Specific translation of supported Kmehr table codes |
| 1.4 | The complete description of the product: (content / medicinalproduct / intendedname or deliveredname) displayed in the “medication” column including dose and galenic form. | The dose is not provided as separate attribute in KMEHR. Information about brand name, galenic form, dose and packaging size is available via the CNK (National Code Number), but not all care providers have a database of CNKs available. |
| 1.5 | Unit uniformly displayed We take the first CD-ADMINISTRATIONUNIT element from regimen as the unit. There is 1 column ingestion /unit entered for the ingestion pattern. We provide the same patient oriented translation for form/unit in all software packages. See M. Specific translation of supported Kmehr table codes. | |
| 1.6 | Ingestion uniformly displayed from table CD-DRUG-ROUTE. There is 1 column Ingestion/unit entered for the ingestion pattern. We provide the same patient oriented translation for ingestion between all software suppliers. See M. Specific translation of supported Kmehr table codes | |
| 1.7 | Indication and instructions for use are displayed in the “remark” column. | Indication = Healthcareelement "medicationuse" Instructions = Medication element <instructionforpatient> |
| 1.8 | Medication lines with the validation status “to be validated” are always printed. There is no mention of this status in the print for the patient. | |
| 1.9 | Information message in footnote text | “This medication scheme is managed by your care team and shared via Vitalink. If you have questions about it or in doubt, it is advised to contact your general practicioner. More information can be found at www.vitalink.be/toelichtingms/.” |
2. Uniform format
| No | Description | Comment |
| 2.1 | Sorting of medication lines in a uniform manner | Sorting by:
|
| 2.1.1 | Periodic subdivision 1: show daily (frequency = "D") medication together. | Periodicity D = daily |
| 2.1.2 | Periodic subdivision 2: show 'N+1'-daily (multiple of weeks) medication medication together. The frequency column contains frequency and the daynumber, e.g. "every 2 days, day 1 & 2 ". | Sorting as defined in M. Specific translation of supported Kmehr table codes. Periodicity DT = 2-daily Ditto for 3-daily, etc. |
| 2.1.3 | Periodic subdivision 3: show weekly (multiple of weeks) medication together. For medication with ingestions on several days per week, the days are displayed on different lines. The frequency column contains the frequency and the daynumber or weekday, e.g. "every 2 weeks, day 3 ". | Sorting by:
|
| 2.1.4 | Periodic subdivision 4: show monthly (multiple of months) medication together. For medication with ingestions on several days per month, the days are displayed on different lines. The frequency column contains the frequency and the daynumber, e.g. "every 2 months, the 3rd". | Sorting by:
|
| 2.1.5 | Periodic subdivision 5: show yearly (multiple of years) medication together. For medication with ingestions on several dates per year, the dates are displayed on different lines. The frequency column contains the frequency and the DD/MM part of the date, e.g. "every 2 years, 15/3". | Sorting by:
|
| 2.2 | Empty horizontal bar between different columns and periodic subdivisions | |
| 2.3 | Start date or condition / End date or condition displayed | At the front in the table Date format = dd/mm/yyyy |
| 2.4 | Subsequent medication: indicate with the help of start & end condition in start/end column | GM 1: end condition “OP = STOP” GM 2: begin condition “With stop GM 1” |
| 2.5 | Treatment suspension | |
| 2.5.1 | Permanent suspension: medication line is only displayed for the patient if the suspension lies in the future. VAZG-147 - Getting issue details... STATUS | |
| 2.5.2 | Temporary suspension: the treatment suspension is only displayed if the suspension lies in the future. VAZG-147 - Getting issue details... STATUS | |
| 2.5.3 | A treatment suspension is displayed as a line under the medication line to which it is applicable, with red background and provided with the text “!STOP! Due to: …” | |
| 2.6 | Specific times are added as column on the right of the scheme, visually explicitly separated from the fixed pattern. | |
| 2.7 | Convert decimal numbers in “quantity” to fractions.
As you see, numbers and fractions > 1 also have to be provided. | |
| 2.8 | Free text <posology> is displayed as a nonstructured text field in a line without columns instead of the ingestion times. | |
| 2.9 | Medication lines for which the frequency is not entered, are considered as non-recurring. | |
| 2.10 | Standard format | A uniform format of the overview scheme with regards to font and style is aimed at. There is only one logo displayed: the Vitalink logo. |