POCP Prescription Enrollment
0.1.0 - CI Build US

POCP Prescription Enrollment - Local Development build (v0.1.0). See the Directory of published versions

Message Content and Structures

Message Content Definitions

Enrollment information and consents shared by the enrollment application, and subsequent information updates supplied by the patient support program or other supporting party are transmitted using the applicable FHIR R4 resource types as identified below.

Content transmitted from the prescriber during initiation of the enrollment process

* Opt. column below: M = Mandatory / always present. S = Situational, may not be present

Opt*

Information

FHIR R4 Resource

FHIR IG

FHIR Profile

Important Content

Notes

 

Enrollment information

M

Patient information

Patient

Specialty Medication Enrollment STU1

Specialty Rx Patient

HL7.FHIR.US.SPECIALTY-RX\Specialty Rx Patient - FHIR v4.0.1

  • Medical Record Number
  • Name
  • DOB
  • Gender
  • Address
  • Language

  • Home phone
  • Work phone
  • Mobile phone
  • Alternate phone
  • Best time to call

 

S

Caregiver, authorized party

RelatedPerson

FHIR R4 (base)

RelatedPerson - FHIR v4.0.1

  • Caregiver name
  • Caregiver phone
  • Caregiver best time to call

Authorized representative (e.g., parent, if the patient is a minor)

M

Patient consent

Consent

QuestionnaireResponse

Provenance (signature)

POCP Enrollment App

POCP Prescription Enrollment Consent with QuestionnaireResponse

POCP Prescription Enrollment Provenance Signature

Authorization event info
(Consent)
  • Date given
  • Date recorded
  • Patient name and MRN
  • Practice organization name, NPI
  • Name of person giving authorization (patient or authorized representative)
Set of authorization statements
(QuestionnaireResponse)
  • Textual statements
Digital signature
(Provenance)
  • JSON Web Signature (JWS)
The Consent resource captures minimal event / participant data and contains the set of authorization statements recorded in a QuestionnaireResponse in the Consent.sourceAttachment element.

The Provenance references the Consent as its target and contains the digital signature in the Provenance.signature element

M

Provider authorizations

Consent

QuestionnaireResponse

Provenance (signature)

POCP Enrollment App

POCP Prescription Enrollment Consent with QuestionnaireResponse

POCP Prescription Enrollment Provenance Signature

As above As above, except representing the prescriber’s authorization

M

Insurance information

Coverage

Specialty Medication Enrollment STU1

Specialty Rx Coverage

HL7.FHIR.US.SPECIALTY-RX\Specialty Rx Coverage - FHIR v4.0.1

Pharmacy insurance
  • Insurer Name
  • Phone
  • Policy ID
  • Group
  • RxBin
  • RxPCN
Medical insurance
  • Insurer Name
  • Phone
  • Policy ID
  • Group
  • Policy holder name
  • Relationship to policy holder

 

M

Prescriber and practice information

Practitioner,

Practitioner Role, Organization

US Core 4.0.0 STU4 Release

US Core Practitioner Profile

HL7.FHIR.US.CORE\US Core Practitioner Profile - FHIR v4.0.1

US Core PractitionerRole Profile

HL7.FHIR.US.CORE\US Core PractitionerRole Profile - FHIR v4.0.1

US Core Organization Profile

HL7.FHIR.US.CORE\US Core Organization Profile - FHIR v4.0.1

Prescriber
  • Name
  • Specialty
  • Address
  • NPI
Practice
  • Practice Name
  • Contact name
  • Email
  • Phone
  • Fax
  • NPI
  • Tax ID

 

M

Prescribed medication therapy

and

Indication diagnosis

Medication Request

Specialty Medication Enrollment STU1

Specialty Rx Medication Request

HL7.FHIR.US.SPECIALTY-RX\Specialty Rx Medication Request - FHIR v4.0.1

  • Product name, strength, dose form
  • NDC
  • RxNorm
  • Directions
  • Quantity prescribed
  • Substitutions allowed
  • Number of refills
  • ICD-10 for indication
  • Date of diagnosis

Draft order, pending authorization and pharmacy identification

S

Preferred specialty pharmacy

Organization

Specialty Medication Enrollment STU1

Specialty Rx Organization – Pharmacy

HL7.FHIR.US.SPECIALTY-RX\Specialty Rx Organization - Pharmacy - FHIR v4.0.1

  • Pharmacy name
  • NCPDP ID
  • Phone
  • Fax
  • NPI

Requested pharmacy. May need to change due to payer coverage

S

Supervising prescriber

Practitioner

US Core 4.0.0 STU4 Release

US Core Practitioner Profile

HL7.FHIR.US.CORE\US Core Practitioner Profile - FHIR v4.0.1

US Core PractitionerRole Profile

HL7.FHIR.US.CORE\US Core PractitionerRole Profile - FHIR v4.0.1

US Core Organization Profile

HL7.FHIR.US.CORE\US Core Organization Profile - FHIR v4.0.1

  • Name
  • NPI

Supervising prescriber (e.g., if the prescriber is an NP, resident, etc.)

M

Other information

Questionnaire Response

FHIR R4 (base)

QuestionnaireResponse - FHIR v4.0.1

Other enrollment form elements, as needed

 

Supporting patient clinical information

 

As available in the EHR and agreed for sharing between partners

S

Problem list

Condition

US Core 4.0.0 STU4 Release

US Core Condition Profile

HL7.FHIR.US.CORE\US Core Condition Profile - FHIR v4.0.1

S

Allergies

Allergy Intolerance

US Core 4.0.0 STU4 Release

US Core AllergyIntolerance Profile

HL7.FHIR.US.CORE\US Core AllergyIntolerance Profile - FHIR v4.0.1

S

Medication list

Medication Request

US Core 4.0.0 STU4 Release

US Core MedicationRequest Profile

HL7.FHIR.US.CORE\US Core MedicationRequest Profile - FHIR v4.0.1

S

Vital signs

Observation

US Core 4.0.0 STU4 Release

US Core Vital Signs Profile

HL7.FHIR.US.CORE\US Core Vital Signs Profile - FHIR v4.0.1

S

Lab results

Observation

US Core 4.0.0 STU4 Release

US Core Laboratory Result Observation Profile

HL7.FHIR.US.CORE\US Core Laboratory Result Observation Profile - FHIR v4.0.1


Content returned to the practice (enrollment application) after authorization

 

Information

FHIR R4 Resource

FHIR IG

FHIR Profile

Notes

 

Updated insurance and therapy information

M

Preferred specialty pharmacy

Organization

Specialty Medication Enrollment STU1

Specialty Rx Organization – Pharmacy

HL7.FHIR.US.SPECIALTY-RX\Specialty Rx Organization - Pharmacy - FHIR v4.0.1

Authorized pharmacy

S

Insurance information

Coverage

Specialty Medication Enrollment STU1

Specialty Rx Coverage

HL7.FHIR.US.SPECIALTY-RX\Specialty Rx Coverage - FHIR v4.0.1

If updated by the Patient Support Program

S

Prescribed medication therapy

and

Indication diagnosis

Medication Request

Specialty Medication Enrollment STU1

Specialty Rx Medication Request

HL7.FHIR.US.SPECIALTY-RX\Specialty Rx Medication Request - FHIR v4.0.1

If updated by the Patient Support Program


Message Structures

Initiation Message

The Initiation message transmits information from a the enrollment application to a stakeholder involved in fulfillment of a specialty medication and/or support of the patient.

The Initiation Message content is structured as entries within a Bundle resources as outlined below.

Notes:

  • Formal profile: rx-enroll-bundle-initiation
  • Example: rx-enroll-bundle-initiation-1
  • This message is not intended to serve as authorization to dispense the referenced medication. An electronic prescription will be transmitted directly to the dispensing pharmacy using the NewRx message defined in the NCPDP SCRIPT standard.
Parameter Cardinality Type Description, profile
patient 1..1 Patient Patient resource representing the Data Source's understanding of the patient
Profile: specialty-rx-patient
patient-consent 0..1 Consent Consent resource conveying patient consent associated with fulfillment of the specialty medication
Profile: rx-enroll-consent
patient-consent-signature 1..2 Consent Provenance resource conveying a digital signature associated with the patient consent
Profile: rx-enroll-provenance-signature
provider-consent 0..1 Consent Consent resource conveying provider authorization associated with fulfillment of the specialty medication
Profile: rx-enroll-consent
provider-consent-signature 1..2 Consent Provenance resource conveying a digital signature associated with the provider authorization
Profile: rx-enroll-provenance-signature
prescription 1..1 MedicationRequest The associated specialty prescription
Profile: specialty-rx-medicationrequest
prescriber 1..1 Practitioner The prescriber of the associated specialty prescription
Profile: specialty-rx-practitioner
prescriber-role 0..1 PractitionerRole The prescriber's practicing roles
Profile: us-core-practitionerrole
supervising-prescriber 0..1 Practitioner Supervising prescriber (e.g., if the prescriber is an NP, resident, etc.)
Profile: specialty-rx-practitioner
practice-organization 0..1 Organization Organization resource representing the practice organization
Profile: us-core-organization
practice-organization 0..1 Organization Organization resources representing the preferred pharmacy (if identified by the prescriber)
Profile: us-core-organization
coverage 1..1 Coverage The patient's coverage information
Profile: specialty-rx-coverage
search-result 1..* Bundle Searchset bundle containing the results from a single search of patient data
Profile: specialty-rx-bundle-search-result

Update Message

Notes:

Parameter Cardinality Type Description, profile
source-patient 1..1 Patient Patient resource reflecting the practice's patient information
Profile: specialty-rx-patient
prescription 0..1 MedicationRequest The associated specialty prescription
Profile: specialty-rx-medicationrequest
authorized-pharmacy 1..* Organization One or more pharmacies authorized to dispense the medication
Profile: specialty-rx-organization-pharmacy
coverage 0..1 Coverage Updates to the patient's coverage information
Profile: specialty-rx-coverage