This page is part of the MyHealth@Eu Electronic Prescription and Dispense (v1.0.0-poc: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

About this guide

Overview

This guide:

• Specifies a set of rules to be applied to HL7 FHIR to define how to represent ePrescription and eDispensation for the European cross-border exchange, coherently with the European eHN Guidelines (see the European eHealth - Key documents).
• Provides a representation of the ePrescription and eDispensation content specified in the MyHealth@EU Functional Requirements expressed as HL7 FHIR Logical Models.
• Is derived from the HL7 Europe Medication Prescription and Dispense IG fulfilling the MyHealth@EU Functional Requirements.
• Refines the EHDS logical information models from the Xt-EHR project to reflect MyHealth@EU-specific obligations.

The following figure shows how the eHN guidelines, MyHealth@EU Functional Requirements, and HL7 FHIR specifications relate across the different IGs.

Figure 1 - From the eHN guidelines to the MyHealth@EU specifications

What is in this Guide

This guide includes two main kinds of content:

1. HL7 FHIR Logical Models — representing the MyHealth@EU ePrescription and eDispensation information requirements, derived from EHDS logical models. Logical models are not intended to be directly implemented or exchanged.
2. HL7 FHIR Conformance Resources — profiles, value sets, and code systems describing how to implement HL7 FHIR for the purpose of this guide.

Figure 2 - Guide Content

A detailed description on how to read HL7 FHIR Implementation Guides is provided in the Reading Implementation Guides guide.

Obligations Framework

This guide uses obligations on the logical models to highlight the elements identified by the MyHealth@EU Functional Requirements. Three types of obligations are defined:

• Mandatory (SHALL:handle) — the data element must be provided.
• Required (SHOULD:handle) — the data element must be provided, although exceptional justifications may apply.
• Optional (MAY:able-to-populate) — the data element may be omitted.

These obligations are implemented using the following rule sets:

• ObligationMandatory — SHALL:handle for mandatory elements
• ObligationRequired — SHOULD:handle for required elements
• ObligationOptional — MAY:able-to-populate for optional elements

Important: Regardless of whether data elements are mandatory, required, or optional, if they are present in the document, they cannot be omitted when displaying information to health professionals. All present data elements must be displayed by consuming systems.

Representing Functional Requirements

Implementers should be aware of the differences between HL7 FHIR and HL7 CDA when interpreting obligation levels.

In HL7 CDA, elements can generally be nullFlavored unless explicitly flagged otherwise. In HL7 FHIR, 1.. cardinality implies a truly mandatory element. For this reason, required fields are not necessarily mapped to 1.. cardinality — the data-absent-reason extension is used where a value may be legitimately absent.

Models to Profiles Forward Mapping

The Mapping to Profiles page documents how each MyHealth@EU logical model element maps to a specific FHIR R4 path in the corresponding profile. Mappings are expressed as tables with three columns:

• Logical model element — the element name as defined in the MyHealth@EU logical model.
• FHIR Path (R4) — the target FHIR R4 element path in the profile.
• Comment — clarifications on the mapping, including use of extensions or R5 preadoption patterns.

More details about the ePrescription and eDispensation models are available on the ePrescription and eDispensation Models Overview page.