# Logical Record Architecture for Health and Social Care
## Discharge Summary Release 0.02

Contents
The content of this release is not comprehensive and is not fully validated and must not be used in live system implementations.
# ENTRY Constrained Domain Model: MedicationRecommendation
A constrained ENTRY containing a collection of data items required to represent recommendations made in context of a medication activity. The medication recommendation ENTRY represents a list of medications (and medications-related) recommendations advised for action following discharge. Comprises a Medication Recommendation Activity with one or more of a choice of a coded representation of a recommendation made to start or change a medication (Current Medication Activity), a coded representation of a recommendation made to stop a medication (Stopped Medication Activity) , a coded representation of a recommendation made to review a medication (Medication Review Activity), or a textual representation of the recommendation made if it cannot be coded It may also optionally comprise of a textual representation of the event , a recommended date in the future for performing the activity, and a maximum of one recipient of a recommendation activity which may include a health professional, a health organisation, or a subject of care amongst others. Recommended guidelines to follow for the coding and constraining of relevant SCT expression constraints for medication recommendations as per the reconciliation status requirements are listed below: Reconciliation Status Requirement -recommend Record artefact -Medicationrecommendation Context Value Attribute constraint -(385643006 | To be done |) OR (410521004 | Not to be done |) OR(385654001 | To be stopped |) OR (385653007 | Not to be stopped |) ## Specializes ## ProductOrSubstanceRelatedActivity ## Attributes
Name | Data type | Occurs | Description | Value constraints
--- | --- | --- | --- | ---
name | SC | 1..1 | The name, expressed as a coded value or as plain text, specifies the clinical or administrative concept to which this EHR node corresponds, as labelled in the EHR system in which it was first committed. |
value
Literal value(s): ENTRY
rc_id | II | 1..1 | The globally-unique identifier by which this node in the EHR hierarchy is referenced in the EHR system to which the data were first committed. This identifier shall be retained by the EHR Recipient and re-used whenever this RECORD_COMPONENT is subsequently included in another EHR_EXTRACT. |
synthesised | BL | 1..1 | This attribute value shall be TRUE if this RECORD_COMPONENT has been created in order to comply with this standard , but this point in the EHR hierarchy has no corresponding node in the EHR from which it was extracted. |
value
Default value: false
uncertainty_expressed | BL | 1..1 | This attribute is set to TRUE to advise the EHR Recipient that this ENTRY contains data that indicates some degree of uncertainty, and that care should be taken when using these data within automated processes and systems. |
nullFlavor
Literal value(s): NA
## Contained ELEMENTs ## Graphical Representation
Subject ELEMENT class | Related object classes
--- | ---
Name | ELEMENT Class | Occurs | Description | Relationship | Occurs | Class | Dependency
items | CurrentMedicationActivity | 0 .. * |  | HasTemporalContext | 0..* | MedicationFutureCourseTiming MedicationCourseTiming | INDEPENDENT
HasRecordRole | 0..* | CurrentMedicationReconciliationStatus | INDEPENDENT
HasTemporalContext | 0..* | CurrentMedicationActivity | INDEPENDENT
HasParameterSetting | 0..* | DoseQuantity | INDEPENDENT
AssertsTiming | 0..* | EventDoseFrequency MeasuredDoseFrequency MedicationReviewText | INDEPENDENT
Consumes | 1..* | MedicinalProductOrSubstance | INDEPENDENT
HasAnnotation | 0..* | DosageInstructions | INDEPENDENT
UsesDevice | 0..* | MedicinalDevice ComplianceDevice | INDEPENDENT
IsProspectOf | 1..* | MedicationRecommendationActivity | INDEPENDENT
IsPrecedentOf | 1..* | StoppedMedicationActivity | INDEPENDENT
HasAnnotation | 0..* | DosageInstructions AdditionalInstructions | INDEPENDENT
HasIndication | 0..* | AllergiesOrAdverseReactionEvent TreatmentActivity InvestigationActivity FindingObservation CurrentMedicationActivity ReasonForMedicationText PropertyObservation ProcedureActivity CareIssues Diagnosis | INDEPENDENT
IsComponentActionOf | 0..* | CurrentMedicationActivity TreatmentActivity | INDEPENDENT
HasComponentAction | 0..* | MedicationReviewActivity | INDEPENDENT
items | MedicationRecommendationText | 0 .. * |  |  |  |  |
items | Text | 0 .. * |  |  |  |  |
items | StoppedMedicationActivity | 0 .. * |  | HasRecordRole | 0..* | StoppedMedicationReconciliationStatus | INDEPENDENT
HasAnnotation | 0..* | Text | INDEPENDENT
HasTemporalContext | 0..* | StoppedMedicationActivity | INDEPENDENT
IsComponentActionOf | 0..* | StoppedMedicationActivity TreatmentActivity | INDEPENDENT
HasPredecessor | 1..* | CurrentMedicationActivity | INDEPENDENT
HasIndication | 0..* | ReasonForStoppingMedicationText ProcedureActivity FindingObservation PropertyObservation AllergiesOrAdverseReactionEvent StoppedMedicationActivity InvestigationActivity Diagnosis CareIssues TreatmentActivity | INDEPENDENT
items | MedicationRecommendationActivity | 1 .. * |  | HasAnnotation | 0..* | Text | INDEPENDENT
HasProspect | 0..1 | MedicationRecommendationText MedicationReviewActivity StoppedMedicationActivity CurrentMedicationActivity | INDEPENDENT
AssertsTiming | 0..* | MedicationRecommendationFutureDateTime | INDEPENDENT
items | MedicationReviewActivity | 0 .. * |  | AssertsTiming | 0..* | MedicationReviewFutureTiming | INDEPENDENT
HasAnnotation | 0..* | MedicationReviewText | INDEPENDENT
IsComponentActionOf | 1..* | CurrentMedicationActivity | INDEPENDENT
items | MedicationRecommendationFutureDateTime | 0 .. * |  |  |  |  |
## Participations ### Other Participations
Name | Class | Occurs | Description
--- | --- | --- | ---
other_participations | RecommendationRecipientChoice | 0..1 | Represents a choice of FUNCTIONAL_ROLE classes used to describe the participation of a ROLE class in a COMPOSITION or an ENTRY. The ROLE class shall participate as a recipient of the medication recommendation.
## Content of COMPOSITION Models ### DischargeSummary ## Reference Model Type ## ENTRY