Is it possible to make multiple medication administrations for a given medication?

[mduna]

Is it possible to make multiple medication administrations for a given medication? For example, a vancomycin IV medication once a day for 5 days. Synthea will generate five MedicationRequest resources for five days, one resource per day. If it is possible, could please show me an example? Thanks.

[jawalonoski]

It should be possible to do this. Below is an example of a Module that should work.

However, upon testing it, it does not seem to be functioning correctly. Which means we have a bug somewhere.

[jawalonoski]

I made an issue #1079

[mduna]

Hi Jason, Thank your quick response. Follow your example, it does not work for me. Please see my json file. Not sure what I did wrong. Your help will be appreciated.

{
"name": "cot-cdi2",
"remarks": [
"A blank module"
],
"states": {
"Initial": {
"type": "Initial",
"direct_transition": "Jan2022"
},
"Jan2022": {
"type": "Guard",
"allow": {
"condition_type": "And",
"conditions": [
{
"condition_type": "Date",
"operator": ">",
"date": {
"year": 2022,
"month": 1,
"day": 1,
"hour": 0,
"minute": 0,
"second": 0,
"millisecond": 0
}
},
{
"condition_type": "Date",
"operator": "<=",
"date": {
"year": 2022,
"month": 2,
"day": 1,
"hour": 0,
"minute": 0,
"second": 0,
"millisecond": 0
},
"value": 0
}
]
},
"direct_transition": "Wait_1_Month"
},
"Encounter_End": {
"type": "EncounterEnd",
"direct_transition": "Wait_1_Month"
},
"In_hospital_delay": {
"type": "Delay",
"direct_transition": "lab-stool",
"exact": {
"quantity": 2,
"unit": "days"
}
},
"Hospital inpatient Admission_1": {
"type": "Encounter",
"encounter_class": "inpatient",
"reason": "",
"codes": [
{
"system": "SNOMED-CT",
"code": 1505002,
"display": "SNOMED Code"
}
],
"direct_transition": "In_hospital_delay"
},
"Examplitis": {
"type": "ConditionOnset",
"target_encounter": "Hospital inpatient Admission_1",
"codes": [
{
"system": "SNOMED-CT",
"code": 195967001,
"display": "Asthma"
}
],
"direct_transition": "Hospital inpatient Admission_1"
},
"lab-stool": {
"type": "Observation",
"category": "laboratory",
"unit": "mg/dL",
"codes": [
{
"system": "LOINC",
"code": "10895-1",
"display": "Clostridioides difficile toxin B [Presence] in Stool"
}
],
"direct_transition": "Counter",
"value_code": {
"system": "SNOMED-CT",
"code": 719220002,
"display": "Positive"
}
},
"vancomycin1": {
"type": "MedicationOrder",
"codes": [
{
"system": "RxNorm",
"code": 239209,
"display": "vancomycin 100 MG/ML Injectable Solution"
}
],
"direct_transition": "Check_Counter",
"prescription": {
"dosage": {
"amount": 1,
"frequency": 1,
"period": 1,
"unit": "days"
},
"duration": {
"quantity": 1,
"unit": "days"
},
"refills": 5
},
"administration": true
},
"Counter": {
"type": "SetAttribute",
"attribute": "counter",
"direct_transition": "vancomycin1",
"value": 1
},
"Check_Counter": {
"type": "Simple",
"conditional_transition": [
{
"transition": "Increment_Counter",
"condition": {
"condition_type": "Attribute",
"attribute": "counter",
"operator": "<",
"value": 5
}
},
{
"transition": "Encounter_End"
}
]
},
"Increment_Counter": {
"type": "Counter",
"attribute": "counter",
"action": "increment",
"direct_transition": "Wait_1_Day"
},
"Wait_1_Day": {
"type": "Delay",
"distribution": {
"kind": "EXACT",
"parameters": {
"value": 1
}
},
"unit": "days",
"direct_transition": "vancomycin1"
},
"Wait_1_Month": {
"type": "Delay",
"distribution": {
"kind": "EXACT",
"parameters": {
"value": 1
}
},
"unit": "months",
"direct_transition": "Examplitis"
}
},
"gmf_version": 2

[jawalonoski]

I did not look at your module.

There is a bug, which is why I opened a new issue #1079

[mduna]

Hi Jason, Ok, I will wait for the bug fixes, then give a try. Thanks.