Release notes Medicatieproces 9 version 3.0.0-rc.2 ENG

The tables below contain the release notes for this version compared to the previous release (Medication Process 9 3.0.0-rc.1). The hyperlink will take you to the corresponding issue in BITS.

For an overview of relevant wiki pages for the Medication Process, see the Medication Process landing page.

Functioneel Design

Design on the wiki

Documentation

BITS issue	Components	Release note
BITS MP-2151	Design	The chapters of the FOH have been published and thereby replace the previous draft. The accompanying texts are attached as an appendix.
BITS MP-2145	Design	Proposal details are explained in more detail in sections 5.2.5 Proposal details, 5.2.5.1 Proposal for medication agreement, 5.2.5.2 Proposal for dispensing request and 5.2.3.5 Dispensing for approval by prescriber. The rest of the FO has also been updated where necessary. In addition, the following practical examples have been added for illustration purposes: Proposal for medication agreement to prescriber rejected on PRK, dispense after approval of proposal for medication agreement, Dispense before approval of proposal for medication agreement for additional medicine, Dispense before approval of proposal for medication agreement for replacement medicine.
BITS MP-2142	Dataset, Design	This text has been added to the reading guide of the Functional Design: § 1.5.4 Functionalities in beta version. In the previous publication of the Functional Design and the dataset, several functionalities were incorrectly assigned the version designation ‘release candidate 1’. This concerns the Proposal data (see FD section 2.3.2) and the functionalities in the sub-process Administration (see FD section 5.4). In this publication of the FD and the dataset, these functionalities are therefore published as a beta version, as they still need to be validated in practice. This is in accordance with Nictiz’s Sustainable Release Policy. This text has been added to the following paragraphs: Functional Design § 2.3.2 & 5.2.5 on Proposal data: In this functional design and the dataset, the Proposal data are published as a beta version (see FD section 1.5.4). § 2.3.1 & 5.4 on, among other things, Administer In this functional design and the dataset, the sub-process Administer is published as a beta version (see FD section 1.5.4). In the dataset and scenarios in the Art-Decor publication, the ProposalData and MedicationAdministration are labeled as MP9 3.0.0-beta. The value lists contained in file 431 of the G standard have all been republished under version MP9 3.0.0-rc.2. These are: Reason modification or discontinuation MA, Reason modification or discontinuation WDS, Administration agreement reason modification or discontinuation TA, Reason modification or discontinuation of use MGB, Medication Administration reason for deviation MTD, Medication agreement additional information MA, Additional wishes VV, Medication dispense additional information MVE. Of these, the value lists 'Reason for deviation MTD', 'Additional requirements VV' and 'Additional information MVE' remain unchanged in terms of content.
BITS MP-2122	Design	In the Functional Design, it has been clarified that recording the reason for modification or discontinuation (redenWijzigenStaken) is only mandatory when this reason is relevant to the care chain. This is in accordance with chain agreement VO14a.
BITS MP-2105	Design	The figure in the English Functional Design in section 1.3.3 “Medicamenteuze behandeling / Pharmaceutical Treatment” (MBH) has been updated.
BITS MP-2102	Design	In section 5.2.2.5 of the new Functional Design, a change has been made to clarify that interrupted medication is considered current due to the intention to resume it in the future. The sentence regarding its relevance for medication surveillance has been removed.
BITS MP-2101	Design	In section 5.2.2.4.1 of the new Functional Design, the correct approach for correcting a Medication Agreement has been incorporated. Correction is considered a form of modification and is described accordingly.
BITS MP-2093	Design	In the Functional Design, two different approaches were described for shortening the usage period of a stop Medication Agreement (sections 2.2.5.3 and 2.2.5.5). The approach described in section 2.2.5.3 remains leading. The text in section 2.2.5.5 regarding shortening the usage period as a modification (stop MA + new MA) has been removed.
BITS MP-2063	Design	In section H.2.4.4 of the new Functional Design, the text regarding parallel building blocks has been corrected. The rules for parallel building blocks within a single MBH have been revised, including explicit exceptions for MGBs.
BITS MP-2062	Design	In the Functional Design, the derivation rules for generating the administration list have been updated with regard to the use of AdditionalInformation in the MA. If an MA contains the value “per direct” or no AdditionalInformation, it is included directly on the administration list. If the value is “per volgende rolwissel” or “per reguliere voorschriftverwerking” the MA is only included once a corresponding TA has been created.
BITS MP-2021	Design, Test material	The TA of a replacement agent is included in the existing MBH. The TA of an additional agent is included in a new MBH. Based on establishing relationships between the proposed MA and the existing MA and TA, it can be deduced that this concerns a change and that the correct stop and change can be implemented. All of this has been incorporated into the test material.
BITS MP-1997	Design	Clarification has been added to the Functional Design regarding non-daily GDS medication. The start date of an MVE is now unambiguously determined based on the MedicationDispenseDateTime. The end date is derived from the DurationOfUse in days, with the agreement that it always coincides with the last day of the medication roll (for example, 7 days for a weekly roll and 14 days for a biweekly roll). As a result of these changes, section 8.9.4.4 has been removed and the last bullet of the former section 8.9.4.5 has been updated. In the FOH, this information has been included in section 5.8 Overview GDS-medication.
BITS MP-1994	Design, Test material	In the new Functional Design (rc2), the test material and the new practical examples 84 through 86 reflect that sending a Reply proposal medication agreement (AVMA) / Reply proposal dispense request (AVVV) by the prescriber to the proposer is always mandatory when handling the AVMA/AVVV, regardless of the decision on the proposal.
BITS MP-1963	Design	Incorrect sentences regarding parallel MA’s in § 1.3.4 and § 4.1.26 removed.
BITS MP-1926	Design	The definition of the VMA is changed in paragraph 1.3.1 of the Functional Design to: 'Voorstel medicatieafspraak / Proposal medication agreement' is a proposal from a health professional or patient to the prescriber of the MA regarding the agreed medication. The proposal may involve stopping, starting, changing or continuing medication. The definition of the VVV is changed in paragraph 1.3.1 of the Functional Design to: 'Voorstel verstrekkingsverzoek / Proposal dispense request' is a proposal from the pharmacist to the prescriber to authorize a MVE(s) in support of the current MA(s).
BITS MP-1915	Design	In the following paragraphs the word ‘actual’ has been put in single quotation marks, in § 1.3.3 is explained what is meant with this term.
BITS MP-1895	Design	The table containing examples of clinically relevant medication for extramural healthcare providers has been moved to a separate page outside the Functional Design. It can be accessed via the page with additional documentation.
BITS MP-1852	Design	Section 2.3.6.1 of the functional design has been extended with the following text: Administration Agreement for GDS Medication, If medication is to be supplied via a GDS system, or if changes occur to GDS medication, the startDateTime of the TA must be equal to the effective date of the next medication dispensing cycle. Examples 4.2.11 and 4.2.13 have been replaced with new versions.
BITS MP-1790	Design	Example 49 on the example page have been updated.
BITS MP-1780	Design	Some corrections in practical example 4.3.13: “(professional) administrator” replaced with “administrator”. “on the basis of an MA…telephone” replaced with “based on verbal or telephone consultation with a prescriber”. Added at the end: “If necessary, an MA and TA can be recorded within this MBH afterwards.”
BITS MP-1667	Design	At the end of § 2.5.2 _relationships Between Building Blocks_, several general rules regarding referencing have been added.
BITS MP-1612	Design	In the new version of the Functional Design, the activity diagrams are no longer included.
BITS MP-1397	Design	The example in paragraph 4.2.16 has been updated to describe the situation more clearly.
BITS MP-1244	Dataset, Design	In the Dispense Request, the English translation of 'verbruiksperiode' has been updated. PeriodOfUse has been replaced with ValidityPeriod. The English description of the element has also been revised to correctly reflect this change. In sections 2.2.7 and 4.1.34 of the English Functional Design, “period of use” has been replaced with validityPeriod.
BITS MP-1203	Design	The abbreviations of the system roles for the response proposal data have been updated to reflect the new abbreviations in the Functional Design under 'Information Systems and Transactions' in Tables 3 and 4, in the figures in § 2.2.12, 2.3.10 and Chapter 7, in the collection file in Table 6.3, and in Art-Decor under Scenarios – Proposal Data (MP9 3.0.0). In the Kickstart test plan, all new abbreviations have been implemented under _Relevant Transactions_ in §9.3.
BITS MP-1192	Dataset, Design	The following textual changes have been made to the AanvullendeInformatie value list (Additional Information ) for medication appointments: 'Wijziging in GDS per direct' (‘Change in GDS effective immediately’) is now ‘direct op toedienlijst of in GDS’ (‘immediately on the administration list or in GDS’). 'Wijziging in GDS per volgende rolwissel' (‘Change in GDS effective at next role change’) is now 'Per volgende GDS-rolwissel op toedienlijst’ (‘on the administration list at next GDS role change’).
BITS MP-1188	Design	The previous wording explicitly referred to legal provisions and stated that renal function always had to be sent together with the prescription. These passages have been removed or adjusted in paragraph 2.2.8.

Dataset & Transactions

Transactions

BITS issue	Components	Release note
BITS MP-2104	Dataset, Scenario's	The element PharmaceuticalTreatmentID has been added to each medication building block. The conformances and cardinalities remain unchanged compared to the previous modeling of the PharmaceuticalTreatmentID. The group PharmaceuticalTreatmentID and the element PharmaceuticalTreatment/Identifier have been removed from all relevant transactions.
BITS MP-2094	Dataset, Profiles, Scenario's	The MedicationOverview has been removed from the profiles in the FHIR package. MedicationOverview has also been removed from the FHIR Implementation Guide (IG). The MedicationOverview transaction is no longer part of the AD publication.
BITS MP-2091	Scenario's	In the query transactions in Art-Decor, the query parameter 'Type' has been added for clarification. This parameter has a condition with cardinality 1..1. Under the conditions, a single condition has been included with the same cardinality (1..1) and status; required. The fixed value corresponds to the type defined in the associated building block.
BITS MP-1995	Scenario's	In the dataset, conditions have been added to the data elements ResponseMedicationAgreementComment and ResponseDispenseRequestComment in the transactions Sending reply proposal medication agreement (AVMA) and Sending reply proposal dispense request (AVVV), namely: ResponseMedicationAgreementComment/ResponseDispenseRequestComment → 0..1 conditional
BITS MP-1953	Dataset, Scenario's	The Dutch and English descriptions of StopType have been updated for the building blocks MA, TA, WDS, and MGB as follows. For MA and TA, The stop type is only specified in stop or cancel building blocks and indicates whether the stop is temporary or permanent, or whether a future building block is cancelled. For WDS, The stop type is only specified in stop building blocks and indicates that the building block has been stopped For MGB, The stop type is only filled in within stop building blocks and indicates whether the stop is temporary or permanent. In addition, the cardinality for the same building blocks has been changed from 0..1 Required to 0..1 Conditional. For MA and TA, in the case of a stop or cancel building block the cardinality is 1..1 Required, and in all other cases it is 0..0 Not Permitted. For WDS and MGB, in the case of a stop building block the cardinality is 1..1 Required, and in all other cases it is 0..0 Not Permitted.
BITS MP-1887	Scenario's	In Art-Decor, the conditions have been updated for relationMedicatieAgremeent within the MA and for RelationVariableDosingRegimen within the WDS. This change has been implemented for all related transactions within the medication process. For relationMedicatieAgremeent, if a previous medication agreement exists that is stopped or modified by the current medication agreement, the relationship is mandatory (1..1). If a previous medication agreement exists that is not stopped or modified by the current medication agreement, the relationship is optional (0..1). In all other cases, the relationship is not permitted. The same approach applies to RelationVariableDosingRegimen. If a previous variable dosing schedule exists that is stopped or modified by the current one, the relationship is mandatory (1..1). If the previous schedule is not stopped or modified by the current one, the relationship is optional (0..1). In all other cases, the relationship is not permitted.

MedicationAgreement (MA)

BITS issue	Components	Release note
BITS MP-2104	Dataset, Scenario's	The element PharmaceuticalTreatmentID has been added to each medication building block. The conformances and cardinalities remain unchanged compared to the previous modeling of the PharmaceuticalTreatmentID. The group PharmaceuticalTreatmentID and the element PharmaceuticalTreatment/Identifier have been removed from all relevant transactions.
BITS MP-2086	Dataset	The description of Dosage.doseAndRate.dose[x] has been revised for MA, TA, WDS and MGB
BITS MP-2020	Dataset	In the Medication Agreement, the following value has been added to the value list of additionalInformation: “Na reguliere voorschriftverwerking op toedienlijst of in GDS”.
BITS MP-1953	Dataset, Scenario's	The Dutch and English descriptions of StopType have been updated for the building blocks MA, TA, WDS, and MGB as follows. For MA and TA, The stop type is only specified in stop or cancel building blocks and indicates whether the stop is temporary or permanent, or whether a future building block is cancelled. For WDS, The stop type is only specified in stop building blocks and indicates that the building block has been stopped For MGB, The stop type is only filled in within stop building blocks and indicates whether the stop is temporary or permanent. In addition, the cardinality for the same building blocks has been changed from 0..1 Required to 0..1 Conditional.
BITS MP-1939	Dataset	The description of the element ‘dosage’ has been revised to clarify that dosing instructions can be created both in parallel and sequentially. This change has been implemented in the MA, WDS, TA, and MGB.
BITS MP-1935	Dataset, Profiles, Templates, Test materials	Within Medication Agreement, the healthcare provider building block has been added under the element NextPractitioner. In addition, a condition has been added to both healthcareProfessional and healthcareProvider to clarify that the healthcareProvider may only be used when the healthcareProfessional is unknown. No changes were required to HL7v3 template 9446. If only a healthcareProvider is known as the next practitioner, the healthcare professional details may be left empty. The new dataset concept (NextPractitioner/healthcareProvider) has, however, been linked to the template to connect it to the scopingEntity element in template 9446. A new test scenario has been added to scenario set 3 in which NextPractitioner with healthcareProvider is used. In the Functional Design, the following sentence has been added to the explanation of the NextPractitioner field: “If the healthcare professional is unknown, the relevant healthcare provider may be filled in as an alternative.” The FHIR extension ext-MedicationAgreement.NextPractitioner has been extended to include healthcare provider (Organization).
BITS MP-1932	Dataset	The description of the ‘Description’ element in the ‘instructionsOfUse’ in the MA, WDS, TA and MGB was changed to: This textual Description must contain no more and no less than the structured information in the InstructionForUse. A user-friendly or more readable version may also be chosen instead of a structured format, provided that it covers all the information contained in the complete InstructionForUse.
BITS MP-1809	Dataset	The value list has been updated for the following four data elements: MedicationAgreement/ReasonModificationOrDiscontinuation, VariableDosingRegimen/ReasonModificationOrDiscontinuation, AdministrationAgreement/AdministrationAgreementReasonModificationOrDiscontinuation, MedicationUse/ReasonModificationOrDiscontinuationOfUse. In the value list, the item “Treatment previous prescriber continued” has been changed to “Treatment previous health professional continued”
BITS MP-1192	Dataset, Design	The following textual changes have been made to the AanvullendeInformatie value list (Additional Information ) for medication appointments: 'Wijziging in GDS per direct' (‘Change in GDS effective immediately’) is now ‘direct op toedienlijst of in GDS’ (‘immediately on the administration list or in GDS’). 'Wijziging in GDS per volgende rolwissel' (‘Change in GDS effective at next role change’) is now 'Per volgende GDS-rolwissel op toedienlijst’ (‘on the administration list at next GDS role change’).
BITS MP-690	Dataset	Descriptions and mapping from the following fields have been revised to clarify the relationship with the G-standaard: MedicationRequest.dispenseRequest.quantity, Dosage.asNeeded[x]:asNeededCodeableConcept, Dosage.route, Dosage.doseAndRate.dose[x], MedicationRequest.reasonReference, MedicationDispense.quantity, Medication.Form, Medication.ingredient.strenght.numerator.

VariableDosingRegimen (WDS)

BITS issue	Components	Release note
BITS MP-2104	Dataset, Scenario's	The element PharmaceuticalTreatmentID has been added to each medication building block. The conformances and cardinalities remain unchanged compared to the previous modeling of the PharmaceuticalTreatmentID. The group PharmaceuticalTreatmentID and the element PharmaceuticalTreatment/Identifier have been removed from all relevant transactions.
BITS MP-2065	Templates	In the HL7v3 template of the WDS, the relationTA was incorrectly defined. As this element is not included in the functional dataset and is also not present in the FHIR profile, it has been removed from the template.
BITS MP-1953	Dataset, Scenario's	The Dutch and English descriptions of StopType have been updated for the building blocks MA, TA, WDS, and MGB as follows. For MA and TA, The stop type is only specified in stop or cancel building blocks and indicates whether the stop is temporary or permanent, or whether a future building block is cancelled. For WDS, The stop type is only specified in stop building blocks and indicates that the building block has been stopped For MGB, The stop type is only filled in within stop building blocks and indicates whether the stop is temporary or permanent. In addition, the cardinality for the same building blocks has been changed from 0..1 Required to 0..1 Conditional.
BITS MP-1939	Dataset	The description of the element ‘dosage’ has been revised to clarify that dosing instructions can be created both in parallel and sequentially. This change has been implemented in the MA, WDS, TA, and MGB.
BITS MP-1932	Dataset	The description of the ‘Description’ element in the ‘instructionsOfUse’ in the MA, WDS, TA and MGB was changed to: This textual Description must contain no more and no less than the structured information in the InstructionForUse. A user-friendly or more readable version may also be chosen instead of a structured format, provided that it covers all the information contained in the complete InstructionForUse.
BITS MP-1809	Dataset	The value list has been updated for the following four data elements: MedicationAgreement/ReasonModificationOrDiscontinuation, VariableDosingRegimen/ReasonModificationOrDiscontinuation, AdministrationAgreement/AdministrationAgreementReasonModificationOrDiscontinuation, MedicationUse/ReasonModificationOrDiscontinuationOfUse, In the value list, the item “Treatment previous prescriber continued” has been changed to “Treatment previous health professional continued”.
BITS MP-690	Dataset	Descriptions and mapping from the following fields have been revised to clarify the relationship with the G-standaard: MedicationRequest.dispenseRequest.quantity, Dosage.asNeeded[x]:asNeededCodeableConcept, Dosage.route, Dosage.doseAndRate.dose[x], MedicationRequest.reasonReference, MedicationDispense.quantity, Medication.Form, Medication.ingredient.strenght.numerator.

DispenseRequest (VV)

BITS issue	Components	Release note
BITS MP-2104	Dataset, Scenario's	The element PharmaceuticalTreatmentID has been added to each medication building block. The conformances and cardinalities remain unchanged compared to the previous modeling of the PharmaceuticalTreatmentID. The group PharmaceuticalTreatmentID and the element PharmaceuticalTreatment/Identifier have been removed from all relevant transactions.
BITS MP-2082	Dataset, Profiles, Templates	The allowed units for DurationOfUse (MVE) and ValidityPeriod.duration (VV) have been updated. Previously, the permitted units were years, weeks, days, and hours. This has been restricted to days only. The existing HL7v3 templates 9449, 9451, and 9463 for Medication Dispense and (proposal) Dispense Request have been updated accordingly. The element expectedUseTime/width/@unit now has the fixed value “d”. The description in FHIR profile mp-MedicationDispense has been changed and now contains “the duration in days”.
BITS MP-1844	Dataset	The descriptions of the building blocks have been revised and clarified where necessary.
BITS MP-1244	Dataset, Design	In the Dispense Request, the English translation of 'verbruiksperiode' has been updated. PeriodOfUse has been replaced with ValidityPeriod. The English description of the element has also been revised to correctly reflect this change. In sections 2.2.7 and 4.1.34 of the English Functional Design, “period of use” has been replaced with validityPeriod.
BITS MP-690	Dataset	Descriptions and mapping from the following fields have been revised to clarify the relationship with the G-standaard: MedicationRequest.dispenseRequest.quantity, Dosage.asNeeded[x]:asNeededCodeableConcept, Dosage.route, Dosage.doseAndRate.dose[x], MedicationRequest.reasonReference, MedicationDispense.quantity, Medication.Form, Medication.ingredient.strenght.numerator.

AdministrationAgremeent (TA)

BITS issue	Components	Release note
BITS MP-2104	Dataset, Scenario's	The element PharmaceuticalTreatmentID has been added to each medication building block. The conformances and cardinalities remain unchanged compared to the previous modeling of the PharmaceuticalTreatmentID. The group PharmaceuticalTreatmentID and the element PharmaceuticalTreatment/Identifier have been removed from all relevant transactions.
BITS MP-1953	Dataset, Scenario's	The Dutch and English descriptions of StopType have been updated for the building blocks MA, TA, WDS, and MGB as follows. For MA and TA, The stop type is only specified in stop or cancel building blocks and indicates whether the stop is temporary or permanent, or whether a future building block is cancelled. For WDS, The stop type is only specified in stop building blocks and indicates that the building block has been stopped For MGB, The stop type is only filled in within stop building blocks and indicates whether the stop is temporary or permanent.In addition, the cardinality for the same building blocks has been changed from 0..1 Required to 0..1 Conditional.
BITS MP-1939	Dataset	The description of the element ‘dosage’ has been revised to clarify that dosing instructions can be created both in parallel and sequentially. This change has been implemented in the MA, WDS, TA, and MGB.
BITS MP-1932	Dataset	The description of the ‘Description’ element in the ‘instructionsOfUse’ in the MA, WDS, TA and MGB was changed to: This textual Description must contain no more and no less than the structured information in the InstructionForUse. A user-friendly or more readable version may also be chosen instead of a structured format, provided that it covers all the information contained in the complete InstructionForUse.
BITS MP-1809	Dataset	The value list has been updated for the following four data elements:MedicationAgreement/ReasonModificationOrDiscontinuation, VariableDosingRegimen/ReasonModificationOrDiscontinuation, AdministrationAgreement/AdministrationAgreementReasonModificationOrDiscontinuation, MedicationUse/ReasonModificationOrDiscontinuationOfUse. In the value list, the item “Treatment previous prescriber continued” has been changed to “Treatment previous health professional continued”
BITS MP-690	Dataset	Descriptions and mapping from the following fields have been revised to clarify the relationship with the G-standaard: MedicationRequest.dispenseRequest.quantity, Dosage.asNeeded[x]:asNeededCodeableConcept, Dosage.route, Dosage.doseAndRate.dose[x], MedicationRequest.reasonReference, MedicationDispense.quantity, Medication.Form, Medication.ingredient.strenght.numerator.

MedicationDispense (MVE)

BITS issue	Components	Release note
BITS MP-2104	Dataset, Scenario's	The element PharmaceuticalTreatmentID has been added to each medication building block. The conformances and cardinalities remain unchanged compared to the previous modeling of the PharmaceuticalTreatmentID. The group PharmaceuticalTreatmentID and the element PharmaceuticalTreatment/Identifier have been removed from all relevant transactions.
BITS MP-2082	Dataset, Profiles, Templates	The allowed units for DurationOfUse (MVE) and ValidityPeriod.duration (VV) have been updated. Previously, the permitted units were years, weeks, days, and hours. This has been restricted to days only. The existing HL7v3 templates 9449, 9451, and 9463 for Medication Dispense and (proposal) Dispense Request have been updated accordingly. The element expectedUseTime/width/@unit now has the fixed value “d”. The description in FHIR profile mp-MedicationDispense has been changed and now contains “the duration in days”.
BITS MP-1844	Dataset	The descriptions of the building blocks have been revised and clarified where necessary.
BITS MP-690	Dataset	Descriptions and mapping from the following fields have been revised to clarify the relationship with the G-standaard: MedicationRequest.dispenseRequest.quantity, Dosage.asNeeded[x]:asNeededCodeableConcept, Dosage.route, Dosage.doseAndRate.dose[x], MedicationRequest.reasonReference, MedicationDispense.quantity, Medication.Form, Medication.ingredient.strenght.numerator.

MedicationAdministration (MTD)

BITS issue	Components	Release note
BITS MP-2104	Dataset, Scenario's	The element PharmaceuticalTreatmentID has been added to each medication building block. The conformances and cardinalities remain unchanged compared to the previous modeling of the PharmaceuticalTreatmentID. The group PharmaceuticalTreatmentID and the element PharmaceuticalTreatment/Identifier have been removed from all relevant transactions.
BITS MP-690	Dataset	Descriptions and mapping from the following fields have been revised to clarify the relationship with the G-standaard: MedicationRequest.dispenseRequest.quantity, Dosage.asNeeded[x]:asNeededCodeableConcept, Dosage.route, Dosage.doseAndRate.dose[x], MedicationRequest.reasonReference, MedicationDispense.quantity, Medication.Form, Medication.ingredient.strenght.numerator.

MedicationUSe (MGB)

BITS issue	Components	Release note
BITS MP-2104	Dataset, Scenario's	The element PharmaceuticalTreatmentID has been added to each medication building block. The conformances and cardinalities remain unchanged compared to the previous modeling of the PharmaceuticalTreatmentID. The group PharmaceuticalTreatmentID and the element PharmaceuticalTreatment/Identifier have been removed from all relevant transactions.
BITS MP-1953	Dataset, Scenario's	The Dutch and English descriptions of StopType have been updated for the building blocks MA, TA, WDS, and MGB as follows. For MA and TA, The stop type is only specified in stop or cancel building blocks and indicates whether the stop is temporary or permanent, or whether a future building block is cancelled. For WDS, The stop type is only specified in stop building blocks and indicates that the building block has been stopped For MGB, The stop type is only filled in within stop building blocks and indicates whether the stop is temporary or permanent. In addition, the cardinality for the same building blocks has been changed from 0..1 Required to 0..1 Conditional.
BITS MP-1939	Dataset	The description of the element ‘dosage’ has been revised to clarify that dosing instructions can be created both in parallel and sequentially. This change has been implemented in the MA, WDS, TA, and MGB.
BITS MP-1932	Dataset	The description of the ‘Description’ element in the ‘instructionsOfUse’ in the MA, WDS, TA and MGB was changed to: This textual Description must contain no more and no less than the structured information in the InstructionForUse. *A user-friendly or more readable version may also be chosen instead of a structured format, provided that it covers all the information contained in the complete InstructionForUse.*
BITS MP-1844	Dataset	The descriptions of the building blocks have been revised and clarified where necessary.
BITS MP-1809	Dataset	The value list has been updated for the following four data elements: MedicationAgreement/ReasonModificationOrDiscontinuation, VariableDosingRegimen/ReasonModificationOrDiscontinuation, AdministrationAgreement/AdministrationAgreementReasonModificationOrDiscontinuation, MedicationUse/ReasonModificationOrDiscontinuationOfUse. In the value list, the item “Treatment previous prescriber continued” has been changed to “Treatment previous health professional continued”
BITS MP-690	Dataset	Descriptions and mapping from the following fields have been revised to clarify the relationship with the G-standaard: MedicationRequest.dispenseRequest.quantity, Dosage.asNeeded[x]:asNeededCodeableConcept, Dosage.route, Dosage.doseAndRate.dose[x], MedicationRequest.reasonReference, MedicationDispense.quantity, Medication.Form, Medication.ingredient.strenght.numerator.

Other building blocks (patient, (A)VMA, (A)VVV, etc.)

BITS issue	Components	Release note
BITS MP-2033	Dataset, Profiles, Templates	The following relationships have been added to the response proposal data: For MA response proposals, the relationship to the MA. For VV response proposals, the relationship to the VV. The existing HL7v3 templates 9212 and 9396 have been expanded with the above relationships.
BITS MP-2021	Design, Test material	The TA of a replacement agent is included in the existing MBH. The TA of an additional agent is included in a new MBH. Based on establishing relationships between the proposed MA and the existing MA and TA, it can be deduced that this concerns a change and that the correct stop and change can be implemented. All of this has been incorporated into the test material.
BITS MP-1987	Dataset	In the dataset, within the value lists ‘Voorstel antwoord medicatieafspraak’ in ResponseMedicationAgreementDecision (in the AVMA) and ‘Voorstel antwoord verstrekkingsverzoek’ in ResponseDispenseRequestDecision (in the AVVV), the old values have been marked as deprecated and the new values ‘Accepted’, ‘Accepted with changes’, and ‘Rejected’ have been added.
BITS MP-1537	Templates	Cosmetic issue identified in HL7v3 template 9455 for body height in MP9. The body height template contained a zib-2017 version of informant. This has been corrected to the appropriate 2020 version. Since informant for body height is not used in MP9, this concerned a cosmetic issue only.
BITS MP-1020	Dataset, Profiles, Templates	In the dataset, the existing data element _ResponseMedicationAgreement_ has been split into the following data elements: ResponseMedicationAgreementDecision: with a national valueset. ResponseMedicationAgreementComment: with a free text option. The existing HL7v3 templates 9212 and 9213 have been aligned with the changes described here. The FHIR profiles mp-ReplyProposalMedicationAgreement and mp-ReplyProposalMedicationAgreement-Bundle have been aligned with the changes described here.
BITS MP-949	Dataset, Profiles, Templates	In the dataset, the existing data element _ResponseDispenseRequest_ has been split into the following data elements: ResponseDispenseRequestDecision: with a national valueset. ResponseDispenseRequestComment: with a free text option.The existing HL7v3 templates 9212 and 9213 have been aligned with the changes described here. The FHIR profiles mp-ReplyProposalDispenseRequest and mp-ReplyProposalDispenseRequest-Bundle have been aligned with the changes described above.

Technical Design

FHIR Profiles

BITS issue	Componenten	Release note
BITS MP-2152	Profiles	The examples in the FHIR package are deleted.
BITS MP-2144	Profiles	The comment for Dosage.asNeeded[x]:asNeededCodeableConcept has been revised to clarify, when to use this field and when to use the extension Dosage.extension:asNeeded.value[x]
BITS MP-2109	Profiles	Added bake file to MP9’s Simplifier project
BITS MP-2094	Dataset, Profiles, Scenario's	The MedicationOverview has been removed from the profiles in the FHIR package. MedicationOverview has also been removed from the FHIR Implementation Guide (IG). The MedicationOverview transaction is no longer part of the AD publication.
BITS MP-2082	Dataset, Profiles, Templates	The allowed units for DurationOfUse (MVE) and ValidityPeriod.duration (VV) have been updated. Previously, the permitted units were years, weeks, days, and hours. This has been restricted to days only. The existing HL7v3 templates 9449, 9451, and 9463 for Medication Dispense and (proposal) Dispense Request have been updated accordingly. The element expectedUseTime/width/@unit now has the fixed value “d”. The description in FHIR profile mp-MedicationDispense has been changed and now contains “the duration in days”.
BITS MP-2035	Profiles	Changed MedicationDispense.daySupply definition into: The duration in days of the period in which the medication is expected to be used. The value depends on the dose and the dispensed amount.
BITS MP-2033	Dataset, Profiles, Templates	The following relationships have been added to the response proposal data: For MA response proposals, the relationship to the MA. For VV response proposals, the relationship to the VV. The existing HL7v3 templates 9212 and 9396 have been expanded with the above relationships
BITS MP-1935	Dataset, Profiles, Templates, Test materials	Within Medication Agreement, the healthcare provider building block has been added under the element NextPractitioner. In addition, a condition has been added to both healthcareProfessional and healthcareProvider to clarify that the healthcareProvider may only be used when the healthcareProfessional is unknown. No changes were required to HL7v3 template 9446. If only a healthcareProvider is known as the next practitioner, the healthcare professional details may be left empty. The new dataset concept (NextPractitioner/healthcareProvider) has, however, been linked to the template to connect it to the scopingEntity element in template 9446. A new test scenario has been added to scenario set 3 in which NextPractitioner with healthcareProvider is used. In the Functional Design, the following sentence has been added to the explanation of the NextPractitioner field: “If the healthcare professional is unknown, the relevant healthcare provider may be filled in as an alternative.” The FHIR extension ext-MedicationAgreement.NextPractitioner has been extended to include healthcare provider (Organization).
BITS MP-1934	Dataset, Profiles	The description of the query parameter GebruiksPeriode has been updated in ART-DECOR. The query parameter LatestStop has been added to the dataset in ART-DECOR, including the following description: The latest own stop-MedicationAgreements, stop-AdministrationAgreements and stop-VariableDosingRegimens based on the most recent RegistrationDateTime (independent of other PeriodOfUse) per PharmaceuticalTreatment of a specific patient in the source system. This QueryParameter is always part of the query. This clarification has also been added to section 4.3 of the Functional Design. The OperationDefinition mp-latest-stops has been added to the FHIR package.
BITS MP-1020	Dataset, Profiles, Templates	In the dataset, the existing data element _ResponseMedicationAgreement_ has been split into the following data elements: ResponseMedicationAgreementDecision:_ with a national valueset.. ResponseMedicationAgreementComment: with a free text option. The existing HL7v3 templates 9212 and 9213 have been aligned with the changes described here.The FHIR profiles mp-ReplyProposalMedicationAgreement and mp-ReplyProposalMedicationAgreement-Bundle have been aligned with the changes described above.
BITS MP-949	Dataset, Profiles, Templates	In the dataset, the existing data element _ResponseDispenseRequest_ has been split into the following data elements:ResponseDispenseRequestDecision: with a national valueset. ResponseDispenseRequestComment: with a free text option. The existing HL7v3 templates 9212 and 9213 have been aligned with the changes described here. The FHIR profiles mp-ReplyProposalDispenseRequest and mp-ReplyProposalDispenseRequest-Bundle have been aligned with the changes described above.

Other materials (templates, mappings, etc.)

BITS issue	Components	Release note
BITS MP-2082	Dataset	The allowed units for DurationOfUse (MVE) and ValidityPeriod.duration (VV) have been updated. Previously, the permitted units were years, weeks, days, and hours. This has been restricted to days only. The existing HL7v3 templates 9449, 9451, and 9463 for Medication Dispense and (proposal) Dispense Request have been updated accordingly. The element expectedUseTime/width/@unit now has the fixed value “d”. The description in FHIR profile mp-MedicationDispense has been changed and now contains “the duration in days”.
BITS MP-2070	Technical Documentation	Various textual improvements in the FHIR IG.
BITS MP-2065	Templates	In the HL7v3 template of the WDS, the relationTA was incorrectly defined. As this element is not included in the functional dataset and is also not present in the FHIR profile, it has been removed from the template.
BITS MP-2033	Dataset, Profiles, Templates	The following relationships have been added to the response proposal data: For MA response proposals, the relationship to the MA, For VV response proposals, the relationship to the VV. The existing HL7v3 templates 9212 and 9396 have been expanded with the above relationships.
BITS MP-1935	Dataset, Profiles, Templates, Test materials	Within Medication Agreement, the healthcare provider building block has been added under the element NextPractitioner. In addition, a condition has been added to both healthcareProfessional and healthcareProvider to clarify that the healthcareProvider may only be used when the healthcareProfessional is unknown. No changes were required to HL7v3 template 9446. If only a healthcareProvider is known as the next practitioner, the healthcare professional details may be left empty. The new dataset concept (NextPractitioner/healthcareProvider) has, however, been linked to the template to connect it to the scopingEntity element in template 9446. A new test scenario has been added to scenario set 3 in which NextPractitioner with healthcareProvider is used. In the Functional Design, the following sentence has been added to the explanation of the NextPractitioner field: “If the healthcare professional is unknown, the relevant healthcare provider may be filled in as an alternative.” The FHIR extension ext-MedicationAgreement.NextPractitioner has been extended to include healthcare provider (Organization).
BITS MP-1846	Templates	In the existing HL7v3 templates (9436, 9452, 9214, 9398, 9211, and 9300), the cardinality of the id field has been set to 1..1 to align with the cardinality of the concepts Proposal Data/Proposal/Identification and Proposal Data/Response/Identification in the proposal transactions.
BITS MP-1537	Templates	Cosmetic issue identified in HL7v3 template 9455 for body height in MP9. The body height template contained a zib-2017 version of informant. This has been corrected to the appropriate 2020 version. Since informant for body height is not used in MP9, this concerned a cosmetic issue only.
BITS MP-1024	Mapping	Improved the fhir-2-ada handling so that dosageInstructions with same sequence number and boundsDuration end up in the same doseerinstructie element in ada.
BITS MP-1020	Dataset, Profiles, Templates	In the dataset, the existing data element _ResponseMedicationAgreement_ has been split into the following data elements: ResponseMedicationAgreementDecision: with a national valueset., ResponseMedicationAgreementComment: with a free text option. The existing HL7v3 templates 9212 and 9213 have been aligned with the changes described here. The FHIR profiles mp-ReplyProposalMedicationAgreement and mp-ReplyProposalMedicationAgreement-Bundle have been aligned with the changes described here.
BITS MP-949	Dataset, Profiles, Templates	In the dataset, the existing data element _ResponseDispenseRequest_ has been split into the following data elements: ResponseDispenseRequestDecision:_ with a national valueset. ResponseDispenseRequestComment: with a free text option. The existing HL7v3 templates 9212 and 9213 have been aligned with the changes described here. The FHIR profiles mp-ReplyProposalDispenseRequest and mp-ReplyProposalDispenseRequest-Bundle have been aligned with the changes described here.

Other

Test materials

BITS issue	Components	Release note
BITS MP-2143	Test material	For proposals, several new tests have been written. These test scenarios make use of the following system roles:* TEST Voorschrift sturend systeem Voorstelgegevens (MP-VOS), TEST Voorschrift ontvangend systeem Voorstelgegevens (MP-VOO), TEST Afhandelen voorschrift sturend systeem Voorstelgegevens (MP-VAS), TEST Afhandelen voorschrift ontvangend systeem Voorstelgegevens (MP-VAO), TEST Voorstel medicatieafspraak sturend systeem (MP-VMS), TEST Voorstel medicatieafspraak ontvangend systeem (MP-VMO), TEST Antwoord voorstel medicatieafspraak sturend systeem (MP-AVMS), TEST Antwoord voorstel medicatieafspraak ontvangend systeem (MP-AVMO), TEST Voorstel verstrekkingsverzoek sturend systeem (MP-VVS), TEST Voorstel verstrekkingsverzoek ontvangend systeem (MP-VVO), TEST Antwoord voorstel verstrekkingsverzoek sturend systeem (MP-AVVS), TEST Antwoord voorstel verstrekkingsverzoek ontvangend systeem (MP-AVVO),The published material for rc.2 can be found on this Wiki page.
BITS MP-2114	Test material	The following test scenarios are removed and not included in the publication of release candidate 2 due to changes in the data model as a result of the further development of Proposal data: Scenarioset: VMA nieuwe MBH, Scenarioset: VMA voorstel door apotheker, Scenarioset: AVMA nieuwe MBH,Scenarioset: AVMA wijziging keerdosis, Scenario 2: Onvoldoende voorraad, Scenario 3: Tijdelijke medicijnwissel
BITS MP-2107	Test material	In the Prescription transactions – test scenario 1.2a – MBH_300_start_duur, the medicinal product in the Dispense Request has been aligned with that of the Medication Agreement, i.e. at PRK level: LISINOPRIL 10MG TABLET (code = “26638” in codeSystem “G-Standaard PRK”).
BITS MP-2030	Test material	The test materials in scenario set 13 have been expanded to include the Medication Agreement with relatieEpisode and relatieContact as part of both the make query/make available and the send/receive test sets.
BITS MP-2021	Design, Test material	The TA of a replacement agent is included in the existing MBH. The TA of an additional agent is included in a new MBH. Based on establishing relationships between the proposed MA and the existing MA and TA, it can be deduced that this concerns a change and that the correct stop and change can be implemented. All of this has been incorporated into the test material.
BITS MP-1999	Test material	Patient Luzac has been replaced by patient Voortman in scenario set 3 of the test materials.
BITS MP-1996	Test material	Several changes have been implemented in scenario set 9 of the test materials to ensure that the scenarios are correct.
BITS MP-1994	Design, Test material	In the new Functional Design (rc2), the test material and the new practical examples 84 through 86 reflect that sending a Reply proposal medication agreement (AVMA) / Reply proposal dispense request (AVVV) by the prescriber to the proposer is always mandatory when handling the AVMA/AVVV, regardless of the decision on the proposal.
BITS MP-1935	Dataset, Profiles, Templates, Test material	Within Medication Agreement, the healthcare provider building block has been added under the element NextPractitioner. In addition, a condition has been added to both healthcareProfessional and healthcareProvider to clarify that the healthcareProvider may only be used when the healthcareProfessional is unknown.No changes were required to HL7v3 template 9446. If only a healthcareProvider is known as the next practitioner, the healthcare professional details may be left empty. The new dataset concept (NextPractitioner/healthcareProvider) has, however, been linked to the template to connect it to the scopingEntity element in template 9446. A new test scenario has been added to scenario set 3 in which NextPractitioner with healthcareProvider is used. In the Functional Design, the following sentence has been added to the explanation of the NextPractitioner field: “If the healthcare professional is unknown, the relevant healthcare provider may be filled in as an alternative.” The FHIR extension ext-MedicationAgreement.NextPractitioner has been extended to include healthcare provider (Organization).
BITS MP-1744	Test material	The identifiers for MBHs and medication building blocks have been extended by adding a _system role code_ string to the end of the existing identifiers. For example: for prescribing (send/receive), the suffix -vos has been added. And for querying/making medication data available, the suffix -mgb has been added. This ensures that the identifiers we send or make available to testing vendors via our test tooling and are unique.