Validity rules illustrated with examples

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The validity rules 1 to 5 as described in paragraph 4.5.2 of the FO are elaborated below using examples of possible situations.
The building blocks are listed in order of RegistrationDateTime (MA, TA, WDS) or MedicationUseDateTime (MGB).
The green building blocks are the valid building blocks, while those in black italics are no longer valid.
In the case of stop-building blocks, this concerns both stop- and cancelation-building blocks

Prescription medication

Basic situation
The simplest sequence is: a pharmaceutical treatment begins with an MA, followed by a TA that specifies the MA in concrete terms. Medication use can also be recorded. All building blocks are valid in this case.

→ MA – TA – MGB

New MA in existing MBH (modification)
(rule 1)
If a technical stop-MA and a new MA are recorded in an existing MBH for the purpose of a modification, the corresponding previous MA and TAs and all previous MGBs are no longer valid. See section 4.5.2.1.3 for the situation with future MAs and TAs.

→ MA – TA – MGB – stop-MA – MA

A change in the MA leads to a technical stop-TA and new TA that are again valid. Any MGB recorded after the new MA is also valid again.

→ MA – TA – MGB – stop-MA – MA – stop-TA – TA

→ MA – TA – MGB – stop-MA – MA – stop-TA – TA – MGB

Variant:

• If the patient has to stop taking the medication completely, the new MA is a stop-MA. This stop-MA is valid, but the stopped MA is no longer valid. The stop-MA also leads to a stop-TA.

→ MA – TA – MGB – stop-MA – stop-TA

New TA in existing MBH (modification)
(rule 2)
Sometimes a new TA is required for an existing MA, for example when a different product is handed out due to preference policy. The new TA and technical stop-TA invalidate previous TAs and MGBs.

→ MA – TA – MGB – stop-TA – TA

Variant:

• An MGB that is recorded after the new TA is again valid.

→ MA – TA – MGB – stop-TA – TA – MGB

MGB recorded earlier than TA
(rule 2)
It may happen that an MGB is recorded before the TA is recorded. This MGB is no longer valid after the TA has been recorded.

→ MA – MGB

→ MA – MGB – TA

If an MGB is recorded again after that, it will be valid again.

→ MA – MGB – TA – MGB

Prescription medication with variable dosing regimen

Basic situation
The simplest sequence is: an MBH starts with an MA with the dosage being recorded in a WDS. A TA fills in this MA in concrete terms.

→ MA – WDS – TA

New WDS
(rule 3)
The PeriodOfUse of the WDS has expired and a new WDS is being created.

→ MA – WDS – TA – WDS

This does not make the previous WDS invalid, but this previous WDS will be less relevant or no longer relevant for use in, for example, an overview.

Modifying a WDS
(rule 3)
To modify a WDS, a new WDS with the modified information and a technical stop-WDS are created.

→ MA – WDS – TA – stop-WDS – WDS

A stop-WDS does make a previous WDS invalid.

Discontinuing medication with a WDS
(rule 1)
Permanent discontinuation of medication with a WDS is done with a stop-MA, which also leads to a stop-TA. The WDS is made invalid by the stop-MA; no separate stop-WDS is required.

→ MA – WDS – TA – stop-MA – stop-TA

Modifying a TA
Modifying a TA (for example, when changing a trade product) is done by creating a new TA and a technical stop-TA. This does not affect the WDS.

→ MA – WDS – TA – stop-TA – TA

Prescription medication with future MAs and TAs

Basic situation
An MBH can contain multiple current MAs, TAs, and MGBs, both present and future. This is elaborated below, in order of RegistrationDateTime. The future building blocks are referred to here as TMA, TTA, and TMGB.

→ MA – TMA

→ MA – TA – TMA – TTA

→ MA – TA – MGB – TMA – TTA – TMGB

Variant:

• The provider wants to modify a TA because a different strength of a medication was supplied. The patient still has sufficient stock for several weeks based on the existing TA. The technical stop-TA and new TA will therefore only take effect in the future. Until then, the existing TA remains valid.

→ MA – TA – MGB – Tstop-TA – TTA

• When the startDateTime of the new TA is reached, the previous TA becomes invalid.

→ MA – TA – MGB – Tstop-TA – TTA

New MA in situation with future MAs and/or TAs
(rule 1)

• The current medication is modified. To this end, a new MA and a technical stop-MA with reference to the original MA are recorded. The three examples above then look as follows:

→ MA – TMA – stop-MA – MA

→ MA – TA – TMA – TTA – stop-MA – MA – stop-TA – TA

→ MA – TA – MGB – TMA – TTA – TMGB – stop-MA – MA – stop-TA – TA

• The future medication is modified. To this end, a new TMA and a technical cancellation-TMA with reference to the original TMA are recorded. The three examples above then look as follows:

→ MA – TMA – cancellation-TMA – TMA

→ MA – TA – TMA – TTA – cancellation-TMA – TMA – cancellation-TTA – TTA

→ MA – TA – MGB – TMA – TTA – TMGB – cancellation-TMA – TMA – cancellation-TTA – TTA

New TA in situation with future MAs and/or TAs
(rule 2)

• A (new) TA is created for the current MA only, with reference to that current MA. Below are three examples:

→ MA – TMA – TA

→ MA – TA – TMA – TTA – stop-TA – TA

→ MA – TA – MGB – TMA – TTA – TMGB – stop-TA – TA

• A (new) TTA is created for the TMA, with reference to that TMA. The three examples then look as follows:

→ MA – TMA – TA – TTA

→ MA – TA – TMA – TTA – cancellation-TTA – TTA

→ MA – TA – MGB – TMA – TTA – TMGB – cancellation-TTA – TTA

Self-care medication

The use of self-care medications such as paracetamol can be recorded with MGB.

→ MGB

Variant:

• If a prescriber decides to formalize this treatment with an MA, the rules above apply. Below are some examples in order of RegistrationDateTime:
  

(rule 1)

→ MGB – MGB – MA

→ MGB – MGB – MA – MGB

→ MGB – MGB – MA – TA – MGB

(rule 2)

→ MGB – MGB – MA – MGB – TA – MGB

(rules 4 and 5)

→ MGB – MGB – MA – MGB – MGB

Medication use recorded by different authors

(rule 4)
An MGB only makes invalid previous MGBs of the same type of author. Some examples:

MGB-pat = MGB recorded by patient
MGB-hp = MGB recorded by a health professional

→ MA – TA – MGB-hp – MGB-pat

→ MA – TA – MGB-pat – MGB-hp

→ MA – TA – MGB-pat – MGB-pat

→ MA – TA – MGB-hp – MGB-pat – MGB-pat

→ MA – TA – MGB-hp – MGB-pat – MGB-pat – MGB-hp

Discontinuing medication in an MBH without MA

Sometimes there is no MA available in the MBH. This can happen, for example, because the MBH was started with a TA or MGB, or because the MA was not provided upon querying. The prescriber can then record a stop-MA without referring to an MA. This makes invalid all existing building blocks within this MBH. If desired, the prescriber can still create a new MA within this MBH.

→ TA – MGB – stop-MA-zonder-verwijzing – MA

→ TA – TTA – MGB – stop-MA-zonder-verwijzing – MA – TMA

→ TA – MGB – TTA – TMGB – stop-MA-zonder-verwijzing – MA – TMA

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Document history

Version	Date	Description
9 3.0.0-rc.2	February 2026	for all changes see: *Releasenotes