ISO/TR 20831:2017

TECHNICAL ISO/TR
REPORT 20831
First edition
2017-07
Health infomatics — Medication
management concepts and definitions
Informatique de santé — Concepts et définitions relatifs à la gestion
de la médication
Reference number
©
ISO 2017
© ISO 2017, Published in Switzerland
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ii © ISO 2017 – All rights reserved

Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Abbreviated terms . 3
5 General process . 4
6 Data elements relevant to medication management . 5
6.1 General . 5
6.2 Prescription data . 5
6.3 Dispense data . 6
6.4 Medication administration data . 6
6.5 Medication statement data . 6
6.6 Health concern data . 7
6.7 Contraindication risks . 7
6.8 Specific laboratory results . 7
6.9 Drug and alcohol usage . 8
6.10 Smoking habits . . 8
7 Process steps . 8
7.1 The act of gathering data . 8
7.2 The act of making sense of the data . 8
7.3 The act of verification of the data . 9
7.4 The act of adding data to the collection . 9
7.5 The acts of carrying out the therapy and evaluating the outcome .10
8 Definitions of medication management .10
8.1 General .10
8.2 Medication lists.11
8.2.1 General.11
8.2.2 Unreconciled medication list .11
8.2.3 Reconciled medication list .11
8.2.4 Aggregated medication list .12
8.3 Medication profile .12
8.4 Medication management profile .12
8.5 Medication management .13
9 Example use case — Storyboard patient intake at hospital admission .13
Annex A (informative) External reference examples .16
Bibliography .19
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out
through ISO technical committees. Each member body interested in a subject for which a technical
committee has been established has the right to be represented on that committee. International
organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.
ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of
electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are
described in the ISO/IEC Directives, Part 1. In particular the different approval criteria needed for the
different types of ISO documents should be noted. This document was drafted in accordance with the
editorial rules of the ISO/IEC Directives, Part 2 (see www .iso .org/ directives).
Attention is drawn to the possibility that some of the elements of this document may be the subject of
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URL: w w w . i s o .org/ iso/ foreword .html.
This document was prepared by Technical Committee ISO/TC 215, Health informatics.
iv © ISO 2017 – All rights reserved

Introduction
The approach of this document is first to explain the logical steps in a medication therapy of a patient
and to state which data elements are required at that step and what is done with the data. The best
definition that would fit at that stage of medication therapy was identified. It was noticed that where a
listing of definitions that the interpretations of the various terms were to be made, this would lead to
endless discussion of the meaning of the terms.
IHE pharmacy, HL7 Pharmacy and ISO/TC 215 have been convening frequently and noticed that each
individual had a different interpretation of the terms used. As SDOs where communication of medication
information is the core purpose of these organizations, it is of course vital to understand what a noun
means so that all persons have a common understanding of the words used. Terms that have composite
ingredients are to a certain extent arbitrarily defined, but this document contains the definitions that
are agreed on by HL7 pharmacy, IHE Pharmacy and ISO/TC 215.
The scope in the first stage will be on the definitions of composite information, such as lists. This will
be set against the workflow and process in medication therapy.
Communicating information by means of IT can be separated into four layers:
1) The conceptual meaning of terms
2) The content and characteristics of terms
3) The container of information.
4) The communication of information.
The fourth and bottommost layer is the physical distribution of the information, such as pull or push
mechanisms. The logistical aspects are not in the scope of this document, nor is the method or required
infrastructure to obtain the information part of this document.
The third layer defines how the content is formatted so that senders and receivers can recognize the
elements of the content. Examples are CDA documents, HL7v3 or HL7v2 messages. This document is not
intended to go into this matter.
The second layer from the top is also called the syntax layer. It defines the content of a term. Some
of these elements in the content will be optional. In the context of this document the term syntax
refers to the rules governing the composition of meaningful elements. As an example the geographical
coordinates (i.e. 41°24′12.2”N 2°10′26.5”E) could have been chosen as the syntax for a location, but it
could as well be a street, number, postal code and city as the preferred notation of a logical address.
This document is not intended to dive into the syntax of the medication terms.
The top layer is also called the semantic layer. This document focuses on this layer. The intention is to
understand the meaning of a term. The result should be, that when a term as “unreconciled medication
list” is used, that all readers should interpret the term in the same manner. The context in which the
information is exchanged is also of importance for the concept. As an example a medication list for an
intake into a mental ward could put more emphasis on other data than a medication list for discharge at
a general hospital.
TECHNICAL REPORT ISO/TR 20831:2017(E)
Health infomatics — Medication management concepts
and definitions
1 Scope
The purpose of this document is to define the various concepts and terminologies used in the pharmacy
domain when applied to the topic of creating medication lists from existing data.
2 Normative references
There are no normative references in this document.
NOTE For future considerations, the terms from ISO 13940 will be considered.
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.
ISO and IEC maintain terminological databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at http:// www .iso .org/ obp
— IEC Electropedia: available at http:// www .electropedia .org/
3.1
contraindication
contra-indication
condition or factor that increases the risk involved in using a particular drug, carrying out a medical
procedure, or engaging in a particular activity
Note 1 to entry: Pursuing the intention is inadvisable.
[SOURCE: IHE Pharmacy, Standard terminology, modified]
3.2
dispensing
process of validation of the electronic prescription, preparation of the medicinal product, labelling,
informing and handing the medication to the patient or administering healthcare professional
[SOURCE: ISO 17523:2016, 3.2]
3.3
...