Updating dosage and/or frequency using suggestions

[vasofilipov]

I have a service that should lower the dosage of a given medication. On the test harness (http://demo.cds-hooks.org/) this doesn't affect the CDS context in any way, only changes in the medicationCodeableConcept seems to trigger refreshes and actually update the medication.

The following services try this scenario can be found at:

• https://cds-hooks-apps.medapptech.com/lower-dosage-hook
• https://cds-hooks-apps.medapptech.com/morphine-calculator-lower-hook

The I am using the following structure for the suggestions JSON:

{
    ...
    "suggestions": [
        {
            "label": "Lower to suggested",
            "uuid": "00001",
            "create": [
                {
                    "resourceType": "MedicationOrder",
                    "dateWritten": "2017-05-07",
                    "status": "draft",
                    "patient": 
                    {
                        "reference": "Patient/1288992"
                    },
                    "dosageInstruction": [
                        {
                            "doseQuantity": 
                            {
                                "value": 1,
                                "system": "http://unitsofmeasure.org",
                                "code": "{pill}"
                            },
                            "timing": 
                            {
                                "repeat": 
                                {
                                    "frequency": 1,
                                    "period": 1,
                                    "periodUnits": "d",
                                    "boundsPeriod": 
                                    {
                                        "start": "2017-05-07",
                                        "end": "2017-06-07"
                                    }
                                }
                            }
                        }
                    ],
                    "medicationCodeableConcept": 
                    {
                        "text": "Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG / Codeine Phosphate 30 MG Oral Capsule [Ascomp]",
                        "coding": [
                            {
                                "display": "Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG / Codeine Phosphate 30 MG Oral Capsule [Ascomp]",
                                "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                                "code": "994239"
                            }
                        ]
                    }
                }
            ]
        }
    ]
}

[kpshek]

Thanks for logging this @vasofilipov! Should this be an issue on cds-hooks-rx-app rather than here in docs?

[vasofilipov]

Hi @kpshek, well, the problem is that I am not entirely sure since I haven't had the opportunity to see if this works in different environments and deployments so I am not sure if this is an issue with the demo harness or with the specification itself.