- Ya
- 25 Agosti 2026, 17:14 UTC
- Mwandishi
- Kamo
- Ahadi ya
- 2f51ff5
MedicationRequest keys the drug to RxCUI and never to a vendor identifier. FDB's GCN_SEQNO, Medi-Span's GPI, MEDID, HICL_SEQNO are the vendor's moat, and keying internal data to them is the difference between a drug-database switch being a data migration and being a contract renegotiation. intent is enforced rather than decorative: a proposal is what decision support or an AI produces, and treating one as an order sends a prescription nobody signed. reported carries the other asymmetry — a patient-reported medication is NOT ours to refill but absolutely counts for interaction checking, because a drug interaction does not care who wrote it. isControlledSubstance is denormalised because EPCS, PDMP checks and two-person access control all branch on it and none of those paths should join a drug database to find out. The sig text is kept verbatim beside the structured fields, because a parsed sig is an interpretation and the prescriber's words are the legal instruction. ServiceRequest carries closureStatus SEPARATE from FHIR status, and that is the point of the table. Missed follow-up on abnormal results and unclosed referrals are the top two ambulatory diagnostic-error categories, and an order placed and never resulted is invisible in most systems precisely because nothing is wrong — no error fires, no queue fills, it just sits. A request can be completed in FHIR terms because the lab ran it, while the loop is open because nobody reviewed the result or told the patient. Only the second question prevents harm. expectedBy exists so overdue has a definition at all; without it the weekly "ordered and never resulted" digest has nothing to select on. closureReason is required to close without a result, so "closed" can never quietly mean someone got tired of seeing it in the queue. 1728 tests green.