IE Medication Events Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Open Issues

Items that the HIQA draft, or other authoritative sources available to this PoC, do not settle. Nothing here is invented. Where the IG needs a value in the meantime, it uses a clearly named placeholder and points back to this list.

Issues inherited from IE Core keep IE Core's number (OI-0xx), so references in the copied profiles still resolve. Issues specific to this IG are numbered OI-1xx.

ID	Topic	What is unclear	Source	Placeholder / interim handling	Owner to ask
OI-002	IHI format	HIQA says "18 or 10-digit". How the forms relate (legacy vs current, check digit) is not stated	EP 1.3.1	Accept ^[0-9]{18}$ or ^[0-9]{10}$ (ie-pat-1)	HSE (IHI Register)
OI-003	Identifier system URIs	No HSE-published FHIR system URIs for IHI, PPSN, PCRS schemes, NePS or PSI. The sid/* URIs are minted under IE Core's canonical and shared by this IG	EP 1.3, 2.6, 2.8, 3.1	Keep IE Core's URIs, marked "placeholder" in the NamingSystem descriptions	HSE / NePS team
OI-004	SNOMED CT Irish Edition module	The HSE CTS serves module 1601000220105; the Irish Edition is published in the SNOMED International browser as MAIN/SNOMEDCT-IE (release 2026-09-21). The module id should be confirmed there	—	Use 1601000220105	HSE CTTO terminology team
OI-006	Anomalies in the HIQA draft	"Mandatory 0..n" (EP 1.6.x.4.2/3); numbering (EP 3.6.1)	EP	Mandatory inside an optional cluster is read as "1..1 if the parent is present"	HIQA (consultation feedback)
OI-007	Coded values in general	HIQA: "Coded values have not yet been specified in this standard"	EP p. 18	Bindings chosen from recognised standards; the MDA schedule, supply legal status and PCRS scheme are experimental placeholders	HIQA
OI-008	PPSN in health records	The legal basis and limits for using the PPSN as a health identifier. HIQA includes it (Required), but PPSN use is restricted by statute	EP 1.3.2	Slice with no MustSupport	DoH / DPC / HIQA
OI-009	Electronic signature format	HIQA EP 2.13 says only "electronic or digital signature". The format (e.g. AdES/JAdES), eIDAS assurance level and who verifies it are not stated	EP 2.13	Provenance.signature with the FHIR signature-type code; no format constraint	HSE NePS / DoH
OI-012	Stricter-than-HIQA constraints	authorizingPrescription 1..1 (HIQA 6.5 Required 0..1); dosageInstruction.text 1..1 (HIQA 5.1 Optional); dispenseRequest.quantity 1..1 (HIQA 3.5.7 Required 0..1)	IE Core ADR-003	Kept as deliberate safety deviations	HIQA
OI-013	Healthcare facility address enforcement	HIQA EP 2.9 is Mandatory, with postcode, line, county and country Mandatory. Enforcing it on the base Organization would also constrain payers and foreign organisations	EP 2.9	MustSupport on the base; rows kept Partial	IE MPD (design, next iteration)
OI-014	Exempt medication item	HIQA EP 4.11 does not say what the item is exempt from	EP 4.11	Boolean extension, experimental	HIQA
OI-015	Cross-border signature direction	HIQA EP 2.13 makes the signature a legal requirement for prescriptions issued in another EU Member State and dispensed in Ireland; the IG requires it in both directions	EP 2.13	The cross-border Bundle requires it in both directions (ie-bnd-xb-2)	HIQA / NePS
OI-017	Dose on a medication statement	HIQA PS 6.3.9 Dose is Mandatory. Requiring it would reject "as directed" statements where only free-text dosage is known	PS 6.3.9	dose[x] MustSupport, not 1..1; dosage.text 1..1	HIQA
OI-018	NMPC refsets	NMPC codes are SNOMED CT Irish Extension concepts, checked in the NMPC Meds Catalogue (docs/hiqa-2026/nmpc-verification.csv). The catalogue does not show refset ids, so ValueSets for the NMPC levels (VMP, VMPP, AMP, AMPP) are not defined here	EP 4.1, 4.3	Medication codes bind to the Irish Edition product hierarchy	HSE CTTO / NMPC
OI-021	County in addresses	address.state is a string, but the IG binds it (extensible) to a coded county ValueSet. HIQA EP 1.2 treats the county as text, so the examples raise a binding warning	EP 1.2	Examples use the county name (HIQA)	IE MPD
OI-022	SNOMED CT Irish Edition on public terminology servers	tx.fhir.org does not host the Irish Edition, so the validator cannot check the Medication Codes ValueSet that filters on it: 1 validator error that only the HSE CTS can clear	OI-004, OI-018	Reported as a known validator error (QA baseline)	HSE CTTO
OI-023	HPRA authorisation numbers in FHIR	No FHIR code system or identifier system URI for HPRA authorisation numbers is published	EP 4.1	Carry the number in Medication.identifier once a system is agreed	HPRA / HSE CTTO
OI-027	Controlled-drug rules HIQA leaves open	(a) The first instalment of a Schedule 2/3 instalment prescription must be dispensed within 14 days of issue: a dispensing-time check, not expressible on the MedicationRequest. (b) Whether "Number of instalments" (EP 3.5.12) is required on every Schedule 2/3/4 Part 1 prescription or only on instalment prescriptions	EP 3.5.9.1, 3.5.12	ie-rx-cd-2 allows two months when instalments are stated; ie-rx-cd-3 requires the number of instalments for Schedule 2/3/4 Part 1 (conservative, as decided for IE Core on 24 Sept 2026)	HIQA / Department of Health
OI-028	Allergy statement at dispensing	HIQA requires the allergy statement on the prescription; it does not say whether the pharmacy must re-confirm it at dispensing	EP 1.6, 6	Not modelled	HIQA
OI-030	Health Services Provider Identifier (HSPI)	The Health Identifiers Act 2014 (s.13–14) defines one identifier type, kept in one register with Parts for individuals (A, C, D) and organisations (B, E). The Act sets no format and names no FHIR system. Whether the HSE issues individual and organisation HSPIs from one number range, the format, and the system URI(s) are not published	Health Identifiers Act 2014; HIQA health identifiers FAQ (2017)	Optional HSP-I (Practitioner) and HSP-O (Organization) slices on IE Core's placeholder systems sid/hsp-i, sid/hsp-o; no format rule	HSE (HSPI register) / Department of Health
OI-101	No HIQA dataset for administration	The HIQA EP draft stops at dispensing. Hospital and community medication administration records have no national dataset	—	IE-defined profile on base FHIR R4 (ADR-002); no HIQA claim	HIQA / HSE
OI-102	Statement scope	The medication statement traces to HIQA PS 6.3, which is a Patient Summary section. Whether HIQA intends the same dataset for statements exchanged outside a Patient Summary (e.g. medicines reconciliation) is not stated	PS 6.3	Same element mapping, carried in element comments	HIQA
OI-103	Coded reasons for a dose not given	No Irish or HIQA code list for "dose not given" reasons	—	statusReason required, free text allowed	HSE (nursing / pharmacy informatics)
OI-104	Inactive SNOMED CT concept in the allergy ValueSet	The IG Publisher reports 418038007 "Propensity to adverse reactions to substance" (a filter in the Allergy Intolerance Set, copied from IE Core) as inactive. Its replacement has not been checked	IE Core ValueSets.fsh	Kept unchanged, so both IGs stay aligned; review with IE Core	IE MPD / IE Core terminology owner