Difference between revisions of "Drug Safety Content"

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<h2>1. Proposed Profile: <i>{{PAGENAME}}</i></h2>
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Drug Safety Content (DSC) describes the content and format to be used to pre-populate data for safety reporting purposes.  DSC is a content profile that uses transactions described within Retrieve Form for Data-capture (RFD).  
  
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==Summary==
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<p>
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DSC is part of a set of profiles that create interoperability between EHRs and specialized research systems, resulting in EHR-enabled research. The purpose of this profile is to support a standard set of data in Continuity of Care Document format which the EHR provides for use in reporting adverse events as it relates to Drug Safety. In addition this profile will reference the ability to convert this output into the ICH E2B(R3) standard.
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</p>
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__TOC__
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==Benefits==
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<p>
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DSC both saves labor and improves the quality of drug safety data. By eliminating duplicate data entry, the use of DSC saves time in the process of completing a drug safety report form. By using existing EHR data to automatically pre-populate the form, DSC eliminates data entry errors, thus improving data quality.
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</p>
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==Details==
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<p>
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DSC is activated by the Retrieve Form for Data-capture (RFD) profile at the point where RFD retrieves a data safety from a safety reporting system. DSC defines the export document based on HL7's Continuity of Care Document, and provides a mapping to the ICH E2B(R3) standard.
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</p>
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==Systems Affected==
 
<ul>
 
<ul>
    <li> Proposal Editor: <i>[[user: landenbain | Landen Bain, CDISC Liaison to Healthcare ]]</i>
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<li> Electronic Health Record
    <li> Editor: <i>Michael Ibara, Head of Pharmacovigilance Information Management, Pfizer</i>
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<li> Safety Reporting System
    <li> Date: <i> January 2008 </i>
 
    <li> Version: <i> 1.0 </i>
 
    <li> Domain: <i> Patient Care Coordination</i>
 
 
</ul>
 
</ul>
  
<h2> 2. The Problem </h2>
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==Specification==
<p><i><b>While RFD simplifies data capture for investigator sites, content profiles will extend its value.</b></i></p>
 
  
<p>RFD has proved itself to be particularly useful in two use cases that pertain to the biopharmaceutical industry: collection of clinical trial data (addressed in the companion profile “Clinical Research Data Collection Fields”, and drug safety, the topic of this proposal. The drug safety use case addressed here is the post-market reporting of adverse drug events.  This reporting begins with a trigger event within the EHR which identifies the need to report an adverse event.  RFD summons a drug safety data capture form from the appropriate source, and the form is completed by the EHR user, assisted by auto-population scripts within the EHR.  The problem which this profile addresses is the lack of standard content for the auto-population. </p>
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'''Profile Status:''' [[Comments| Trial Implementation]]  
<p>The proposed content profile will align the data requirements of the RFD data safety report with HL7’s ICSR (E2B) standard.  ICSR provides the basis for identifying the data elements required from the EHR, and greatly simplifies the involvement of the EHRs in drug safety reporting.
 
This content profile will also complement the Query for Existing Data profile currently in development.  An ICSR-based content profile would provide the list of data elements that an EHR should have on hand to respond to an external query from a drug safety sponsor.</P>
 
  
<h2>3. Key Use Case</h2>
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'''Documents:'''
<p> The point of departure for this use case is a patient care site which currently reports drug safety information using RFD without a content profile.  The ‘before’ state shows the use of RFD without a content profile.  The ‘after’ state describes the use of RFD in concert with the proposed content profile. </p>
 
  
<h4>Before Drug Safety Content:</h4>
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'' http://ihe.net/Technical_Framework/upload/IHE_QRPH_Suppl_DSC.pdf ''
<p>A physician discovers a suspected adverse event during a patient outpatient visit. The physician uses RFD to fetch a drug safety form from the appropriate source and completes the form by hand. </p>
 
  
<h4>After Drug Safety Content:</h4>
 
<p>  A physician discovers a suspected adverse event during a patient outpatient visit.  The physician uses RFD to fetch a drug safety form from the appropriate source.  The EHR automatically provides the data elements specified in the Drug Safety Content Profile, and the forms manager populates the form and returns it to the form filler for display.  The physician reviews the partially completed form, and fills in those sections which the content profile did not specify.  RFD returns the data to the Forms Receiver.</p>
 
17.1.3 Pharmaco-vigilance Scenario
 
355 A community-based physician, Dr. Cramp, sees a patient in an outpatient clinic and accesses the
 
patient’s electronic health record which reveals that the patient is on one of the new statin drugs.
 
The physical examination turns up muscle weakness in the patient’s calves, which the physician
 
recognizes as a possible adverse reaction to the statin. He orders a total creatinine kinase lab test
 
to help in diagnosing the problem.
 
360 17.1.3.1 Current State
 
Dr. Cramp exits the EHR and, using a web browser, goes to http://www.fda.gov/medwatch/. He
 
brings up form FDA 3500, for ‘voluntary reporting of adverse events noted spontaneously in the
 
course of clinical care’. He navigates through several screens of routing and instructions to
 
arrive at the first screen of the actual form, which requests patient identifier, age at time of event
 
365 or date of birth, sex, and weight; the second screen requests seven entries: a classification of the
 
event, classification of outcome, event date, report date, description, relevant tests (he notes that
 
a test has been ordered), and other relevant history (the last three fields are text entry); the third
 
and fourth screens ask for details about the product ; and so forth. In actuality, the current state
 
is that this form is seldom completed.
 
370 17.1.3.2 Desired State
 
Dr. Cramp sees the patient and accesses the EHR as above. Upon finding the potential problem,
 
he clicks on an ‘Adverse Event Reporting’ button which brings up FDA form 3500, which has
 
been styled to fit in with the look and feel of the EHR user interface. The form is presented with
 
the demographics already completed. The product name is part of the working context of the
 
375 EHR session, and is automatically loaded into the appropriate field. Dr. Cramp completes the
 
empty fields of the form and submits directly to the FDA Medwatch site.
 
RFD takes care of retrieving the form from MedWatch, displaying it, and returning the form to
 
FDA. Note that the profile does not address whether or not the EHR stores a copy of the form or
 
preloads it with EHR data. Simply using the EHR to display, complete, and submit the form is
 
380 sufficient. The EHR and the site might decide to capture and store the form in the EHR
 
database, which would be a permitted extension of the profile, but not necessary.
 
  
<h2>4. Standards & Systems </h2>
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'''Underlying Standards:'''
<h4> Systems</h4>
 
<ul>
 
<li>Participating EHRs;
 
<li>Participating drug safety systems.
 
</ul>
 
  
<h4> Standards </h4>
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:* HL7 Continuity of Care Document
<ul>
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:* ICH E2B standard
<li>CDISC standards: ODM, SDTM
 
<li> IHE: RFD, QED
 
<li>W3C standards: XForm
 
<li>HL7 standards: ICSR.
 
</ul>
 
  
<h2>5. Discussion </h2>
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[[Category:Profiles]]
<p>IHE has successfully reached the biopharmaceutical industry through a content-free integration profile, RFD.  Extending the reach of RFD by binding it to drug safety specific content profiles further reinforces this cross-industry alliance.  Benefits achieved will result in greater reporting compliance and improved data quality.</p>
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[[Category:QRPH Profile]]
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[[Category:CDA]]
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[[Category:RFD]]

Latest revision as of 13:56, 4 November 2019

Drug Safety Content (DSC) describes the content and format to be used to pre-populate data for safety reporting purposes. DSC is a content profile that uses transactions described within Retrieve Form for Data-capture (RFD).

Summary

DSC is part of a set of profiles that create interoperability between EHRs and specialized research systems, resulting in EHR-enabled research. The purpose of this profile is to support a standard set of data in Continuity of Care Document format which the EHR provides for use in reporting adverse events as it relates to Drug Safety. In addition this profile will reference the ability to convert this output into the ICH E2B(R3) standard.


Benefits

DSC both saves labor and improves the quality of drug safety data. By eliminating duplicate data entry, the use of DSC saves time in the process of completing a drug safety report form. By using existing EHR data to automatically pre-populate the form, DSC eliminates data entry errors, thus improving data quality.

Details

DSC is activated by the Retrieve Form for Data-capture (RFD) profile at the point where RFD retrieves a data safety from a safety reporting system. DSC defines the export document based on HL7's Continuity of Care Document, and provides a mapping to the ICH E2B(R3) standard.

Systems Affected

  • Electronic Health Record
  • Safety Reporting System

Specification

Profile Status: Trial Implementation

Documents:

http://ihe.net/Technical_Framework/upload/IHE_QRPH_Suppl_DSC.pdf


Underlying Standards:

  • HL7 Continuity of Care Document
  • ICH E2B standard