Medication Documentation

Looking at Medication Reconciliation, it seems that before looking at reconciliation (i.e. solving apparently contradictory information) we must look at the data and its meaning.
In medication the problem is very simple (the solution less simple): Except in institutional settings, it is usually not possible to determine what medication is a patient really taking.

Prescribed and dispensed medication may be a good indication of what has been administered, but not 100% accurate:
 - Patient may be taking medication that was not prescribed;
 - Dispense does not indicate the adherence to the therapy
 - Patient's statement may not be accurate or trustworthy.

Other challenges:
- How to consider the personal medication dispensers? How to take into consideration that barriers to reporting (cultural, others) may exist (e.g. contraceptive pill)?
- What is current? Last 6 months? Last 6 years? May vary across sites, or for different medication types.

This started with an effort to query a patient's current medication in IHE. "Current Medication" was not a steady target, which led to this proposal:
https://docs.google.com/leaf?id=0BzWchnBwBx3eN2EwM2M3MTUtMDY1MC00ODQ0LTlmMTUtMTEzNmM4MWViYjNk&hl=en_US

Short version:

1. We store the data and its clear meaning
2. The data must be queriable. It may be possible or intended to display this data.
3. Any view or interpretation of that data that has reduced quality can also be stored, as long as the meaning is also stored with it.
4. These views or interpretations are also queriable
5. Original data may be relevant for display. One example of displaying detailed information in a perceivable view:

Other, simpler views are also possible.

A white paper is now being prepared for medication.

This same approach would also apply for other areas where information is distributed, and there is no single consensual interpretation of a view - or when there are many possible and desired views.
- Radiation exposure
-...