# Medication models: Where does "route" belong?

**URL:** <https://discourse.openehr.org/t/medication-models-where-does-route-belong/994>\
**Category:** Clinical\
**Tags:** archetype\
**Created:** [25 September 2020 07:08 UTC](https://discourse.openehr.org/t/medication-models-where-does-route-belong/994 "2020-09-25T07:08:46Z")\
**Posts on this page:** 1\
**Showing post:** 12

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**Author:** ![siljelb](https://discourse.openehr.org/user_avatar/discourse.openehr.org/siljelb/32/12_2.png) [@siljelb](https://discourse.openehr.org/u/siljelb)\
**Post date:** [30 September 2020 11:48 UTC](https://discourse.openehr.org/t/medication-models-where-does-route-belong/994/12 "2020-09-30T11:48:46Z")

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> [@heather.leslie](#):
>
> Different routes often require different doses - oral vs IM analgesics/antiemetics will require 2 orders.

I’m assuming we’re talking hospital settings here? When you’re into PRN injectable analgesics/antiemetics they would normally be titrated, not given according to a set dosage.

> [@heather.leslie](#):
>
> Just as we record the actual term a clinician chooses from a value set, even if a preferred term is stored and used for persistence, I’m still curious about the investigating the medicolegal issues re ensuring that the complete order for how a drug should be administered needs to be explicitly recorded.

Sure. Do we have any legal frameworks to lean on in this level of detail?

> [@heather.leslie](#):
>
> Also understanding the provenance of our model - where else is this design pattern used in parallel standards or are we isolated here?

Good question. The “Route” element was [added to the INSTRUCTION.medication\_order archetype](https://ckm.openehr.org/ckm/archetypes/1013.1.1445/5) by @ian.mcnicoll on 29 Oct 2015, with this set of references:

```auto
openEHR Foundation Medication archetypes http://www.openehr.org/knowledge

NEHTA's Therapeutic Good Use Data Group from the NEHTA Website http://www.nehta.gov.au

Intermountain Healthcare Medication order model, Personal Communication to Sam Heard by Dr Stan Huff.

Royal Australian College of General Practitioners. Fact Sheet: Medicines List. 2010.

```

At that time, FHIR was at DSTU2, and had Route as part of the “DosageInstruction” group within the MedicationOrder resource: [MedicationOrder - FHIR v1.0.2](http://hl7.org/fhir/DSTU2/medicationorder.html). I.e. similar to today’s pattern only they’ve divided it up into separate resources. I don’t know how to find the references for FHIR resources.

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