I specifically did not create these concepts for exactly that reason. They overlap with other concepts and I am not sure this value set has had careful scrutiny. It would make sense to create an “off market” concept since it doesn’t overlap, but I wonder how important it is to ensure 100% compliance with this value set at this time…
Since it’s listed in FHIR as an “example” rather than “required” (or even “preferred”), I would say “not at all”. The FHIR specification says of “example” bindings that “Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.” In other words, unlike other ValueSets we’ve implemented in the past, this one is not really getting proper review or use.
Thanks all, for what it’s worth, I’m not married to have this exact value set in CIEL, we just want to have some example of this value set in CIEL for a reference implementation of the Dispensing ESM. (There’s are a couple of times we need ask a “status reason” question in the app).
For the PIH-specfiic use case, we presented this list to our pharmacy team as an example, and they did want to have both these out-of-stock answers, so we’d like them as PIH concepts, but if we can’t come up with a CIEL standard, that’s fine, I’ll defer to @akanter and @ball on that. If we really think these are the wrong answers, we could potentially go back to the pharmacy team with suggestions.
@akanter Partners In Health doesn’t want all the reasons now, but does wants 11 of the 21 in the FHIR documentation. Maybe @mogoodrich or @fanderson can explain and differentiate between “Medication unavailable” and “medication out of stock”. “Medication unavailable” seems like a general reason. “Off market” does seem different.
An existing “Drug unavailable” could either be seen as a parent (i.e., unavailable, reason not specified) or could be converted to “Drug unavailable - out of stock” to avoid the ambiguity. The latter might make more sense if that has been the 90% use case to date.