GET /Medication returns entries that aren't resolved by the chart widget after we submit them

[jayant-walvekar-falconeer]

Hi,

Fflagging behavior we're seeing on the FHIR API and would like to understand the intent.

What we're doing

For each medication on a patient's intake list, we call GET /Medication?_text=… to find a code, then POST /MedicationStatement with that code. Most rows render correctly in the chart. Some come back with a blank drug name.

Observation 1: not all search results are resolvable by the chart widget

GET /Medication?_text=… returns a mix of entries for the same drug. We can't tell from the response shape which ones will be resolvable by the chart Medications widget after we submit them. Some submit and render with the drug name; others submit successfully (your write endpoint accepts them, no error) but show as a blank row in the chart.

Example. GET /Medication?_text=levothyroxine+50+mcg+tablet on our dev tenant returns four entries:

id	coding[] systems	display
fdb-216187	FDB only	THSC Levothyroxine Sodium 50 mcg tablet
fdb-278640	FDB only	THSC Levothyroxine Sodium 150 mcg tablet
fdb-237361	FDB + RxNorm	levothyroxine 50 mcg tablet
fdb-248321	FDB + RxNorm	levothyroxine 150 mcg tablet

In our testing on this tenant, MedicationStatements submitted with 216187 or 278640 show a blank drug name in the chart. 237361 and 248321 render correctly.

Full shape of one of the entries that renders correctly:

{
  "resource": {
    "resourceType": "Medication",
    "id": "fdb-248321",
    "text": {
      "status": "generated",
      "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">levothyroxine 150 mcg tablet</div>"
    },
    "code": {
      "coding": [
        {
          "system": "http://www.fdbhealth.com/",
          "code": "248321",
          "display": "levothyroxine 150 mcg tablet"
        },
        {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "966225",
          "display": "levothyroxine 150 mcg tablet"
        }
      ],
      "text": "levothyroxine 150 mcg tablet"
    }
  }
}

Observation 2: _text token-AND drops entries when the query contains a qualifier the display lacks

_text matching looks like a token-AND on the display string. When the input contains a word that isn't present in some matching entries' display, those entries get filtered out:

query	total	entries returned
_text=levothyroxine 50 mcg tablet	4	216187, 278640, 237361, 248321
_text=levothyroxine sodium 50 mcg tablet	2	216187, 278640

The display of 237361 and 248321 contains no "sodium", so adding "sodium" to the query drops them. Your UI medication picker doesn't seem to behave this way — typing levothyroxine sodium 50 mcg there does find 237361. That suggests the UI is using a different lookup than /Medication?_text=.

Questions

1. What's the intended way to use GET /Medication?_text=… to find entries that will be resolvable by the chart widget? Is there a flag, parameter, or different endpoint we should be using?
2. For entries that come back from search but aren't resolvable at render time — are these intentionally in the search index, or is this a data/indexing issue on our tenant?
3. Is there a way to tell on the client whether a given search result will render correctly before we submit it, without round-tripping a write?
4. Is the _text behavior in Observation 2 expected? If so, is there a recommended way to search across the same catalog your UI medication picker uses?

[rmagier1]

@jayant-walvekar-falconeer Looks like this question is similar to your other post #1728, is there any other outstanding question here you need further explanation on that wasn't answered in that other discussion?