What is the meaning of “Medication, Discharge” and how is it different from “Medication, Active” and “Medication, Order”?

"Medication, Discharge" represents medications included on a patient's discharge medication list and intended for use after the patient leaves the hospital. These medications are the reconciled medications documented at discharge. Some may be newly prescribed, while others may already be available in the home or obtained over the counter. Therefore, “Medication, Discharge” is not limited to medication orders.

"Medication, Order" represents a medication that has been ordered or prescribed. However, it does not distinguish between medications intended for administration immediately before discharge and those intended for use after discharge.

"Medication, Active" represents a medication that is documented as being actively taken by the patient during the time period of interest. In QDM, this datatype indicates that the medication is being taken by the patient and may be represented at a point in time or over a period during which the medication remains active on the medication record.

"Medication, Discharge" events should start and end within the episode of care, even though the patient may not begin taking the medication until after discharge. The expectation is that discharge medications will correspond to the subsequent home medication list for medications relevant to the eCQM, although changes may occur between episodes of care.

For FHIR-based data exchange, US Core represents active medications using MedicationRequest resources with an appropriate status and intent. The setting for discharge medications can be identified using the category element, allowing discharge medications to be represented separately. QDM v5.5 introduced a setting attribute for Medication, Discharge that aligns with the US Core category and supports the transition to FHIR-based representations.