Canadian Baseline
1.2.0 - CI Build

Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-Canada/ca-baseline/ and changes regularly. See the Directory of published versions

## Resource Profile: MedicationStatement Profile

Official URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationstatement | Version: 1.2.0
Draft as of 2024-12-13 | Computable Name: MedicationStatementProfile

Proposed constraints and extensions on the MedicationStatement resource. Generated as a first step toward creating a set of Canadian Baseline FHIR profiles.

This profile was generated from HL7 StructureDefinition on 2019-03-28 and constrained during a review of US Core against Canadian sources.

Key differences from USCoreR4 MedicationStatement:

- MedicationStatement.medication updated:
  - CodeableConcept binding to ValueSet-prescriptionmedicinalproduct
  - Reference to profile-medication
- MedicationStatement.subject reference updated to profile-patient

Usages:

- Refer to this Profile: MedicationStatement Profile

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | MedicationStatement Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
basedOn | Σ | 0..* | Reference(MedicationRequest Profile | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration Profile | MedicationDispense Profile | MedicationStatement Profile | Procedure Profile | Observation Profile (General Use)) | Part of referenced event
status | ?!S Σ | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
medication[x] | S Σ | 1..1 |  | What medication was taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S Σ | 1..1 | Reference(Patient Profile) | Who is/was taking the medication
context | Σ | 0..1 | Reference(Encounter Profile | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
effective[x] | S Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
informationSource | S | 0..1 | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(MedicationRequest Profile | MedicationDispense Profile | Claim | Observation Profile (General Use) | QuestionnaireResponse) | Additional supporting information
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile) | Condition or observation that supports why the medication is being/was taken
dosage | S | 0..* | Dosage | Details of how medication is/was taken or should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationStatement | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationStatement

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | MedicationStatement Profile
basedOn |  | 0..* | Reference(MedicationRequest Profile | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf |  | 0..* | Reference(MedicationAdministration Profile | MedicationDispense Profile | MedicationStatement Profile | Procedure Profile | Observation Profile (General Use)) | Part of referenced event
status | S | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
medication[x] | S | 1..1 |  | What medication was taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S | 1..1 | Reference(Patient Profile) | Who is/was taking the medication
context |  | 0..1 | Reference(Encounter Profile | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
effective[x] | S | 0..1 | dateTime, Period | The date/time or interval when the medication is/was/will be taken
informationSource | S | 0..1 | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(MedicationRequest Profile | MedicationDispense Profile | Claim | Observation Profile (General Use) | QuestionnaireResponse) | Additional supporting information
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile) | Condition or observation that supports why the medication is being/was taken
dosage | S | 0..* | Dosage | Details of how medication is/was taken or should be taken
text | S | 0..1 | string | Free text dosage instructions e.g. SIG
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | MedicationStatement Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External identifier
basedOn | Σ | 0..* | Reference(MedicationRequest Profile | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration Profile | MedicationDispense Profile | MedicationStatement Profile | Procedure Profile | Observation Profile (General Use)) | Part of referenced event
status | ?!S Σ | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
statusReason |  | 0..* | CodeableConcept | Reason for current status Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
category | Σ | 0..1 | CodeableConcept | Type of medication usage Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
medication[x] | S Σ | 1..1 |  | What medication was taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S Σ | 1..1 | Reference(Patient Profile) | Who is/was taking the medication
context | Σ | 0..1 | Reference(Encounter Profile | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
effective[x] | S Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
dateAsserted | Σ | 0..1 | dateTime | When the statement was asserted?
informationSource | S | 0..1 | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(MedicationRequest Profile | MedicationDispense Profile | Claim | Observation Profile (General Use) | QuestionnaireResponse) | Additional supporting information
reasonCode |  | 0..* | CodeableConcept | Reason for why the medication is being/was taken Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
dosage | S | 0..* | Dosage | Details of how medication is/was taken or should be taken
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​statusReason | Base | example | SNOMED CT Drug Therapy Status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​category | Base | preferred | Medication usage category codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationStatement | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationStatement

Summary

Must-Support: 7 elements

Structures

This structure refers to these other structures:

- MedicationRequest Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest)
- MedicationAdministration Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationadministration)
- MedicationDispense Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationdispense)
- MedicationStatement Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationstatement)
- Procedure Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-procedure)
- Observation Profile (General Use) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation)
- Medication Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medication)
- Patient Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient)
- Encounter Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter)
- Practitioner Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner)
- PractitionerRole Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole)
- Organization Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization)
- Condition Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-condition)
- DiagnosticReport Profile for Laboratory Results Reporting (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreport)
- Diagnostic Report for Report and Note Exchange Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreportnote)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | MedicationStatement Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
basedOn | Σ | 0..* | Reference(MedicationRequest Profile | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration Profile | MedicationDispense Profile | MedicationStatement Profile | Procedure Profile | Observation Profile (General Use)) | Part of referenced event
status | ?!S Σ | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
medication[x] | S Σ | 1..1 |  | What medication was taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S Σ | 1..1 | Reference(Patient Profile) | Who is/was taking the medication
context | Σ | 0..1 | Reference(Encounter Profile | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
effective[x] | S Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
informationSource | S | 0..1 | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(MedicationRequest Profile | MedicationDispense Profile | Claim | Observation Profile (General Use) | QuestionnaireResponse) | Additional supporting information
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile) | Condition or observation that supports why the medication is being/was taken
dosage | S | 0..* | Dosage | Details of how medication is/was taken or should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationStatement | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from MedicationStatement

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | MedicationStatement Profile
basedOn |  | 0..* | Reference(MedicationRequest Profile | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf |  | 0..* | Reference(MedicationAdministration Profile | MedicationDispense Profile | MedicationStatement Profile | Procedure Profile | Observation Profile (General Use)) | Part of referenced event
status | S | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
medication[x] | S | 1..1 |  | What medication was taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S | 1..1 | Reference(Patient Profile) | Who is/was taking the medication
context |  | 0..1 | Reference(Encounter Profile | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
effective[x] | S | 0..1 | dateTime, Period | The date/time or interval when the medication is/was/will be taken
informationSource | S | 0..1 | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(MedicationRequest Profile | MedicationDispense Profile | Claim | Observation Profile (General Use) | QuestionnaireResponse) | Additional supporting information
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile) | Condition or observation that supports why the medication is being/was taken
dosage | S | 0..* | Dosage | Details of how medication is/was taken or should be taken
text | S | 0..1 | string | Free text dosage instructions e.g. SIG
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | MedicationStatement Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External identifier
basedOn | Σ | 0..* | Reference(MedicationRequest Profile | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration Profile | MedicationDispense Profile | MedicationStatement Profile | Procedure Profile | Observation Profile (General Use)) | Part of referenced event
status | ?!S Σ | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
statusReason |  | 0..* | CodeableConcept | Reason for current status Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
category | Σ | 0..1 | CodeableConcept | Type of medication usage Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
medication[x] | S Σ | 1..1 |  | What medication was taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S Σ | 1..1 | Reference(Patient Profile) | Who is/was taking the medication
context | Σ | 0..1 | Reference(Encounter Profile | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
effective[x] | S Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
dateAsserted | Σ | 0..1 | dateTime | When the statement was asserted?
informationSource | S | 0..1 | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(MedicationRequest Profile | MedicationDispense Profile | Claim | Observation Profile (General Use) | QuestionnaireResponse) | Additional supporting information
reasonCode |  | 0..* | CodeableConcept | Reason for why the medication is being/was taken Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
dosage | S | 0..* | Dosage | Details of how medication is/was taken or should be taken
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​statusReason | Base | example | SNOMED CT Drug Therapy Status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​category | Base | preferred | Medication usage category codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationStatement | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationStatement

Summary

Must-Support: 7 elements

Structures

This structure refers to these other structures:

- MedicationRequest Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest)
- MedicationAdministration Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationadministration)
- MedicationDispense Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationdispense)
- MedicationStatement Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationstatement)
- Procedure Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-procedure)
- Observation Profile (General Use) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation)
- Medication Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medication)
- Patient Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient)
- Encounter Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter)
- Practitioner Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner)
- PractitionerRole Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole)
- Organization Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization)
- Condition Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-condition)
- DiagnosticReport Profile for Laboratory Results Reporting (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreport)
- Diagnostic Report for Report and Note Exchange Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreportnote)

Other representations of profile: CSV, Excel, Schematron