US Core Implementation Guide
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US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 8.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core Medication Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication Version: 8.0.0-ballot
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreMedicationProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.37

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The US Core Medication Profile inherits from the FHIR Medication resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Medication resource to record, search, and fetch medications associated with a patient. When referencing a medication, the MedicationRequest resource can use a code or refer to this profile. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

Example Usage Scenarios:

Queries on Medication resources are expected to be within the context of a MedicationRequest resource query. The following are example usage scenarios for the US Core Medication profile:

  • Read Medication resources referenced in MedicationRequest resources.

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Medication Must Have:

  1. A medication code

Profile Specific Implementation Guidance:

  • RXNorm concepts are defined as an extensible binding. USCDI recommends the National Drug Codes (NDC) as an optional terminology. They can be supplied as an additional coding element.
  • Since the binding is extensible when a code is unavailable, just text is allowed.
  • When the medication is compounded and is a list of ingredients, the code is still present and may contain only the text.

Usage:

Changes since version 7.0.0:

  • No changes

    • Formal Views of Profile Content

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

    This structure is derived from Medication

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Medication 0..* Medication Definition of a Medication
    ... code S 1..1 CodeableConcept Codes that identify this medication
    Binding: Medication Clinical Drug . (extensible)

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Medication.codeextensibleMedicationClinicalDrug .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Medication 0..* Medication Definition of a Medication
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    dom-3: 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
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... code SΣ 1..1 CodeableConcept Codes that identify this medication
    Binding: Medication Clinical Drug . (extensible)
    ele-1: All FHIR elements must have a @value or children
    ... status ?!Σ 0..1 code active | inactive | entered-in-error
    Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.


    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Medication.codeextensibleMedicationClinicalDrug .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
    Medication.statusrequiredMedication Status Codes
    http://hl7.org/fhir/ValueSet/medication-status|4.0.1
    from the FHIR Standard
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Medication 0..* Medication Definition of a Medication
    ... 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 BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... 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 Business identifier for this medication
    ... code SΣ 1..1 CodeableConcept Codes that identify this medication
    Binding: Medication Clinical Drug . (extensible)
    ... status ?!Σ 0..1 code active | inactive | entered-in-error
    Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.

    ... manufacturer Σ 0..1 Reference(Organization) Manufacturer of the item
    ... form 0..1 CodeableConcept powder | tablets | capsule +
    Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.

    ... amount Σ 0..1 Ratio Amount of drug in package
    ... ingredient 0..* BackboneElement Active or inactive ingredient
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... item[x] 1..1 The actual ingredient or content
    ..... itemCodeableConcept CodeableConcept
    ..... itemReference Reference(Substance | Medication)
    .... isActive 0..1 boolean Active ingredient indicator
    .... strength 0..1 Ratio Quantity of ingredient present
    ... batch 0..1 BackboneElement Details about packaged medications
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... lotNumber 0..1 string Identifier assigned to batch
    .... expirationDate 0..1 dateTime When batch will expire

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Medication.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    Medication.codeextensibleMedicationClinicalDrug .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
    Medication.statusrequiredMedication Status Codes
    http://hl7.org/fhir/ValueSet/medication-status|4.0.1
    from the FHIR Standard
    Medication.formexampleSNOMEDCTFormCodes
    http://hl7.org/fhir/ValueSet/medication-form-codes
    from the FHIR Standard

    This structure is derived from Medication

    Summary

    Mandatory: 1 element
    Must-Support: 1 element

    Maturity: 3

    Differential View

    This structure is derived from Medication

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Medication 0..* Medication Definition of a Medication
    ... code S 1..1 CodeableConcept Codes that identify this medication
    Binding: Medication Clinical Drug . (extensible)

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Medication.codeextensibleMedicationClinicalDrug .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Medication 0..* Medication Definition of a Medication
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    dom-3: 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
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... code SΣ 1..1 CodeableConcept Codes that identify this medication
    Binding: Medication Clinical Drug . (extensible)
    ele-1: All FHIR elements must have a @value or children
    ... status ?!Σ 0..1 code active | inactive | entered-in-error
    Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.


    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Medication.codeextensibleMedicationClinicalDrug .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
    Medication.statusrequiredMedication Status Codes
    http://hl7.org/fhir/ValueSet/medication-status|4.0.1
    from the FHIR Standard

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Medication 0..* Medication Definition of a Medication
    ... 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 BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... 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 Business identifier for this medication
    ... code SΣ 1..1 CodeableConcept Codes that identify this medication
    Binding: Medication Clinical Drug . (extensible)
    ... status ?!Σ 0..1 code active | inactive | entered-in-error
    Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.

    ... manufacturer Σ 0..1 Reference(Organization) Manufacturer of the item
    ... form 0..1 CodeableConcept powder | tablets | capsule +
    Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.

    ... amount Σ 0..1 Ratio Amount of drug in package
    ... ingredient 0..* BackboneElement Active or inactive ingredient
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... item[x] 1..1 The actual ingredient or content
    ..... itemCodeableConcept CodeableConcept
    ..... itemReference Reference(Substance | Medication)
    .... isActive 0..1 boolean Active ingredient indicator
    .... strength 0..1 Ratio Quantity of ingredient present
    ... batch 0..1 BackboneElement Details about packaged medications
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... lotNumber 0..1 string Identifier assigned to batch
    .... expirationDate 0..1 dateTime When batch will expire

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Medication.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    Medication.codeextensibleMedicationClinicalDrug .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
    Medication.statusrequiredMedication Status Codes
    http://hl7.org/fhir/ValueSet/medication-status|4.0.1
    from the FHIR Standard
    Medication.formexampleSNOMEDCTFormCodes
    http://hl7.org/fhir/ValueSet/medication-form-codes
    from the FHIR Standard

    This structure is derived from Medication

    Summary

    Mandatory: 1 element
    Must-Support: 1 element

    Maturity: 3

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    Quick Start

    Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

    • See the Scopes Format section for a description of the SMART scopes syntax.
    • See the Search Syntax section for a description of the US Core search syntax.
    • See the General Requirements section for additional rules and expectations when a Server requires status parameters.
    • See the General Guidance section for additional guidance on searching for multiple patients.

    US Core Scopes

    Servers providing access to data MAY support these US Core SMART Scopes:

    No required search criteria for us-core-medication profile.