International Patient Summary Implementation Guide
1.1.0 - CI Build International flag

International Patient Summary Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-ips/ and changes regularly. See the Directory of published versions

Resource Profile: Medication Statement (IPS)

Official URL: http://hl7.org/fhir/uv/ips/StructureDefinition/MedicationStatement-uv-ips Version: 1.1.0
Standards status: Trial-use Maturity Level: 2 Computable Name: MedicationStatementIPS

This profile represents the constraints applied to the MedicationStatement resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A record of a medication statement is represented in the patient summary as an instance of a MedicationStatement resource constrained by this profile.

This profile constrains the representation of a medication statement related to the patient, in the context of the international patient summary as specified by the IPS project of HL7 International.

medicationCodeableConcept vs. medicationReference

In the previously balloted versions the medicationCodeableConcept was used only to provide information about the known absent/unknown medications; using the medicationReference to describe the actual medication. To better support local implementations of patient summaries and align with the US Core appoach, both options (medicationCodeableConcept and medicationReference) have been made possible; recognizing however that there are jurisdictions that impose that the medicationReference is always used.

Implemeters are encouraged "to improve global interoperability (...)" to use the medicationReference, limiting the usage of the medicationCodeableConcept only to the cases in which no other information than a simple code is available.

It also should be noted that in an anticipated future version of the IG based on R5, these two slices on medication[x] will be replaced by the 'medication' element in the MedicationUsage resource (which replaces MedicationStatement), as it uses the new CodeableReference data type.

Usage:

Formal Views of Profile Content

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

This structure is derived from MedicationStatement

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*MedicationStatementRecord of medication being taken by a patient
... status 1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
... medication[x] S1..1What medication was taken
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medicationReferenceReference(Medication (IPS))
.... medicationCodeableConceptCodeableConcept(CodeableConceptIPS)
... subject S1..1Reference(Patient (IPS))Who is/was taking the medication
.... reference S1..1stringLiteral reference, Relative, internal or absolute URL
.... data-absent-reason S0..1codeeffective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.

... dosage S0..*DosageDetails of how medication is/was taken or should be taken
.... text S0..1stringFree text dosage instructions e.g. SIG
.... timing S0..1TimingWhen medication should be administered
.... route 0..1CodeableConceptIPSConcept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms


doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*MedicationStatementRecord of medication being taken by a patient
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!Σ1..1codeactive | 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.

.... medicationReferenceReference(Medication (IPS))
.... medicationCodeableConceptCodeableConcept(CodeableConceptIPS)
... subject SΣ1..1Reference(Patient (IPS))Who is/was taking the medication
.... reference SΣC1..1stringLiteral reference, Relative, internal or absolute URL
... effective[x] SΣ1..1The date/time or interval when the medication is/was/will be taken
.... effective[x]:All Types Content/Rules for all Types
..... data-absent-reason S0..1codeeffective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.


.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dosage S0..*DosageDetails of how medication is/was taken or should be taken
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... timing SΣ0..1TimingWhen medication should be administered
.... route 0..1CodeableConceptIPSConcept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*MedicationStatementRecord of medication being taken by a patient
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal identifier
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... status ?!Σ1..1codeactive | 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..*CodeableConceptReason for current status
Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.


... category Σ0..1CodeableConceptType 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] SΣ1..1What medication was taken
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medicationReferenceReference(Medication (IPS))
.... medicationCodeableConceptCodeableConcept(CodeableConceptIPS)
... subject SΣ1..1Reference(Patient (IPS))Who is/was taking the medication
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC1..1stringLiteral reference, Relative, internal or absolute URL
.... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
.... display Σ0..1stringText alternative for the resource
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... effective[x] SΣ1..1The date/time or interval when the medication is/was/will be taken
.... effective[x]:All Types Content/Rules for all Types
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... data-absent-reason S0..1codeeffective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.


.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the statement was asserted?
... informationSource 0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication
... derivedFrom 0..*Reference(Resource)Additional supporting information
... reasonCode 0..*CodeableConceptReason 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 | Observation | DiagnosticReport)Condition or observation that supports why the medication is being/was taken
... note 0..*AnnotationFurther information about the statement
... dosage S0..*DosageDetails of how medication is/was taken or should be taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental 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 Σ0..1stringPatient or consumer oriented instructions
.... timing SΣ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route 0..1CodeableConceptIPSConcept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms

.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.statusReasonexampleSNOMEDCTDrugTherapyStatusCodes
http://hl7.org/fhir/ValueSet/reason-medication-status-codes
from the FHIR Standard
MedicationStatement.categorypreferredMedication usage category codes
http://hl7.org/fhir/ValueSet/medication-statement-category
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationStatement.dosage.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG
MedicationStatement.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationStatement.dosage.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from MedicationStatement

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*MedicationStatementRecord of medication being taken by a patient
... status 1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
... medication[x] S1..1What medication was taken
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medicationReferenceReference(Medication (IPS))
.... medicationCodeableConceptCodeableConcept(CodeableConceptIPS)
... subject S1..1Reference(Patient (IPS))Who is/was taking the medication
.... reference S1..1stringLiteral reference, Relative, internal or absolute URL
.... data-absent-reason S0..1codeeffective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.

... dosage S0..*DosageDetails of how medication is/was taken or should be taken
.... text S0..1stringFree text dosage instructions e.g. SIG
.... timing S0..1TimingWhen medication should be administered
.... route 0..1CodeableConceptIPSConcept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms


doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*MedicationStatementRecord of medication being taken by a patient
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!Σ1..1codeactive | 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.

.... medicationReferenceReference(Medication (IPS))
.... medicationCodeableConceptCodeableConcept(CodeableConceptIPS)
... subject SΣ1..1Reference(Patient (IPS))Who is/was taking the medication
.... reference SΣC1..1stringLiteral reference, Relative, internal or absolute URL
... effective[x] SΣ1..1The date/time or interval when the medication is/was/will be taken
.... effective[x]:All Types Content/Rules for all Types
..... data-absent-reason S0..1codeeffective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.


.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dosage S0..*DosageDetails of how medication is/was taken or should be taken
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... timing SΣ0..1TimingWhen medication should be administered
.... route 0..1CodeableConceptIPSConcept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*MedicationStatementRecord of medication being taken by a patient
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal identifier
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... status ?!Σ1..1codeactive | 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..*CodeableConceptReason for current status
Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.


... category Σ0..1CodeableConceptType 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] SΣ1..1What medication was taken
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medicationReferenceReference(Medication (IPS))
.... medicationCodeableConceptCodeableConcept(CodeableConceptIPS)
... subject SΣ1..1Reference(Patient (IPS))Who is/was taking the medication
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC1..1stringLiteral reference, Relative, internal or absolute URL
.... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
.... display Σ0..1stringText alternative for the resource
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... effective[x] SΣ1..1The date/time or interval when the medication is/was/will be taken
.... effective[x]:All Types Content/Rules for all Types
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... data-absent-reason S0..1codeeffective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.


.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the statement was asserted?
... informationSource 0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication
... derivedFrom 0..*Reference(Resource)Additional supporting information
... reasonCode 0..*CodeableConceptReason 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 | Observation | DiagnosticReport)Condition or observation that supports why the medication is being/was taken
... note 0..*AnnotationFurther information about the statement
... dosage S0..*DosageDetails of how medication is/was taken or should be taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental 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 Σ0..1stringPatient or consumer oriented instructions
.... timing SΣ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route 0..1CodeableConceptIPSConcept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms

.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.statusReasonexampleSNOMEDCTDrugTherapyStatusCodes
http://hl7.org/fhir/ValueSet/reason-medication-status-codes
from the FHIR Standard
MedicationStatement.categorypreferredMedication usage category codes
http://hl7.org/fhir/ValueSet/medication-statement-category
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationStatement.dosage.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG
MedicationStatement.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationStatement.dosage.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

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