QI-Core Implementation Guide
8.0.0-ballot - STU 8 - ballot

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. 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/fhir-qi-core/ and changes regularly. See the Directory of published versions

## Resource Profile: QICore MedicationStatement

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationstatement | Version: 8.0.0-ballot
Standards status: Trial-use Active as of 2018-08-22 | Maturity Level: 4 | Computable Name: QICoreMedicationStatement

Profile of MedicationStatement for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
QI Elements:

- subject: (QI) Who is/was taking the medication
- status: (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
- dateAsserted: (QI) When the statement was asserted?
- derivedFrom: (QI) Additional supporting information
- medication[x]: (QI) What medication was taken
- effective[x]: (QI) The date/time or interval when the medication is/was/will be taken
- informationSource: (QI) Person or organization that provided the information about the taking of this medication

Primary code path: medication
(PCPath) This element is the primary code path for this resource CQL Retrieve
Usage

See the patterns page for implementation and usage patterns.

### Examples

Penicillin MedicationStatement Example

Usages:

- Refer to this Profile: QICore AdverseEvent
- Examples for this Profile: MedicationStatement/example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (QI) 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] | Σ | 1..1 |  | (QI) What medication was taken Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(QICore Medication) |
subject | Σ | 1..1 | Reference(QICore Patient) | (QI) Who is/was taking the medication
effective[x] | Σ | 0..1 |  | (QI) The date/time or interval when the medication is/was/will be taken
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
dateAsserted | Σ | 0..1 | dateTime | (QI) When the statement was asserted?
informationSource |  | 0..1 | Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) | (QI) Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | (QI) 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.
dosage |  | 0..* | Dosage | (QI) Details of how medication is/was taken or should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extension
timing | Σ | 0..1 | Timing | (QI) When medication should be administered
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 | (QI) How drug should enter body Binding: SNOMEDCTRouteCodes (preferred)
doseAndRate | Σ | 0..* | Element | (QI) Amount of medication administered
dose[x] | Σ | 0..1 |  | (QI) Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
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 | Medication Clinical Drug | 📦20240606 | VSAC v0.23
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis 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 | preferred | SNOMED CT Route Codes | 📦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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
status |  | 1..1 | code | (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
medication[x] |  | 1..1 |  | (QI) What medication was taken Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(QICore Medication) |
subject |  | 1..1 | Reference(QICore Patient) | (QI) Who is/was taking the medication
effective[x] |  | 0..1 | dateTime, Period | (QI) The date/time or interval when the medication is/was/will be taken
dateAsserted |  | 0..1 | dateTime | (QI) When the statement was asserted?
informationSource |  | 0..1 | Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) | (QI) Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | (QI) Additional supporting information
reasonCode |  | 0..* | CodeableConcept | Reason for why the medication is being/was taken
dosage |  | 0..* | Dosage | (QI) Details of how medication is/was taken or should be taken
modifierExtension | ?! | 0..* | Extension | Extension
timing |  | 0..1 | Timing | (QI) When medication should be administered
site |  | 0..1 | CodeableConcept | Body site to administer to
route |  | 0..1 | CodeableConcept | (QI) How drug should enter body Binding: SNOMEDCTRouteCodes (preferred)
doseAndRate |  | 0..* | Element | (QI) Amount of medication administered
dose[x] |  | 0..1 | Range, SimpleQuantity(4.0.1) | (QI) Amount of medication per dose
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20240606 | VSAC v0.23
MedicationStatement.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
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 | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
status | ?!Σ | 1..1 | code | (QI) 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] | Σ | 1..1 |  | (QI) What medication was taken Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(QICore Medication) |
subject | Σ | 1..1 | Reference(QICore Patient) | (QI) Who is/was taking the medication
context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
effective[x] | Σ | 0..1 |  | (QI) The date/time or interval when the medication is/was/will be taken
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
dateAsserted | Σ | 0..1 | dateTime | (QI) When the statement was asserted?
informationSource |  | 0..1 | Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) | (QI) Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | (QI) 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 | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
dosage |  | 0..* | Dosage | (QI) 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 | Extension
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | 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 | (QI) 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 | (QI) How drug should enter body Binding: SNOMEDCTRouteCodes (preferred)
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 | (QI) 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 |  | (QI) 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 | Medication Clinical Drug | 📦20240606 | VSAC v0.23
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 | preferred | 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()`

Summary

Structures

This structure refers to these other structures:

- QICore Medication (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication)
- QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
- QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
- QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (QI) 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] | Σ | 1..1 |  | (QI) What medication was taken Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(QICore Medication) |
subject | Σ | 1..1 | Reference(QICore Patient) | (QI) Who is/was taking the medication
effective[x] | Σ | 0..1 |  | (QI) The date/time or interval when the medication is/was/will be taken
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
dateAsserted | Σ | 0..1 | dateTime | (QI) When the statement was asserted?
informationSource |  | 0..1 | Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) | (QI) Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | (QI) 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.
dosage |  | 0..* | Dosage | (QI) Details of how medication is/was taken or should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extension
timing | Σ | 0..1 | Timing | (QI) When medication should be administered
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 | (QI) How drug should enter body Binding: SNOMEDCTRouteCodes (preferred)
doseAndRate | Σ | 0..* | Element | (QI) Amount of medication administered
dose[x] | Σ | 0..1 |  | (QI) Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
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 | Medication Clinical Drug | 📦20240606 | VSAC v0.23
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis 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 | preferred | SNOMED CT Route Codes | 📦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()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
status |  | 1..1 | code | (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
medication[x] |  | 1..1 |  | (QI) What medication was taken Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(QICore Medication) |
subject |  | 1..1 | Reference(QICore Patient) | (QI) Who is/was taking the medication
effective[x] |  | 0..1 | dateTime, Period | (QI) The date/time or interval when the medication is/was/will be taken
dateAsserted |  | 0..1 | dateTime | (QI) When the statement was asserted?
informationSource |  | 0..1 | Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) | (QI) Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | (QI) Additional supporting information
reasonCode |  | 0..* | CodeableConcept | Reason for why the medication is being/was taken
dosage |  | 0..* | Dosage | (QI) Details of how medication is/was taken or should be taken
modifierExtension | ?! | 0..* | Extension | Extension
timing |  | 0..1 | Timing | (QI) When medication should be administered
site |  | 0..1 | CodeableConcept | Body site to administer to
route |  | 0..1 | CodeableConcept | (QI) How drug should enter body Binding: SNOMEDCTRouteCodes (preferred)
doseAndRate |  | 0..* | Element | (QI) Amount of medication administered
dose[x] |  | 0..1 | Range, SimpleQuantity(4.0.1) | (QI) Amount of medication per dose
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20240606 | VSAC v0.23
MedicationStatement.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
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 | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
status | ?!Σ | 1..1 | code | (QI) 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] | Σ | 1..1 |  | (QI) What medication was taken Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(QICore Medication) |
subject | Σ | 1..1 | Reference(QICore Patient) | (QI) Who is/was taking the medication
context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
effective[x] | Σ | 0..1 |  | (QI) The date/time or interval when the medication is/was/will be taken
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
dateAsserted | Σ | 0..1 | dateTime | (QI) When the statement was asserted?
informationSource |  | 0..1 | Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) | (QI) Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | (QI) 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 | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
dosage |  | 0..* | Dosage | (QI) 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 | Extension
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | 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 | (QI) 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 | (QI) How drug should enter body Binding: SNOMEDCTRouteCodes (preferred)
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 | (QI) 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 |  | (QI) 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 | Medication Clinical Drug | 📦20240606 | VSAC v0.23
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 | preferred | 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()`

Summary

Structures

This structure refers to these other structures:

- QICore Medication (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication)
- QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
- QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
- QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)

Maturity: 4

Other representations of profile: CSV, Excel, Schematron