medTech IG
0.1.0 - CI Build

medTech IG, published by medtech. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7NZ/medtech/ and changes regularly. See the Directory of published versions

Resource Profile: MtMedicationStatement - XML Profile

XML representation of the mtMedicationStatement resource profile.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="mtMedicationStatement"/>
  <text>
    <status value="additional"/>
    <div xmlns="http://www.w3.org/1999/xhtml">MedTech MedicationStatement profile</div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category">
    <valueString value="Clinical.Medications"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient"/>
  </extension>
  <url value="http://hl7.org.nz/fhir/StructureDefinition/MtMedicationStatement"/>
  <version value="0.1.0"/>
  <name value="MtMedicationStatement"/>
  <title value="MedicationStatement profile"/>
  <status value="active"/>
  <date value="2021-07-11T23:33:42+00:00"/>
  <publisher value="medtech"/>
  <contact>
    <name value="medtech"/>
    <telecom>
      <system value="email"/>
      <value value="mailto:pkoval@medtechglobal.com"/>
    </telecom>
  </contact>
  <description
               value="The MedicationStatement resource exposed by the ALEX infrastructure."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="NZ"/>
    </coding>
  </jurisdiction>
  <purpose
           value="The MedicationStatement resource exposed by the ALEX infrastructure."/>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Pattern"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="MedicationStatement"/>
  <baseDefinition
                  value="http://hl7.org/fhir/StructureDefinition/MedicationStatement"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="MedicationStatement">
      <path value="MedicationStatement"/>
      <short value="Record of medication being taken by a patient"/>
      <definition
                  value="A record of a medication that is being consumed by a patient.   A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future.  The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician.  A common scenario where this information is captured is during the history taking process during a patient visit or stay.   The medication information may come from sources such as the patient&#39;s memory, from a prescription bottle,  or from a list of medications the patient, clinician or other party maintains. 

The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication.  A medication statement is often, if not always, less specific.  There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise.  As stated earlier, the medication statement information may come from the patient&#39;s memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains.  Medication administration is more formal and is not missing detailed information."/>
      <comment
               value="When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:
MedicationStatement.status + MedicationStatement.wasNotTaken
Status=Active + NotTaken=T = Not currently taking
Status=Completed + NotTaken=T = Not taken in the past
Status=Intended + NotTaken=T = No intention of taking
Status=Active + NotTaken=F = Taking, but not as prescribed
Status=Active + NotTaken=F = Taking
Status=Intended +NotTaken= F = Will be taking (not started)
Status=Completed + NotTaken=F = Taken in past
Status=In Error + NotTaken=N/A = In Error."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationStatement"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="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"/>
        <expression
                    value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="SubstanceAdministration"/>
      </mapping>
    </element>
    <element id="MedicationStatement.id">
      <path value="MedicationStatement.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="MedicationStatement.meta">
      <path value="MedicationStatement.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="MedicationStatement.implicitRules">
      <path value="MedicationStatement.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it&#39;s narrative along with other profiles, value sets, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation"/>
      <isSummary value="true"/>
    </element>
    <element id="MedicationStatement.language">
      <path value="MedicationStatement.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
    </element>
    <element id="MedicationStatement.text">
      <path value="MedicationStatement.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="MedicationStatement.contained">
      <path value="MedicationStatement.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationStatement.extension">
      <path value="MedicationStatement.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="MedicationStatement.extension:nzeps-long-term-medication">
      <path value="MedicationStatement.extension"/>
      <sliceName value="nzeps-long-term-medication"/>
      <short value="NZePS Long Term Medication Indicator"/>
      <definition value="NZePS Long Term Medication Indicator"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org.nz/fhir/StructureDefinition/nzeps-long-term-medication"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
    </element>
    <element id="MedicationStatement.modifierExtension">
      <path value="MedicationStatement.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element&#39;s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationStatement.identifier">
      <path value="MedicationStatement.identifier"/>
      <short value="External identifier"/>
      <definition
                  value="Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server."/>
      <comment value="This is a business identifier, not a resource identifier."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationStatement.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
    </element>
    <element id="MedicationStatement.basedOn">
      <path value="MedicationStatement.basedOn"/>
      <short value="Fulfils plan, proposal or order"/>
      <definition
                  value="A plan, proposal or order that is fulfilled in whole or in part by this event."/>
      <requirements
                    value="Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.basedOn"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"/>
      </mapping>
    </element>
    <element id="MedicationStatement.partOf">
      <path value="MedicationStatement.partOf"/>
      <short value="Part of referenced event"/>
      <definition
                  value="A larger event of which this particular event is a component or step."/>
      <requirements
                    value="This should not be used when indicating which resource a MedicationStatement has been derived from.  If that is the use case, then MedicationStatement.derivedFrom should be used."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.partOf"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/MedicationStatement"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.partOf"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationStatement.status">
      <path value="MedicationStatement.status"/>
      <short
             value="active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken"/>
      <definition
                  value="A code representing the patient or other source&#39;s judgment about the state of the medication used that this statement is about.  Generally, this will be active or completed."/>
      <comment
               value="MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationStatement.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationStatementStatus"/>
        </extension>
        <strength value="required"/>
        <description
                     value="A coded concept indicating the current status of a MedicationStatement."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".statusCode"/>
      </mapping>
    </element>
    <element id="MedicationStatement.statusReason">
      <path value="MedicationStatement.statusReason"/>
      <short value="Reason for current status"/>
      <definition
                  value="Captures the reason for the current state of the MedicationStatement."/>
      <comment
               value="This is generally only used for &quot;exception&quot; statuses such as &quot;not-taken&quot;, &quot;on-hold&quot;, &quot;cancelled&quot; or &quot;entered-in-error&quot;. The reason for performing the event at all is captured in reasonCode, not here."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.statusReason"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationStatementStatusReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept indicating the reason for the status of the statement."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/reason-medication-status-codes"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.statusReason"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde"/>
      </mapping>
    </element>
    <element id="MedicationStatement.category">
      <path value="MedicationStatement.category"/>
      <short value="Type of medication usage"/>
      <definition
                  value="Indicates where the medication is expected to be consumed or administered."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.category"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationStatementCategory"/>
        </extension>
        <strength value="preferred"/>
        <description
                     value="A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/medication-statement-category"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type of medication usage&quot;].value"/>
      </mapping>
    </element>
    <element id="MedicationStatement.medication[x]">
      <path value="MedicationStatement.medication[x]"/>
      <short value="What medication was taken"/>
      <definition
                  value="Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications."/>
      <comment
               value="If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number, then you must reference the Medication resource."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationStatement.medication[x]"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Medication"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationCode"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept identifying the substance or product being taken."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-codes"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.what[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=CSM].role[classCode=ADMM or MANU]"/>
      </mapping>
    </element>
    <element id="MedicationStatement.subject">
      <path value="MedicationStatement.subject"/>
      <short value="Who is/was taking  the medication"/>
      <definition
                  value="The person, animal or group who is/was taking the medication."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationStatement.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3-Patient ID List"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject"/>
      </mapping>
    </element>
    <element id="MedicationStatement.context">
      <path value="MedicationStatement.context"/>
      <short value="Encounter / Episode associated with MedicationStatement"/>
      <definition
                  value="The encounter or episode of care that establishes the context for this MedicationStatement."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.context"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.context"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type of encounter or episode&quot;]"/>
      </mapping>
    </element>
    <element id="MedicationStatement.effective[x]">
      <path value="MedicationStatement.effective[x]"/>
      <short
             value="The date/time or interval when the medication is/was/will be taken"/>
      <definition
                  value="The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No)."/>
      <comment
               value="This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the &quot;end&quot; date will be omitted.  The date/time attribute supports a variety of dates - year, year/month and exact date.  If something more than this is required, this should be conveyed as text."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationStatement.effective[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.done[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dateAsserted">
      <path value="MedicationStatement.dateAsserted"/>
      <short value="When the statement was asserted?"/>
      <definition
                  value="The date when the medication statement was asserted by the information source."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationStatement.dateAsserted"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.recorded"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].time"/>
      </mapping>
    </element>
    <element id="MedicationStatement.informationSource">
      <path value="MedicationStatement.informationSource"/>
      <short
             value="Person or organization that provided the information about the taking of this medication"/>
      <definition
                  value="The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.informationSource"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.source"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"/>
      </mapping>
    </element>
    <element id="MedicationStatement.derivedFrom">
      <path value="MedicationStatement.derivedFrom"/>
      <short value="Additional supporting information"/>
      <definition
                  value="Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement."/>
      <comment
               value="Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers.  The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim.  it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.derivedFrom"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationStatement.reasonCode">
      <path value="MedicationStatement.reasonCode"/>
      <short value="Reason for why the medication is being/was taken"/>
      <definition value="A reason for why the medication is being/was taken."/>
      <comment
               value="This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.reasonCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept identifying why the medication is being taken."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-code"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
    </element>
    <element id="MedicationStatement.reasonReference">
      <path value="MedicationStatement.reasonReference"/>
      <short
             value="Condition or observation that supports why the medication is being/was taken"/>
      <definition
                  value="Condition or observation that supports why the medication is being/was taken."/>
      <comment
               value="This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationStatement.reasonReference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonReference"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;reason for use&quot;].value"/>
      </mapping>
    </element>
    <element id="MedicationStatement.note">
      <path value="MedicationStatement.note"/>
      <short value="Further information about the statement"/>
      <definition
                  value="Provides extra information about the medication statement that is not conveyed by the other attributes."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="MedicationStatement.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.note"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage">
      <path value="MedicationStatement.dosage"/>
      <short value="Details of how medication is/was taken or should be taken"/>
      <definition
                  value="Indicates how the medication is/was or should be taken by the patient."/>
      <comment
               value="The dates included in the dosage on a Medication Statement reflect the dates for a given dose.  For example, &quot;from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.&quot;  It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationStatement.dosage"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Dosage"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="refer dosageInstruction mapping"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.id">
      <path value="MedicationStatement.dosage.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.extension">
      <path value="MedicationStatement.dosage.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.modifierExtension">
      <path value="MedicationStatement.dosage.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element&#39;s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.sequence">
      <path value="MedicationStatement.dosage.sequence"/>
      <short value="The order of the dosage instructions"/>
      <definition
                  value="Indicates the order in which the dosage instructions should be applied or interpreted."/>
      <requirements
                    value="If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.sequence"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="integer"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="TQ1-1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.text">
      <path value="MedicationStatement.dosage.text"/>
      <short value="Free text dosage instructions e.g. SIG"/>
      <definition value="Free text dosage instructions e.g. SIG."/>
      <requirements
                    value="Free text dosage instructions can be used for cases where the instructions are too complex to code.  The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated.  If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.  Additional information about administration or preparation of the medication should be included as text."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-6; RXE-21"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.additionalInstruction">
      <path value="MedicationStatement.dosage.additionalInstruction"/>
      <short
             value="Supplemental instruction or warnings to the patient - e.g. &quot;with meals&quot;, &quot;may cause drowsiness&quot;"/>
      <definition
                  value="Supplemental instructions to the patient on how to take the medication  (e.g. &quot;with meals&quot; or&quot;take half to one hour before food&quot;) or warnings for the patient about the medication (e.g. &quot;may cause drowsiness&quot; or &quot;avoid exposure of skin to direct sunlight or sunlamps&quot;)."/>
      <comment
               value="Information about administration or preparation of the medication (e.g. &quot;infuse as rapidly as possibly via intraperitoneal port&quot; or &quot;immediately following drug x&quot;) should be populated in dosage.text."/>
      <requirements
                    value="Additional instruction is intended to be coded, but where no code exists, the element could include text.  For example, &quot;Swallow with plenty of water&quot; which might or might not be coded."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.additionalInstruction"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AdditionalInstruction"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept identifying additional instructions such as &quot;take with water&quot; or &quot;avoid operating heavy machinery&quot;."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/additional-instruction-codes"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.patientInstruction">
      <path value="MedicationStatement.dosage.patientInstruction"/>
      <short value="Patient or consumer oriented instructions"/>
      <definition
                  value="Instructions in terms that are understood by the patient or consumer."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.patientInstruction"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing">
      <path value="MedicationStatement.dosage.timing"/>
      <short value="When medication should be administered"/>
      <definition value="When medication should be administered."/>
      <comment
               value="This attribute might not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing."/>
      <requirements
                    value="The timing schedule for giving the medication to the patient. This  data type allows many different expressions. For example: &quot;Every 8 hours&quot;; &quot;Three times a day&quot;; &quot;1/2 an hour before breakfast for 10 days from 23-Dec 2011:&quot;; &quot;15 Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn&#39;t imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.timing"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Timing"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.asNeeded[x]">
      <path value="MedicationStatement.dosage.asNeeded[x]"/>
      <short value="Take &quot;as needed&quot; (for x)"/>
      <definition
                  value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept)."/>
      <comment
               value="Can express &quot;as needed&quot; without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express &quot;as needed&quot; with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not &quot;prn&quot; or &quot;as needed&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.asNeeded[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAsNeededReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30 minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="TQ1-9"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=&quot;as needed&quot;].value=boolean or codable concept"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.site">
      <path value="MedicationStatement.dosage.site"/>
      <short value="Body site to administer to"/>
      <definition value="Body site to administer to."/>
      <comment
               value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both."/>
      <requirements
                    value="A coded specification of the anatomic site where the medication first enters the body."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.site"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAdministrationSite"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept describing the site location the medicine enters into or onto the body."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/approach-site-codes"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".approachSiteCode"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.route">
      <path value="MedicationStatement.dosage.route"/>
      <short value="How drug should enter body"/>
      <definition value="How drug should enter body."/>
      <requirements
                    value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient&#39;s body."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.route"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RouteOfAdministration"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/route-codes"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".routeCode"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.method">
      <path value="MedicationStatement.dosage.method"/>
      <short value="Technique for administering medication"/>
      <definition value="Technique for administering medication."/>
      <comment
               value="Terminologies used often pre-coordinate this term with the route and or form of administration."/>
      <requirements
                    value="A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections.  For examples, Slow Push; Deep IV."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.method"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAdministrationMethod"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept describing the technique by which the medicine is administered."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/administration-method-codes"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".doseQuantity"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.doseAndRate">
      <path value="MedicationStatement.dosage.doseAndRate"/>
      <short value="Amount of medication administered"/>
      <definition value="The amount of medication administered."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.doseAndRate"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="TQ1-2"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.doseAndRate.id">
      <path value="MedicationStatement.dosage.doseAndRate.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.doseAndRate.extension">
      <path value="MedicationStatement.dosage.doseAndRate.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.doseAndRate.type">
      <path value="MedicationStatement.dosage.doseAndRate.type"/>
      <short value="The kind of dose or rate specified"/>
      <definition
                  value="The kind of dose or rate specified, for example, ordered or calculated."/>
      <requirements
                    value="If the type is not populated, assume to be &quot;ordered&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.doseAndRate.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DoseAndRateType"/>
        </extension>
        <strength value="example"/>
        <description value="The kind of dose or rate specified."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/dose-rate-type"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-21; RXE-23"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.doseAndRate.dose[x]">
      <path value="MedicationStatement.dosage.doseAndRate.dose[x]"/>
      <short value="Amount of medication per dose"/>
      <definition value="Amount of medication per dose."/>
      <comment
               value="Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours."/>
      <requirements
                    value="The amount of therapeutic or other substance given at one administration event."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.doseAndRate.dose[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-2, RXE-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".doseQuantity"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.doseAndRate.rate[x]">
      <path value="MedicationStatement.dosage.doseAndRate.rate[x]"/>
      <short value="Amount of medication per unit of time"/>
      <definition value="Amount of medication per unit of time."/>
      <comment
               value="It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity.  The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator.  Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour."/>
      <requirements
                    value="Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours.   Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn&#39;t imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.doseAndRate.rate[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE22, RXE23, RXE-24"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".rateQuantity"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerPeriod">
      <path value="MedicationStatement.dosage.maxDosePerPeriod"/>
      <short value="Upper limit on medication per unit of time"/>
      <definition value="Upper limit on medication per unit of time."/>
      <comment
               value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example &quot;2 tablets every 4 hours to a maximum of 8/day&quot;."/>
      <requirements
                    value="The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time.  For example, 1000mg in 24 hours."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.maxDosePerPeriod"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Ratio"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-23, RXE-19"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".maxDoseQuantity"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerAdministration">
      <path value="MedicationStatement.dosage.maxDosePerAdministration"/>
      <short value="Upper limit on medication per administration"/>
      <definition value="Upper limit on medication per administration."/>
      <comment
               value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg."/>
      <requirements
                    value="The maximum total quantity of a therapeutic substance that may be administered to a subject per administration."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.maxDosePerAdministration"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="not supported"/>
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerLifetime">
      <path value="MedicationStatement.dosage.maxDosePerLifetime"/>
      <short value="Upper limit on medication per lifetime of the patient"/>
      <definition value="Upper limit on medication per lifetime of the patient."/>
      <requirements
                    value="The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.maxDosePerLifetime"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="not supported"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="MedicationStatement">
      <path value="MedicationStatement"/>
    </element>
    <element id="MedicationStatement.extension">
      <path value="MedicationStatement.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
    </element>
    <element id="MedicationStatement.extension:nzeps-long-term-medication">
      <path value="MedicationStatement.extension"/>
      <sliceName value="nzeps-long-term-medication"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org.nz/fhir/StructureDefinition/nzeps-long-term-medication"/>
      </type>
    </element>
    <element id="MedicationStatement.basedOn">
      <path value="MedicationStatement.basedOn"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.partOf">
      <path value="MedicationStatement.partOf"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.statusReason">
      <path value="MedicationStatement.statusReason"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.category">
      <path value="MedicationStatement.category"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.context">
      <path value="MedicationStatement.context"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.informationSource">
      <path value="MedicationStatement.informationSource"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.derivedFrom">
      <path value="MedicationStatement.derivedFrom"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.reasonCode">
      <path value="MedicationStatement.reasonCode"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.note">
      <path value="MedicationStatement.note"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.sequence">
      <path value="MedicationStatement.dosage.sequence"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.additionalInstruction">
      <path value="MedicationStatement.dosage.additionalInstruction"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.patientInstruction">
      <path value="MedicationStatement.dosage.patientInstruction"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.timing">
      <path value="MedicationStatement.dosage.timing"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.site">
      <path value="MedicationStatement.dosage.site"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.route">
      <path value="MedicationStatement.dosage.route"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.method">
      <path value="MedicationStatement.dosage.method"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.doseAndRate">
      <path value="MedicationStatement.dosage.doseAndRate"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerPeriod">
      <path value="MedicationStatement.dosage.maxDosePerPeriod"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerAdministration">
      <path value="MedicationStatement.dosage.maxDosePerAdministration"/>
      <max value="0"/>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerLifetime">
      <path value="MedicationStatement.dosage.maxDosePerLifetime"/>
      <max value="0"/>
    </element>
  </differential>
</StructureDefinition>