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Pharmacy Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: Encounter, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the MedicationUsage resource.

MedicationUsage
Element IdMedicationUsage
Definition

A record of a medication that is being consumed by a patient. A MedicationUsage 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's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains.

The primary difference between a medicationusage and a medicationadministration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medicationusage 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 Usage information may come from the patient'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.

Cardinality0..*
TypeDomainResource
MedicationUsage.identifier
Element IdMedicationUsage.identifier
Definition

Identifiers associated with this Medication Usage 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.

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Summarytrue
Comments

This is a business identifier, not a resource identifier.

MedicationUsage.basedOn
Element IdMedicationUsage.basedOn
Definition

A plan, proposal or order that is fulfilled in whole or in part by this event.

Cardinality0..*
TypeReference(MedicationRequest | CarePlan | ServiceRequest)
PatternsReference(MedicationRequest,CarePlan,ServiceRequest): Common patterns = Request
Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Summarytrue
MedicationUsage.partOf
Element IdMedicationUsage.partOf
Definition

A larger event of which this particular event is a component or step.

Cardinality0..*
TypeReference(MedicationAdministration | MedicationDispense | MedicationUsage | Procedure | Observation)
PatternsReference(MedicationAdministration,MedicationDispense,MedicationUsage,Procedure,Observation): Common patterns = Event
Requirements

This should not be used when indicating which resource a MedicationUsage has been derived from. If that is the use case, then MedicationUsage.derivedFrom should be used.

Summarytrue
MedicationUsage.status
Element IdMedicationUsage.status
Definition

A code representing the patient or other source's judgment about the state of the medication used that this usage is about. Generally, this will be active or completed.

Cardinality1..1
Terminology BindingMedication usage status codes (Required)
Typecode
Is Modifiertrue (Reason: 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)
Summarytrue
Comments

MedicationUsage is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationUsage.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 Usage 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.

MedicationUsage.statusReason
Element IdMedicationUsage.statusReason
Definition

Captures the reason for the current state of the MedicationUsage.

Cardinality0..*
Terminology BindingSNOMED CT Drug Therapy Status codes (Example)
TypeCodeableConcept
Comments

This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

MedicationUsage.category
Element IdMedicationUsage.category
Definition

Indicates where the medication is expected to be consumed or administered.

Cardinality0..*
Terminology BindingMedication usage category codes (Preferred)
TypeCodeableConcept
Summarytrue
MedicationUsage.medication[x]
Element IdMedicationUsage.medication[x]
Definition

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.

Cardinality1..1
Terminology BindingSNOMED CT Medication Codes (Example)
TypeCodeableConcept|Reference(Medication)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Comments

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.

MedicationUsage.subject
Element IdMedicationUsage.subject
Definition

The person, animal or group who is/was taking the medication.

Cardinality1..1
TypeReference(Patient | Group)
PatternsReference(Patient,Group): Common patterns = Participant
Summarytrue
MedicationUsage.encounter
Element IdMedicationUsage.encounter
Definition

The encounter that establishes the context for this MedicationUsage.

Cardinality0..1
TypeReference(Encounter)
Summarytrue
MedicationUsage.effective[x]
Element IdMedicationUsage.effective[x]
Definition

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 MedicationUsage.status element is NotTaken).

Cardinality0..1
TypedateTime|Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Comments

This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Usages. f the medication is still being taken and is expected to continue indefinitely at the time the usage is recorded, the "end" date will be omitted. If the end date is known, then it is included as the "end date". 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.

MedicationUsage.dateAsserted
Element IdMedicationUsage.dateAsserted
Definition

The date when the Medication Usage was asserted by the information source.

Cardinality0..1
TypedateTime
Summarytrue
MedicationUsage.informationSource
Element IdMedicationUsage.informationSource
Definition

The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationUsage is derived from other resources, e.g. Claim or MedicationRequest.

Cardinality0..1
TypeReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
PatternsReference(Patient,Practitioner,PractitionerRole,RelatedPerson,Organization): Common patterns = Participant
MedicationUsage.derivedFrom
Element IdMedicationUsage.derivedFrom
Definition

Allows linking the MedicationUsage to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationUsage.

Cardinality0..*
TypeReference(Any)
Comments

Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationUsage comes from creating a MedicationUsage 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 MedicationUsage from.

MedicationUsage.reasonCode
Element IdMedicationUsage.reasonCode
Definition

A reason for why the medication is being/was taken.

Cardinality0..*
Terminology BindingCondition/Problem/Diagnosis Codes (Example)
TypeCodeableConcept
Comments

This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

MedicationUsage.reasonReference
Element IdMedicationUsage.reasonReference
Definition

Condition or observation that supports why the medication is being/was taken.

Cardinality0..*
TypeReference(Condition | Observation | DiagnosticReport)
PatternsReference(Condition,Observation,DiagnosticReport): Common patterns = Event
Comments

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.

MedicationUsage.note
Element IdMedicationUsage.note
Definition

Provides extra information about the Medication Usage that is not conveyed by the other attributes.

Cardinality0..*
TypeAnnotation
MedicationUsage.dosage
Element IdMedicationUsage.dosage
Definition

Indicates how the medication is/was or should be taken by the patient.

Cardinality0..*
TypeDosage
Comments

The dates included in the dosage on a Medication Usage reflect the dates for a given dose. For example, "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." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Usage is derived from a MedicationRequest.

MedicationUsage.takenAsOrdered
Element IdMedicationUsage.takenAsOrdered
Definition

Indicates if the medication is being consumed or administered as prescribed.

Cardinality0..1
Typeboolean