Generated Narrative: StructureDefinition ch-emed-epr-medicationstatement-changed-list Name Flags Card. Type Description & Constraints MedicationStatement <a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R4/conformance-rules.html#constraints" title="This element has or is affected by constraints ( split-dosage-unit-must-match-base-dosage )">C 0..* CHEMEDMedicationStatementChangedList CH EMED MedicationStatement Changed (LIST) Constraints: split-dosage-unit-must-match-base-dosage #xD; meta #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.meta.extension" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">extension D 0..* Extension ✕ This element is not supported #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.meta.versionId" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">versionId D 0..1 id ✕ This element is not supported #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.meta.lastUpdated" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">lastUpdated D 0..1 instant ✕ This element is not supported #xD; source D 0..1 uri ✕ This element is not supported #xD; security D 0..* Coding ✕ This element is not supported #xD; tag D 0..* Coding ✕ This element is not supported #xD; implicitRules 0..0 A set of rules under which this content was created #xD; extension 1..* Extension Extension #xD; Slices for extension Content/Rules for all slices #xD; extension:substitution 0..1 CHEMEDExtSubstitution Whether the dispenser can substitute the prescribed medicine/package by another that is deemed equivalent, for medical or logistical reasons. By default, substitution is authorized. #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.extension:substitution.id" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">id D 0..1 string ✕ This element is not supported #xD; value[x] 1..1 CodeableConcept Whether substitution is allowed or not Binding: Substance Administration Substitution Codes (required) #xD; coding 0..* Coding Code defined by a terminology system Required Pattern: At least the following #xD; system 1..1 uri Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution #xD; code 1..1 code Symbol in syntax defined by the system Fixed Value: N #xD; display 1..1 string Representation defined by the system Fixed Value: none #xD; extension:parentDocument 1..1 CHEMEDExtPharmaceuticalAdvice CH EMED Extension #xD; extension:authorDocument 0..1 Author Optional Extensions Element #xD; Slices for value[x] Content/Rules for all slices #xD; value[x]:valueReference 1..1 Reference(CH EMED EPR PractitionerRole | CH EMED EPR Patient | CH EMED EPR RelatedPerson) Author of the content #xD; modifierExtension 0..0 Extension #xD; identifier #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.identifier.extension" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">extension D 0..* Extension ✕ This element is not supported #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.identifier.type" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">type D 0..1 CodeableConcept ✕ This element is not supported #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.identifier.period" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">period D 0..1 Period ✕ This element is not supported #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.identifier.assigner" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">assigner D 0..1 Reference(CH EMED EPR Organization) ✕ This element will be removed in PML(C) documents #xD; basedOn D 0..* Reference(MedicationRequest | CarePlan | ServiceRequest) ✕ This element will be removed in PML(C) documents #xD; status 1..1 code active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Required Pattern: active #xD; statusReason D 0..* CodeableConcept ✕ This element is not supported #xD; category D 0..1 CodeableConcept ✕ This element is not supported #xD; medication[x] 1..1 Reference(CH Core Medication) What medication was taken #xD; Slices for medication[x] Content/Rules for all slices #xD; medication[x]:medicationReference 0..1 Reference(CH EMED EPR Medication) {c} Reference to the contained medication #xD; subject 1..1 Reference(CH EMED EPR Patient) {r, b} Patient #xD; id D 0..1 string ✕ This element is not supported #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.subject.extension" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">extension D 0..* Extension ✕ This element is not supported #xD; context D 0..1 Reference(Encounter | EpisodeOfCare) ✕ This element will be removed in PML(C) documents #xD; effective[x] D 0..1 dateTime, Period ✕ Do not use. The effective period is contained in the main dosage #xD; informationSource 1..1 Reference(CH EMED EPR PractitionerRole | CH EMED EPR Patient | CH EMED EPR RelatedPerson) The author of the medical decision, see also 'Guidance - Authorship' #xD; derivedFrom D 0..* Reference(Resource) ✕ This element will be removed in PML(C) documents #xD; reasonCode 0..* CodeableConcept The treatment reason(s) as text, and optionally coded #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.reasonCode.extension" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">extension D 0..* Extension ✕ This element is not supported #xD; text 1..1 string Plain text representation of the treatment reason(s) #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.reasonReference" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">reasonReference D 0..* Reference(Condition | Observation | DiagnosticReport) ✕ This element will be removed in PML(C) documents #xD; note #xD; id D 0..1 string ✕ This element is not supported #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.note.extension" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">extension D 0..* Extension ✕ This element is not supported #xD; <a href="StructureDefinition-ch-emed-epr-medicationstatement-changed-list-definitions.html#MedicationStatement.note.author[x]" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">author[x] D 0..1 Reference(Practitioner | Patient | RelatedPerson | Organization), string ✕ The note author is ignored, as it cannot be different than the document and/or entry's author #xD; time D 0..1 dateTime ✕ This element is not supported #xD; text 1..1 markdown The annotation text content (as raw text, no markdown allowed). #xD; Slices for dosage Content/Rules for all slices #xD; dosage:baseEntry 1..1 CHEMEDEPRDosage Base entry of the dosage instruction #xD; dosage:additionalEntry 0..* CHEMEDEPRDosageSplit Additional entry of the dosage instruction #xD; Documentation for this format
Definition of the changed medication statement for the medication list document
CH EMED MedicationStatement Changed (LIST)
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'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'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.
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.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1.
(dosage.count() > 1 implies dosage.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage') and sequence = 1).exists()) and (dosage.count() = 1 implies dosage.single().sequence.exists().not())
The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match.
(dosage.count() > 1) implies dosage.doseAndRate.dose.ofType(Quantity).code.union(dosage.doseAndRate.dose.ofType(Range).low.code).union(dosage.doseAndRate.dose.ofType(Range).high.code).union(dosage.doseAndRate.rate.numerator.code).count() = 1
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R4/http.html#read) interaction.
In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Security Labels from the Healthcare Privacy and Security Classification System.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
A set of rules under which this content was created
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.
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's narrative along with other profiles, value sets, etc. All modifiers SHALL be documented in the profile, in order to be usable.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
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.
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.
Whether the dispenser can substitute the prescribed medicine/package by another that is deemed equivalent, for medical or logistical reasons. By default, substitution is authorized.
Optional Extension Element - found in all resources.
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
Source of the definition for the extension code - a logical name or a URL.
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
Additional content defined by implementations
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.
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.
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Extension to define the timestamp of the authorship/data input
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
...All modifiers SHALL be documented in the profile, in order to be usable.
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
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.
This is a business identifier, not a resource identifier.
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Identifier.system is always case sensitive.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Role.effectiveTime or implied by context
✕ This element will be removed in PML(C) documents
✕ Unsupported reference. It'll be stripped when generating PML(C) documents.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.
.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
Reference to the Observation from type 'CHANGE'
A larger event of which this particular event is a component or step.
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.
.outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]
active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.
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.
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
A coded concept indicating the current status of a MedicationStatement.
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.
A coded concept indicating the reason for the status of the statement.
.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].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.
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.
.participation[typeCode=CSM].role[classCode=ADMM or MANU]
The person, animal or group who is/was taking the medication.
.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
✕ Do not use. The effective period is contained in the main dosage
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 "end" 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.
The date when the medication statement was asserted by the information source.
The author of the medical decision, see also 'Guidance - Authorship'
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.
.participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)
The treatment reason(s) as text, and optionally coded
A reason for why the medication is being/was taken. Content creators should keep it as simple and short as possible (e.g. 'blood clog', 'hypertension').
This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.
A coded concept identifying why the medication is being taken.
Plain text representation of the treatment reason(s)
.outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value
Provides extra information about the medication statement that is not conveyed by the other attributes.
✕ The note author is ignored, as it cannot be different than the document and/or entry's author
Organization is used when there's no need for specific attribution as to who made the comment.
The annotation text content (as raw text, no markdown allowed).
The text of the annotation in markdown format.
Indicates how the medication is/was or should be taken by the patient.
The dates included in the dosage on a Medication Statement 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 Statement is derived from a MedicationRequest.
Additional entry of the dosage instruction
...Content creators should keep it as simple and short as possible (e.g. 'blood clog', 'hypertension').