HL7 Czech Hospital Discharge Report Implementation Guide
0.0.2 - ci-build Czechia flag

HL7 Czech Hospital Discharge Report Implementation Guide, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/hdr/ and changes regularly. See the Directory of published versions

Resource Profile: CZ_MedicationStatementObligationsHdr - Detailed Descriptions

Page standards status: Informative Maturity Level: 0

Definitions for the cz-medicationstatement-obl-hdr resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationStatement
Definition

This profile is derived from the Medication Statement in FHIR, which is a record of the medication the patient is taking.


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.

ShortCzech Medication StatementRecord of medication being taken by a patient
Comments

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.

Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. MedicationStatement.implicitRules
Definition

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.

ShortA set of rules under which this content was created
Comments

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.

Control0..1
Typeuri
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationStatement.modifierExtension
Definition

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'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).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

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.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MedicationStatement.identifier
Definition

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.

ShortExternal identifier
Comments

This is a business identifier, not a resource identifier.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationStatement.status
Definition

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.

Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Comments

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.

Control1..1
BindingThe codes SHALL be taken from Medication Status Codeshttp://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/medication-statement-status)
Typecode
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MedicationStatement.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.

ShortWhat medication was taken
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.

Control1..1
BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
(example to http://hl7.org/fhir/ValueSet/medication-codes)

A coded concept identifying the substance or product being taken.

TypeChoice of: CodeableConcept, Reference(Medication (CZ), Medication)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 12. MedicationStatement.medication[x]:medicationCodeableConcept
    Slice NamemedicationCodeableConcept
    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.

    ShortWhat medication was taken
    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.

    Control01..1
    BindingThe codes SHALL be taken from For example codes, see Value set of DLP Lecive pripravkyhttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
    (required to https://hl7.cz/fhir/core/ValueSet/cz-dlplecivepripravky-vs)
    TypeCodeableConcept, Reference(Medication)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Obligations
      ObligationsActor
      SHALL:able-to-populateHdrCreator-L2
      SHALL:displayHdrConsumer-L2
      SHALL:able-to-populateHdrCreator-L3
      SHALL:displayHdrConsumer-L3
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. MedicationStatement.subject
      Definition

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

      ShortWho is/was taking the medication
      Control1..1
      TypeReference(Patient (CZ core), Group, Patient, Group)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. MedicationStatement.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 MedicationStatement.taken element is No).

      ShortThe date/time or interval when the medication is/was/will be taken
      Comments

      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.

      Control0..1
      TypeChoice of: dateTime, Period
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 18. MedicationStatement.effective[x]:effectivePeriod
        Slice NameeffectivePeriod
        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 MedicationStatement.taken element is No).

        ShortThe date/time or interval when the medication is/was/will be taken
        Comments

        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.

        Control0..1
        TypePeriod, dateTime
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Obligations
          ObligationsActor
          SHALL:able-to-populateHdrCreator-L2
          SHALL:displayHdrConsumer-L2
          SHALL:able-to-populateHdrCreator-L3
          SHALL:displayHdrConsumer-L3
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. MedicationStatement.reasonCode
          Definition

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

          ShortReason for why the medication is being/was taken
          Comments

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

          Control0..*
          BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
          (example to http://hl7.org/fhir/ValueSet/condition-code)

          A coded concept identifying why the medication is being taken.

          TypeCodeableConcept
          Is Modifierfalse
          Obligations
            ObligationsActor
            SHALL:able-to-populateHdrCreator-L2
            SHALL:displayHdrConsumer-L2
            SHALL:able-to-populateHdrCreator-L3
            SHALL:displayHdrConsumer-L3
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. MedicationStatement.reasonReference
            Definition

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

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

            Control0..*
            TypeReference(Condition, Observation, DiagnosticReport, Condition, Observation, DiagnosticReport)
            Is Modifierfalse
            Obligations
              ObligationsActor
              SHALL:able-to-populateHdrCreator-L2
              SHALL:displayHdrConsumer-L2
              SHALL:able-to-populateHdrCreator-L3
              SHALL:displayHdrConsumer-L3
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

              Guidance on how to interpret the contents of this table can be foundhere

              0. MedicationStatement
              2. MedicationStatement.medication[x]:medicationCodeableConcept
              Slice NamemedicationCodeableConcept
              TypeCodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Obligations
                ObligationsActor
                SHALL:able-to-populateHdrCreator-L2
                SHALL:displayHdrConsumer-L2
                SHALL:able-to-populateHdrCreator-L3
                SHALL:displayHdrConsumer-L3
                4. MedicationStatement.effective[x]
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 6. MedicationStatement.effective[x]:effectivePeriod
                  Slice NameeffectivePeriod
                  Control0..1
                  TypePeriod
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Obligations
                    ObligationsActor
                    SHALL:able-to-populateHdrCreator-L2
                    SHALL:displayHdrConsumer-L2
                    SHALL:able-to-populateHdrCreator-L3
                    SHALL:displayHdrConsumer-L3
                    8. MedicationStatement.reasonCode
                    Obligations
                      ObligationsActor
                      SHALL:able-to-populateHdrCreator-L2
                      SHALL:displayHdrConsumer-L2
                      SHALL:able-to-populateHdrCreator-L3
                      SHALL:displayHdrConsumer-L3
                      10. MedicationStatement.reasonReference
                      Obligations
                        ObligationsActor
                        SHALL:able-to-populateHdrCreator-L2
                        SHALL:displayHdrConsumer-L2
                        SHALL:able-to-populateHdrCreator-L3
                        SHALL:displayHdrConsumer-L3

                        Guidance on how to interpret the contents of this table can be foundhere

                        0. MedicationStatement
                        Definition

                        This profile is derived from the Medication Statement in FHIR, which is a record of the medication the patient is taking.

                        ShortCzech Medication Statement
                        Comments

                        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.

                        Control0..*
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                        dom-6: A resource should have narrative for robust management (text.`div`.exists())
                        2. MedicationStatement.id
                        Definition

                        The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                        ShortLogical id of this artifact
                        Comments

                        The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                        Control0..1
                        Typeid
                        Is Modifierfalse
                        Summarytrue
                        4. MedicationStatement.meta
                        Definition

                        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.

                        ShortMetadata about the resource
                        Control0..1
                        TypeMeta
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        6. MedicationStatement.implicitRules
                        Definition

                        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.

                        ShortA set of rules under which this content was created
                        Comments

                        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.

                        Control0..1
                        Typeuri
                        Is Modifiertrue because 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
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        8. MedicationStatement.language
                        Definition

                        The base language in which the resource is written.

                        ShortLanguage of the resource content
                        Comments

                        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).

                        Control0..1
                        BindingThe codes SHOULD be taken from CommonLanguages
                        (preferred to http://hl7.org/fhir/ValueSet/languages)

                        A human language.

                        Additional BindingsPurpose
                        AllLanguagesMax Binding
                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        10. MedicationStatement.text
                        Definition

                        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.

                        ShortText summary of the resource, for human interpretation
                        Comments

                        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.

                        Control0..1
                        TypeNarrative
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesnarrative, html, xhtml, display
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        12. MedicationStatement.contained
                        Definition

                        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.

                        ShortContained, inline Resources
                        Comments

                        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.

                        Control0..*
                        TypeResource
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesinline resources, anonymous resources, contained resources
                        14. MedicationStatement.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the resource. 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.

                        ShortAdditional content defined by implementations
                        Comments

                        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.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        16. MedicationStatement.modifierExtension
                        Definition

                        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'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).

                        ShortExtensions that cannot be ignored
                        Comments

                        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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Summaryfalse
                        Requirements

                        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.

                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        18. MedicationStatement.identifier
                        Definition

                        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.

                        ShortExternal identifier
                        Comments

                        This is a business identifier, not a resource identifier.

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control1..*
                        TypeIdentifier
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        20. MedicationStatement.basedOn
                        Definition

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

                        ShortFulfils plan, proposal or order
                        Control0..*
                        TypeReference(MedicationRequest, CarePlan, ServiceRequest)
                        Is Modifierfalse
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        22. MedicationStatement.partOf
                        Definition

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

                        ShortPart of referenced event
                        Control0..*
                        TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Observation)
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        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.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        24. MedicationStatement.status
                        Definition

                        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.

                        Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
                        Comments

                        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.

                        Control1..1
                        BindingThe codes SHALL be taken from Medication Status Codes
                        (required to http://hl7.org/fhir/ValueSet/medication-statement-status)
                        Typecode
                        Is Modifiertrue because 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
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        26. MedicationStatement.statusReason
                        Definition

                        Captures the reason for the current state of the MedicationStatement.

                        ShortReason for current status
                        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.

                        Control0..*
                        BindingFor example codes, see SNOMEDCTDrugTherapyStatusCodes
                        (example to http://hl7.org/fhir/ValueSet/reason-medication-status-codes)

                        A coded concept indicating the reason for the status of the statement.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        28. MedicationStatement.category
                        Definition

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

                        ShortType of medication usage
                        Control0..1
                        BindingThe codes SHOULD be taken from Medication usage category codes
                        (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category)

                        A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        30. MedicationStatement.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.

                        ShortWhat medication was taken
                        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.

                        Control1..1
                        BindingFor example codes, see SNOMEDCTMedicationCodes
                        (example to http://hl7.org/fhir/ValueSet/medication-codes)

                        A coded concept identifying the substance or product being taken.

                        TypeChoice of: CodeableConcept, Reference(Medication (CZ))
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                        • type @ $this
                        • 32. MedicationStatement.medication[x]:medicationCodeableConcept
                          Slice NamemedicationCodeableConcept
                          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.

                          ShortWhat medication was taken
                          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.

                          Control0..1
                          BindingThe codes SHALL be taken from Value set of DLP Lecive pripravky
                          (required to https://hl7.cz/fhir/core/ValueSet/cz-dlplecivepripravky-vs)
                          TypeCodeableConcept
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Obligations
                            ObligationsActor
                            SHALL:able-to-populateHdrCreator-L2
                            SHALL:displayHdrConsumer-L2
                            SHALL:able-to-populateHdrCreator-L3
                            SHALL:displayHdrConsumer-L3
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            34. MedicationStatement.subject
                            Definition

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

                            ShortWho is/was taking the medication
                            Control1..1
                            TypeReference(Patient (CZ core), Group)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            36. MedicationStatement.context
                            Definition

                            The encounter or episode of care that establishes the context for this MedicationStatement.

                            ShortEncounter / Episode associated with MedicationStatement
                            Control0..1
                            TypeReference(Encounter, EpisodeOfCare)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            38. MedicationStatement.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 MedicationStatement.taken element is No).

                            ShortThe date/time or interval when the medication is/was/will be taken
                            Comments

                            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.

                            Control0..1
                            TypeChoice of: dateTime, Period
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • type @ $this
                            • 40. MedicationStatement.effective[x]:effectivePeriod
                              Slice NameeffectivePeriod
                              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 MedicationStatement.taken element is No).

                              ShortThe date/time or interval when the medication is/was/will be taken
                              Comments

                              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.

                              Control0..1
                              TypePeriod
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Obligations
                                ObligationsActor
                                SHALL:able-to-populateHdrCreator-L2
                                SHALL:displayHdrConsumer-L2
                                SHALL:able-to-populateHdrCreator-L3
                                SHALL:displayHdrConsumer-L3
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                42. MedicationStatement.dateAsserted
                                Definition

                                The date when the medication statement was asserted by the information source.

                                ShortWhen the statement was asserted?
                                Control0..1
                                TypedateTime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                44. MedicationStatement.informationSource
                                Definition

                                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.

                                ShortPerson or organization that provided the information about the taking of this medication
                                Control0..1
                                TypeReference(Patient (CZ core), Practitioner (CZ core), Practitioner Role (CZ core), Related Person (CZ core), Organization (CZ core))
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                46. MedicationStatement.derivedFrom
                                Definition

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

                                ShortAdditional supporting information
                                Comments

                                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.

                                Control0..*
                                TypeReference(Resource)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                48. MedicationStatement.reasonCode
                                Definition

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

                                ShortReason for why the medication is being/was taken
                                Comments

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

                                Control0..*
                                BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                (example to http://hl7.org/fhir/ValueSet/condition-code)

                                A coded concept identifying why the medication is being taken.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Obligations
                                  ObligationsActor
                                  SHALL:able-to-populateHdrCreator-L2
                                  SHALL:displayHdrConsumer-L2
                                  SHALL:able-to-populateHdrCreator-L3
                                  SHALL:displayHdrConsumer-L3
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  50. MedicationStatement.reasonReference
                                  Definition

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

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

                                  Control0..*
                                  TypeReference(Condition, Observation, DiagnosticReport)
                                  Is Modifierfalse
                                  Obligations
                                    ObligationsActor
                                    SHALL:able-to-populateHdrCreator-L2
                                    SHALL:displayHdrConsumer-L2
                                    SHALL:able-to-populateHdrCreator-L3
                                    SHALL:displayHdrConsumer-L3
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    52. MedicationStatement.note
                                    Definition

                                    Provides extra information about the medication statement that is not conveyed by the other attributes.

                                    ShortFurther information about the statement
                                    Control0..*
                                    TypeAnnotation
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    54. MedicationStatement.dosage
                                    Definition

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

                                    ShortDetails of how medication is/was taken or should be taken
                                    Comments

                                    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.

                                    Control0..*
                                    TypeDosage
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))