HL7 Czech Hospital Discharge Report Implementation Guide
0.1.0 - ci-build CZ

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 0.1.0 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: MedicationStatement: Obligations (HDR CZ) - 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 EU core profile, 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.extension:adherence
Slice Nameadherence
Definition

R5: MedicationStatement.adherence (new:BackboneElement)

ShortR5: Indicates whether the medication is or is not being consumed or administered (new)
Comments

Element MedicationStatement.adherence has a context of MedicationStatement based on following the parent source element upwards and mapping to MedicationStatement. Element MedicationStatement.adherence has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). This element can be used to indicate whether a patient is following a course of treatment as instructed/prescribed or whether they are taking medications of their own volition. It can also be used to indicate that a patient is not taking a medication, either because they were told not to or because they decided on their own.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(R5: Indicates whether the medication is or is not being consumed or administered (new)) (Complex Extension)
Is Modifierfalse
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.extension:adherence.extension
Definition

An Extension


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.

ShortExtensionAdditional 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.

Control10..*
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())
ele-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())
SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. MedicationStatement.extension:adherence.extension:code
    Slice Namecode
    Definition

    An Extension

    ShortType of adherence.Additional content defined by implementations
    Control10..1*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    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())
    ele-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())
    10. MedicationStatement.extension:adherence.extension:code.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    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.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuecode
    12. MedicationStatement.extension:adherence.extension:code.value[x]
    Definition

    Type of the adherence for the medication.


    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortType of adherenceValue of extension
    Control10..1
    BindingFor example codes, see For codes, see R5MedicationStatementAdherenceForR4 (0.1.0)
    (example to http://hl7.org/fhir/uv/xver/ValueSet/R5-medication-statement-adherence-for-R4|0.1.0)
    TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. MedicationStatement.extension:adherence.extension:reason
    Slice Namereason
    Definition

    R5: MedicationStatement.adherence.reason (new:CodeableConcept)

    ShortR5: Details of the reason for the current use of the medication (new)Additional content defined by implementations
    Comments

    Element MedicationStatement.adherence.reason is part of an existing definition because parent element MedicationStatement.adherence requires a cross-version extension. Element MedicationStatement.adherence.reason has a context of MedicationStatement based on following the parent source element upwards and mapping to MedicationStatement. Element MedicationStatement.adherence.reason has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). This is generally only used for "exception" statuses such as "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

    Control0..1*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Requirements

    Element MedicationStatement.adherence.reason is part of an existing definition because parent element MedicationStatement.adherence requires a cross-version extension. Element MedicationStatement.adherence.reason has a context of MedicationStatement based on following the parent source element upwards and mapping to MedicationStatement. Element MedicationStatement.adherence.reason has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

    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())
    ele-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.extension:adherence.extension:reason.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    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.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuereason
    18. MedicationStatement.extension:adherence.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    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.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence
    20. MedicationStatement.extension:adherence.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control0..01
    TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
    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()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. 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())
    24. 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.

    ShortMedication Statement IdentifierExternal 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()))
    26. 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.

    ShortState of the medicationactive | 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|4.0.1)

    A coded concept indicating the current status of a MedicationStatement.

    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
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. 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 Medications - IPShttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
    (example to http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips)
    TypeChoice of: CodeableConcept, Reference(Medication (CZ core), 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
    • 30. 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 DLP_lecivepripravky (0.3.0)http://hl7.org/fhir/ValueSet/medication-codes|4.0.1
      (required to https://sukl.cz/terminology/ValueSet/dlp-lecivepripravky|0.3.0)
      TypeCodeableConcept, Reference(Medication)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Obligations
        ObligationsActor
        SHALL:able-to-populateCreator_L2
        SHALL:displayConsumer_L2
        SHALL:able-to-populateCreator_L3
        SHALL:displayConsumer_L3
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. 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()))
        34. 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 Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 36. 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).

          ShortPeriod when the medication is/was or should be used.The 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-populateCreator_L2
            SHALL:displayConsumer_L2
            SHALL:able-to-populateCreator_L3
            SHALL:displayConsumer_L3
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. MedicationStatement.reasonCode
            Definition

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

            ShortCoded reason for useReason 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|4.0.1)

            A coded concept identifying why the medication is being taken.

            TypeCodeableConcept
            Is Modifierfalse
            Obligations
              ObligationsActor
              SHALL:able-to-populateCreator_L2
              SHALL:displayConsumer_L2
              SHALL:able-to-populateCreator_L3
              SHALL:displayConsumer_L3
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. 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-populateCreator_L2
                SHALL:displayConsumer_L2
                SHALL:able-to-populateCreator_L3
                SHALL:displayConsumer_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-populateCreator_L2
                  SHALL:displayConsumer_L2
                  SHALL:able-to-populateCreator_L3
                  SHALL:displayConsumer_L3
                  4. MedicationStatement.effective[x]:effectivePeriod
                  Slice NameeffectivePeriod
                  TypePeriod
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Obligations
                    ObligationsActor
                    SHALL:able-to-populateCreator_L2
                    SHALL:displayConsumer_L2
                    SHALL:able-to-populateCreator_L3
                    SHALL:displayConsumer_L3
                    6. MedicationStatement.reasonCode
                    Obligations
                      ObligationsActor
                      SHALL:able-to-populateCreator_L2
                      SHALL:displayConsumer_L2
                      SHALL:able-to-populateCreator_L3
                      SHALL:displayConsumer_L3
                      8. MedicationStatement.reasonReference
                      Obligations
                        ObligationsActor
                        SHALL:able-to-populateCreator_L2
                        SHALL:displayConsumer_L2
                        SHALL:able-to-populateCreator_L3
                        SHALL:displayConsumer_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 EU core profile, 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 statement
                        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|4.0.1)

                        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

                        An Extension

                        ShortExtension
                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        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())
                        SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 16. MedicationStatement.extension:adherence
                          Slice Nameadherence
                          Definition

                          R5: MedicationStatement.adherence (new:BackboneElement)

                          ShortR5: Indicates whether the medication is or is not being consumed or administered (new)
                          Comments

                          Element MedicationStatement.adherence has a context of MedicationStatement based on following the parent source element upwards and mapping to MedicationStatement. Element MedicationStatement.adherence has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). This element can be used to indicate whether a patient is following a course of treatment as instructed/prescribed or whether they are taking medications of their own volition. It can also be used to indicate that a patient is not taking a medication, either because they were told not to or because they decided on their own.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(R5: Indicates whether the medication is or is not being consumed or administered (new)) (Complex Extension)
                          Is Modifierfalse
                          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.extension:adherence.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          20. MedicationStatement.extension:adherence.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control1..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          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())
                          SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 22. MedicationStatement.extension:adherence.extension:code
                            Slice Namecode
                            Definition

                            An Extension

                            ShortType of adherence.
                            Control1..1
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            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())
                            24. MedicationStatement.extension:adherence.extension:code.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            26. MedicationStatement.extension:adherence.extension:code.extension
                            Definition

                            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.

                            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())
                            SlicingThis element introduces a set of slices on MedicationStatement.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 28. MedicationStatement.extension:adherence.extension:code.url
                              Definition

                              Source of the definition for the extension code - a logical name or a URL.

                              Shortidentifies the meaning of the extension
                              Comments

                              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.

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Valuecode
                              30. MedicationStatement.extension:adherence.extension:code.value[x]
                              Definition

                              Type of the adherence for the medication.

                              ShortType of adherence
                              Control1..1
                              BindingFor example codes, see R5MedicationStatementAdherenceForR4 (0.1.0)
                              (example to http://hl7.org/fhir/uv/xver/ValueSet/R5-medication-statement-adherence-for-R4|0.1.0)
                              TypeCodeableConcept
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              32. MedicationStatement.extension:adherence.extension:reason
                              Slice Namereason
                              Definition

                              R5: MedicationStatement.adherence.reason (new:CodeableConcept)

                              ShortR5: Details of the reason for the current use of the medication (new)
                              Comments

                              Element MedicationStatement.adherence.reason is part of an existing definition because parent element MedicationStatement.adherence requires a cross-version extension. Element MedicationStatement.adherence.reason has a context of MedicationStatement based on following the parent source element upwards and mapping to MedicationStatement. Element MedicationStatement.adherence.reason has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). This is generally only used for "exception" statuses such as "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

                              Control0..1
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Element MedicationStatement.adherence.reason is part of an existing definition because parent element MedicationStatement.adherence requires a cross-version extension. Element MedicationStatement.adherence.reason has a context of MedicationStatement based on following the parent source element upwards and mapping to MedicationStatement. Element MedicationStatement.adherence.reason has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

                              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())
                              34. MedicationStatement.extension:adherence.extension:reason.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              36. MedicationStatement.extension:adherence.extension:reason.extension
                              Definition

                              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.

                              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())
                              SlicingThis element introduces a set of slices on MedicationStatement.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 38. MedicationStatement.extension:adherence.extension:reason.url
                                Definition

                                Source of the definition for the extension code - a logical name or a URL.

                                Shortidentifies the meaning of the extension
                                Comments

                                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.

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                Fixed Valuereason
                                40. MedicationStatement.extension:adherence.extension:reason.value[x]
                                Definition

                                Captures the reason for the current use or adherence of a medication.

                                ShortDetails of the reason for the current use of the medication
                                Comments

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

                                Control0..1
                                TypeCodeableConcept
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                42. MedicationStatement.extension:adherence.url
                                Definition

                                Source of the definition for the extension code - a logical name or a URL.

                                Shortidentifies the meaning of the extension
                                Comments

                                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.

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence
                                44. MedicationStatement.extension:adherence.value[x]
                                Definition

                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                ShortValue of extension
                                Control0..0
                                TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                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()))
                                46. 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())
                                48. 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.

                                ShortMedication Statement 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()))
                                50. 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()))
                                52. 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()))
                                54. 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.

                                ShortState of the medication
                                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|4.0.1)

                                A coded concept indicating the current status of a MedicationStatement.

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

                                Captures the reason for the current state of the MedicationStatement.

                                ShortReason for the 'exception' statuses of the medication
                                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|4.0.1)

                                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()))
                                58. MedicationStatement.category
                                Definition

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

                                ShortType of intended use
                                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()))
                                60. 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 Medications - IPS
                                (example to http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips)
                                TypeChoice of: CodeableConcept, Reference(Medication (CZ core))
                                [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
                                • 62. 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 DLP_lecivepripravky (0.3.0)
                                  (required to https://sukl.cz/terminology/ValueSet/dlp-lecivepripravky|0.3.0)
                                  TypeCodeableConcept
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Obligations
                                    ObligationsActor
                                    SHALL:able-to-populateCreator_L2
                                    SHALL:displayConsumer_L2
                                    SHALL:able-to-populateCreator_L3
                                    SHALL:displayConsumer_L3
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    64. 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()))
                                    66. 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()))
                                    68. 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 Closed, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 70. 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).

                                      ShortPeriod when the medication is/was or should be used.
                                      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-populateCreator_L2
                                        SHALL:displayConsumer_L2
                                        SHALL:able-to-populateCreator_L3
                                        SHALL:displayConsumer_L3
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        72. 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()))
                                        74. 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()))
                                        76. MedicationStatement.derivedFrom
                                        Definition

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

                                        ShortThe reference to the source of the statement
                                        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()))
                                        78. MedicationStatement.reasonCode
                                        Definition

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

                                        ShortCoded reason for use
                                        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|4.0.1)

                                        A coded concept identifying why the medication is being taken.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Obligations
                                          ObligationsActor
                                          SHALL:able-to-populateCreator_L2
                                          SHALL:displayConsumer_L2
                                          SHALL:able-to-populateCreator_L3
                                          SHALL:displayConsumer_L3
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          80. 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-populateCreator_L2
                                            SHALL:displayConsumer_L2
                                            SHALL:able-to-populateCreator_L3
                                            SHALL:displayConsumer_L3
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            82. 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()))
                                            84. MedicationStatement.note.id
                                            Definition

                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            86. MedicationStatement.note.extension
                                            Definition

                                            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.

                                            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())
                                            SlicingThis element introduces a set of slices on MedicationStatement.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 88. MedicationStatement.note.author[x]
                                              Definition

                                              The individual responsible for making the annotation.

                                              ShortIndividual responsible for the annotation
                                              Comments

                                              Organization is used when there's no need for specific attribution as to who made the comment.

                                              Control0..1
                                              TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                              [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()))
                                              90. MedicationStatement.note.time
                                              Definition

                                              Indicates when this particular annotation was made.

                                              ShortWhen the annotation was made
                                              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()))
                                              92. MedicationStatement.note.text
                                              Definition

                                              The text of the annotation in markdown format.

                                              ShortTextual note about the statement
                                              Control1..1
                                              Typemarkdown
                                              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()))
                                              94. 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()))