US Core Implementation Guide
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US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Extension: US Core Medication Adherence Extension

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence Version: 7.0.0
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreMedicationAdherenceExtension
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.32

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The Medication Adherence Extension is used to report whether a medication has been consumed according to instructions as reported by a patient or on behalf of the patient.

Context of Use

This extension may be used on the following element(s):

  • Element ID MedicationRequest

Profile Specific Implementation Guidance:

This Complex Extension is made up of three sub-extensions:

  1. A required Medication Adherence Code, which is bound to the Medication Adherence ValueSet - a “starter” set of medication compliance SNOMED CT and NullValue codes. Its binding is extensible, and other concepts from SNOMED CT or another code system, including local codes, can be used. The table below illustrates basic scenarios of how an implementer can use them:

    Example Scenario Medication Adherence Code (SCT ID)|Preferred Term
    The medication is being taken as directed. 1156699004|Complies with drug therapy (finding)
    The medication is being taken, but not as directed. For example, the patient occasionally forgets or takes two pills instead of three. 702565001|Non-compliance of drug therapy (finding)
    The medication is not being taken. For example, the patient did not pick up a prescription. 715036001|Does not take medication (finding)
  2. A required date asserting when the information was provided
  3. A Must Support information source code with an example binding to the Medication Adherence ValueSet - a “starter” set of informant role codes.

Usage info

Usage:

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

Summary

Complex Extension: The Medication Adherence Extension is used to report whether a medication has been consumed according to instructions as reported by a patient or on behalf of the patient.

  • medicationAdherence: CodeableConcept: Code stating whether the patient is consuming medications according to instructions.
  • dateAsserted: dateTime: When the medication adherence was asserted by the information source
  • informationSource: CodeableConcept: The person or organization that provided the information about the medication adherence

Maturity: 3

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension Extension
... Slices for extension 2..* Extension Extension
Slice: Unordered, Open by value:url
... extension:medicationAdherence S 1..1 Extension Medication adherence code
.... url 1..1 uri "medicationAdherence"
.... value[x] 1..1 CodeableConcept Value of extension
Binding: Medication Adherence . (extensible): This set of values contains terms representing whether a medication has been consumed according to instructions.

... extension:dateAsserted S 1..1 Extension When the medication adherence was asserted
.... url 1..1 uri "dateAsserted"
.... value[x] 1..1 dateTime Value of extension
... extension:informationSource S 0..* Extension Who provided the information about the medication adherence
.... url 1..1 uri "informationSource"
.... value[x] 1..1 CodeableConcept Value of extension
Binding: VSAC 2.16.840.1.113762.1.4.1267.11 . (example): The person or organization that provided the information about the medication adherence

... url 1..1 uri "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence"
... value[x] 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension Extension
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 2..* Extension Extension
Slice: Unordered, Open by value:url
... extension:medicationAdherence S 1..1 Extension Medication adherence code
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1 uri "medicationAdherence"
.... value[x] 1..1 CodeableConcept Value of extension
Binding: Medication Adherence . (extensible): This set of values contains terms representing whether a medication has been consumed according to instructions.

... extension:dateAsserted S 1..1 Extension When the medication adherence was asserted
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1 uri "dateAsserted"
.... value[x] 1..1 dateTime Value of extension
... extension:informationSource S 0..* Extension Who provided the information about the medication adherence
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1 uri "informationSource"
.... value[x] 1..1 CodeableConcept Value of extension
Binding: VSAC 2.16.840.1.113762.1.4.1267.11 . (example): The person or organization that provided the information about the medication adherence

... url 1..1 uri "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: The Medication Adherence Extension is used to report whether a medication has been consumed according to instructions as reported by a patient or on behalf of the patient.

  • medicationAdherence: CodeableConcept: Code stating whether the patient is consuming medications according to instructions.
  • dateAsserted: dateTime: When the medication adherence was asserted by the information source
  • informationSource: CodeableConcept: The person or organization that provided the information about the medication adherence

Maturity: 3

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension Extension
... Slices for extension 2..* Extension Extension
Slice: Unordered, Open by value:url
... extension:medicationAdherence S 1..1 Extension Medication adherence code
.... url 1..1 uri "medicationAdherence"
.... value[x] 1..1 CodeableConcept Value of extension
Binding: Medication Adherence . (extensible): This set of values contains terms representing whether a medication has been consumed according to instructions.

... extension:dateAsserted S 1..1 Extension When the medication adherence was asserted
.... url 1..1 uri "dateAsserted"
.... value[x] 1..1 dateTime Value of extension
... extension:informationSource S 0..* Extension Who provided the information about the medication adherence
.... url 1..1 uri "informationSource"
.... value[x] 1..1 CodeableConcept Value of extension
Binding: VSAC 2.16.840.1.113762.1.4.1267.11 . (example): The person or organization that provided the information about the medication adherence

... url 1..1 uri "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence"
... value[x] 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension Extension
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 2..* Extension Extension
Slice: Unordered, Open by value:url
... extension:medicationAdherence S 1..1 Extension Medication adherence code
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1 uri "medicationAdherence"
.... value[x] 1..1 CodeableConcept Value of extension
Binding: Medication Adherence . (extensible): This set of values contains terms representing whether a medication has been consumed according to instructions.

... extension:dateAsserted S 1..1 Extension When the medication adherence was asserted
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1 uri "dateAsserted"
.... value[x] 1..1 dateTime Value of extension
... extension:informationSource S 0..* Extension Who provided the information about the medication adherence
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1 uri "informationSource"
.... value[x] 1..1 CodeableConcept Value of extension
Binding: VSAC 2.16.840.1.113762.1.4.1267.11 . (example): The person or organization that provided the information about the medication adherence

... url 1..1 uri "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence"

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSetURI
Extension.extension:medicationAdherence.value[x]extensibleMedicationAdherence .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.8
Extension.extension:informationSource.value[x]examplehttp://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.11
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.11