US Core Implementation Guide
7.0.0 - STU7 United States of America flag

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

Resource Profile: US Core Medication Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication Version: 7.0.0
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreMedicationProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.33

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

The US Core Medication Profile inherits from the FHIR Medication resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Medication resource to record, search, and fetch medications associated with a patient. When referencing a medication, the MedicationRequest resource can use a code or refer to this profile. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

Example Usage Scenarios:

Queries on Medication resources are expected to be within the context of a MedicationRequest resource query. The following are example usage scenarios for the US Core Medication profile:

  • Read Medication resources referenced in MedicationRequest resources.

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Medication Must Have:

  1. A medication code

Profile Specific Implementation Guidance:

  • RXNorm concepts are defined as an extensible binding. USCDI recommends the National Drug Codes (NDC) as an optional terminology. They can be supplied as an additional coding element.
  • Since the binding is extensible when a code is unavailable, just text is allowed.
  • When the medication is compounded and is a list of ingredients, the code is still present and may contain only the text.

Usage:

Formal Views of Profile Content

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

This structure is derived from Medication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* Medication Definition of a Medication
... code S 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* Medication Definition of a Medication
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code SΣ 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... status ?!Σ 0..1 code active | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
Medication.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-status|4.0.1
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* Medication Definition of a Medication
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier for this medication
... code SΣ 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... status ?!Σ 0..1 code active | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.

... manufacturer Σ 0..1 Reference(Organization) Manufacturer of the item
... form 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.

... amount Σ 0..1 Ratio Amount of drug in package
... ingredient 0..* BackboneElement Active or inactive ingredient
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(Substance | Medication)
.... isActive 0..1 boolean Active ingredient indicator
.... strength 0..1 Ratio Quantity of ingredient present
... batch 0..1 BackboneElement Details about packaged medications
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... lotNumber 0..1 string Identifier assigned to batch
.... expirationDate 0..1 dateTime When batch will expire

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Medication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
Medication.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-status|4.0.1
from the FHIR Standard
Medication.formexampleSNOMEDCTFormCodes
http://hl7.org/fhir/ValueSet/medication-form-codes
from the FHIR Standard

This structure is derived from Medication

Summary

Mandatory: 1 element
Must-Support: 1 element

Maturity: 3

Differential View

This structure is derived from Medication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* Medication Definition of a Medication
... code S 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* Medication Definition of a Medication
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code SΣ 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... status ?!Σ 0..1 code active | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
Medication.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-status|4.0.1
from the FHIR Standard

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* Medication Definition of a Medication
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier for this medication
... code SΣ 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... status ?!Σ 0..1 code active | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.

... manufacturer Σ 0..1 Reference(Organization) Manufacturer of the item
... form 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.

... amount Σ 0..1 Ratio Amount of drug in package
... ingredient 0..* BackboneElement Active or inactive ingredient
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(Substance | Medication)
.... isActive 0..1 boolean Active ingredient indicator
.... strength 0..1 Ratio Quantity of ingredient present
... batch 0..1 BackboneElement Details about packaged medications
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... lotNumber 0..1 string Identifier assigned to batch
.... expirationDate 0..1 dateTime When batch will expire

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Medication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
Medication.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-status|4.0.1
from the FHIR Standard
Medication.formexampleSNOMEDCTFormCodes
http://hl7.org/fhir/ValueSet/medication-form-codes
from the FHIR Standard

This structure is derived from Medication

Summary

Mandatory: 1 element
Must-Support: 1 element

Maturity: 3

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

  • See the Scopes Format section for a description of the SMART scopes syntax.
  • See the Search Syntax section for a description of the US Core search syntax.
  • See the General Requirements section for additional rules and expectations when a server requires status parameters.
  • See the General Guidance section for additional guidance on searching for multiple patients.

US Core Scopes

Servers providing access to data SHALL support these US Core SMART Scopes:

No required search criteria for us-core-medication profile.