US Core Implementation Guide
​9.0.0-ballot - 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 9.0.0-ballot 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: 9.0.0-ballot
Standards status: Trial-use Active as of 2023-10-17 Maturity Level: 2 Computable Name: USCoreMedicationAdherenceExtension
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.39

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)

Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

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

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 8.0.0:

  • No changes

    • Formal Views of Extension Content

    Description Differentials, Snapshots, and other representations.

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. 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: Information Source for Medication Adherence . (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

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Extension.extension:medicationAdherence.​value[x] Base extensible Medication Adherence . 📦20231025 VSAC v0.23
    Extension.extension:informationSource.​value[x] Base example Information Source for Medication Adherence . 📦20240329 VSAC v0.23
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. 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: Information Source for Medication Adherence . (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

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Extension.extension:medicationAdherence.​value[x] Base extensible Medication Adherence . 📦20231025 VSAC v0.23
    Extension.extension:informationSource.​value[x] Base example Information Source for Medication Adherence . 📦20240329 VSAC v0.23

    Constraints

    Id Grade Path(s) Description Expression
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

    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: 2

    Differential ViewDifferential View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. 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: Information Source for Medication Adherence . (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

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Extension.extension:medicationAdherence.​value[x] Base extensible Medication Adherence . 📦20231025 VSAC v0.23
    Extension.extension:informationSource.​value[x] Base example Information Source for Medication Adherence . 📦20240329 VSAC v0.23

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. 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: Information Source for Medication Adherence . (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

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Extension.extension:medicationAdherence.​value[x] Base extensible Medication Adherence . 📦20231025 VSAC v0.23
    Extension.extension:informationSource.​value[x] Base example Information Source for Medication Adherence . 📦20240329 VSAC v0.23

    Constraints

    Id Grade Path(s) Description Expression
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

    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: 2

     

    Other representations of profile: CSV, Excel, Schematron