De-Identification, Anonymization, Redaction Toolkit Services
0.1.0 - STU1 Release 1 - Standard for Trial-Use United States of America flag

De-Identification, Anonymization, Redaction Toolkit Services, published by HL7 International / Cross Group Projects. 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/fhir-darts/ and changes regularly. See the Directory of published versions

Resource Profile: De-Identified UDS Plus MedicationStatement

Official URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-medicationstatement Version: 0.1.0
Standards status: Trial-use Maturity Level: 1 Computable Name: UDSPlusMedicationStatement

The UDS+ profile is based on the MedicationStatement resource and establishes the core elements, extensions, vocabularies and value sets for representing MedicationStatement for UDS+ program.

All canonical (Official) URLs will be changed in the future and are not available currently on the web.

Introduction

This profile is used to represent de-identified MedicationStatement information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes MedicationStatement.authoredOn.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a MedicationStatement resource text element may contain information such as the MedicationStatement date, patient information. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Ids and References

The original MedicationStatement resource id should not be included in the De-identified MedicationStatement instance. Instead a new id should be created and provided as part of the FHIR resource. The Data Submitter should be capable of using the generated id to relink the data to the original MedicationStatement. All resource references to the MedicationStatement submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

  • subject
  • encounter

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

  • effective[x]
  • dateAsserted

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationStatement 0..* MedicationStatement De-Identified UDS Plus MedicationStatement
... id SΣ 0..1 id The de-identified MedicationStatement identifier created by the health center to send data to UDS+ Data Receiver
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... medication[x] SΣ 1..1 What medication was taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(De-Identified UDS Plus Patient) Who is/was taking the medication
... effective[x] SΣ 0..1 dateTime The date/time or interval when the medication is/was/will be taken
... dateAsserted SΣ 0..1 dateTime When the statement was asserted?
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationStatement.​status Base required Medication status codes 📍4.0.1 FHIR Std.
MedicationStatement.​medication[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationStatement If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationStatement 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 error MedicationStatement 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 error MedicationStatement If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationStatement A resource should have narrative for robust management text.`div`.exists()
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()

This structure is derived from MedicationStatement

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationStatement 0..* MedicationStatement De-Identified UDS Plus MedicationStatement
... id S 0..1 id The de-identified MedicationStatement identifier created by the health center to send data to UDS+ Data Receiver
... text 0..0 Cannot include any text in the resource as part of the de-identified data.
... contained 0..0 Cannot include any contained resources in the resource as part of the de-identified data.
... medication[x] S 1..1 CodeableConcept, Reference(Medication) What medication was taken
... subject S 1..1 Reference(De-Identified UDS Plus Patient) Who is/was taking the medication
.... display 0..0 Text alternative for the resource
... effective[x] S 0..1 dateTime The date/time or interval when the medication is/was/will be taken
... dateAsserted S 0..1 dateTime When the statement was asserted?
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationStatement 0..* MedicationStatement De-Identified UDS Plus MedicationStatement
... id SΣ 0..1 id The de-identified MedicationStatement identifier created by the health center to send data to UDS+ Data Receiver
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External identifier
... basedOn Σ 0..* Reference(MedicationRequest | CarePlan | ServiceRequest) Fulfils plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) Part of referenced event
... status ?!SΣ 1..1 code active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
... statusReason 0..* CodeableConcept Reason for current status
Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
... category Σ 0..1 CodeableConcept Type of medication usage
Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
... medication[x] SΣ 1..1 What medication was taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(De-Identified UDS Plus Patient) Who is/was taking the medication
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
... context Σ 0..1 Reference(Encounter | EpisodeOfCare) Encounter / Episode associated with MedicationStatement
... effective[x] SΣ 0..1 dateTime The date/time or interval when the medication is/was/will be taken
... dateAsserted SΣ 0..1 dateTime When the statement was asserted?
... informationSource 0..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) Person or organization that provided the information about the taking of this medication
... derivedFrom 0..* Reference(Resource) Additional supporting information
... reasonCode 0..* CodeableConcept Reason for why the medication is being/was taken
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport) Condition or observation that supports why the medication is being/was taken
... note 0..* Annotation Further information about the statement
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationStatement.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
MedicationStatement.​status Base required Medication status codes 📍4.0.1 FHIR Std.
MedicationStatement.​statusReason Base example SNOMED CT Drug Therapy Status codes 📍4.0.1 FHIR Std.
MedicationStatement.​category Base preferred Medication usage category codes 📍4.0.1 FHIR Std.
MedicationStatement.​medication[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.
MedicationStatement.​subject.type Base extensible ResourceType 📍4.0.1 FHIR Std.
MedicationStatement.​reasonCode Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationStatement If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationStatement 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 error MedicationStatement 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 error MedicationStatement If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationStatement A resource should have narrative for robust management text.`div`.exists()
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()

This structure is derived from MedicationStatement

Summary

Mandatory: 3 elements
Must-Support: 7 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

Maturity: 1

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationStatement 0..* MedicationStatement De-Identified UDS Plus MedicationStatement
... id SΣ 0..1 id The de-identified MedicationStatement identifier created by the health center to send data to UDS+ Data Receiver
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... medication[x] SΣ 1..1 What medication was taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(De-Identified UDS Plus Patient) Who is/was taking the medication
... effective[x] SΣ 0..1 dateTime The date/time or interval when the medication is/was/will be taken
... dateAsserted SΣ 0..1 dateTime When the statement was asserted?
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationStatement.​status Base required Medication status codes 📍4.0.1 FHIR Std.
MedicationStatement.​medication[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationStatement If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationStatement 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 error MedicationStatement 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 error MedicationStatement If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationStatement A resource should have narrative for robust management text.`div`.exists()
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()

Differential View

This structure is derived from MedicationStatement

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationStatement 0..* MedicationStatement De-Identified UDS Plus MedicationStatement
... id S 0..1 id The de-identified MedicationStatement identifier created by the health center to send data to UDS+ Data Receiver
... text 0..0 Cannot include any text in the resource as part of the de-identified data.
... contained 0..0 Cannot include any contained resources in the resource as part of the de-identified data.
... medication[x] S 1..1 CodeableConcept, Reference(Medication) What medication was taken
... subject S 1..1 Reference(De-Identified UDS Plus Patient) Who is/was taking the medication
.... display 0..0 Text alternative for the resource
... effective[x] S 0..1 dateTime The date/time or interval when the medication is/was/will be taken
... dateAsserted S 0..1 dateTime When the statement was asserted?
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationStatement 0..* MedicationStatement De-Identified UDS Plus MedicationStatement
... id SΣ 0..1 id The de-identified MedicationStatement identifier created by the health center to send data to UDS+ Data Receiver
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External identifier
... basedOn Σ 0..* Reference(MedicationRequest | CarePlan | ServiceRequest) Fulfils plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) Part of referenced event
... status ?!SΣ 1..1 code active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
... statusReason 0..* CodeableConcept Reason for current status
Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
... category Σ 0..1 CodeableConcept Type of medication usage
Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
... medication[x] SΣ 1..1 What medication was taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(De-Identified UDS Plus Patient) Who is/was taking the medication
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
... context Σ 0..1 Reference(Encounter | EpisodeOfCare) Encounter / Episode associated with MedicationStatement
... effective[x] SΣ 0..1 dateTime The date/time or interval when the medication is/was/will be taken
... dateAsserted SΣ 0..1 dateTime When the statement was asserted?
... informationSource 0..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) Person or organization that provided the information about the taking of this medication
... derivedFrom 0..* Reference(Resource) Additional supporting information
... reasonCode 0..* CodeableConcept Reason for why the medication is being/was taken
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport) Condition or observation that supports why the medication is being/was taken
... note 0..* Annotation Further information about the statement
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationStatement.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
MedicationStatement.​status Base required Medication status codes 📍4.0.1 FHIR Std.
MedicationStatement.​statusReason Base example SNOMED CT Drug Therapy Status codes 📍4.0.1 FHIR Std.
MedicationStatement.​category Base preferred Medication usage category codes 📍4.0.1 FHIR Std.
MedicationStatement.​medication[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.
MedicationStatement.​subject.type Base extensible ResourceType 📍4.0.1 FHIR Std.
MedicationStatement.​reasonCode Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationStatement If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationStatement 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 error MedicationStatement 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 error MedicationStatement If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationStatement A resource should have narrative for robust management text.`div`.exists()
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()

This structure is derived from MedicationStatement

Summary

Mandatory: 3 elements
Must-Support: 7 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

Maturity: 1

 

Other representations of profile: CSV, Excel, Schematron